Inclusion in COVID-19 vaccination
Bridging indigenous communities and services through local champions
ZAMBOANGA CITY, 15 February 2023 – Even for the most passionate advocates, it can be extremely challenging to influence one’s own home or community. This was true for Abhar Daud, a trained social mobilizer, community leader, and vaccine champion from a coastal and indigenous community in Barangay Bolong, Zamboanga City.
Abhar is one of the 68 social mobilizers working with UNICEF and Human Development and Empowerment Services (HDES) to support partner local governments in Zamboanga Peninsula to increase demand and uptake for COVID-19 and routine immunization, especially among the most vulnerable and marginalized sectors. Social mobilizers like Abhar play a crucial role in bridging these groups and life-saving services— such as COVID-19 vaccination—by working with local officials, health workers, and community leaders in reaching the most isolated, underserved communities.
Unveiling and understanding unique barriers to vaccination
Deployed to support improving COVID-19 vaccine acceptance in his own community in Sitio Pitas, Abhar never thought it would be his toughest mission yet.
Sitio Pitas is home to around five hundred members of Muslim ethno-linguistic groups Sama Banguingui, Badjao, and Yakan. Abhar, a Sama-Banguingui himself, is no stranger to his community’s beliefs and customs when addressing health problems and diseases, including highly infectious and life-threatening ones. They usually seek the help of a magtatawal or a traditional community healer, self-medicate, or resort to herbal medicines.
“Consulting a doctor would be their last option, and when they do that, it would be too late,” shares Abhar. According to Abhar, the limited access to healthcare and relevant information of Sitio Pitas remains to be a huge factor in the prevalence and acceptance of these beliefs.
In the case of COVID-19 vaccination, Abhar believed the response would be different. With COVID-19 vaccines now certified as halal or permissible to the Islam faith and the presence of an accessible temporary vaccination site, Abhar thought that encouraging vaccination in their small coastal village would now be an easy feat. But his next actions only led him to open a Pandora’s box of unique problems and barriers related to vaccination.
While accessibility was a problem, it was never the main reason for the hesitancy and refusal of most of the Yakans, Badjaos, and Sama-Banguinguis. Talking to unvaccinated individuals in Sitio Pitas, Abhar noticed a common response, one that is heavily based on deep-rooted inequalities experienced by indigenous peoples.
According to Abhar, most members of their community, while aware that vaccines are safe and effective, do not want to go to the vaccination site for fear of discrimination. “They are afraid that other people would come to the vaccination site and shame them because of how they look, speak, or smell,” says Abhar. “They fear getting discriminated against for simply being a Badjao, a Yakan, or a Sama-Banguingui.”
Abhar also added that most of these unvaccinated individuals also shared about not being able to read or write as a reason for their hesitancy. While it is clearly a practical challenge in accessing the services, it is still the fear of being discriminated against or humiliated that concerns them the most.
In some households, this fear would be further triggered by the spread of false information, such as COVID-19 vaccines being developed to intentionally decimate indigenous populations.
“They were comfortable in sharing their fears and reservations with me because I am one of them,” shares Abhar. “They know that I can listen to them without any judgment.”
Knowing that his community trusts him, Abhar maximizes every available opportunity to explain to them the benefits of the COVID-19 vaccines and why it is important for them to avail of these health and life-saving services. Together with their community health workers, he also helps in allaying fears and reassuring every eligible individual in Sitio Pitas that they will be accommodated, well-assisted, and given fair and equal treatment by health workers in vaccination sites.
Abhar also made sure that the concerns from his community were feedbacked to local government partners, who then used the information and data to prepare and train their health workers and vaccination implementers on effectively addressing these issues and to make the local vaccination program more responsive and inclusive. Abhar was also instrumental in advocating for and facilitating the implementation of barangay or mobile vaccination which brings the services closer to the community, a strategy that works to target households with strong hesitancy or refusal.
Working with community leaders and influencers to reach the unvaccinated
Engaging and obtaining strong support from community leaders and local influencers is a key strategy of UNICEF and HDES in reaching the most vulnerable and marginalized unvaccinated groups. Some of them, like Abhar, are trained as social mobilizers to help understand local challenges and develop more targeted, culture-appropriate, and inclusive approaches in generating demand for vaccination. Also serving as the head of a multisectoral association of fishermen and seaweed farmers in their village, Abhar has been a respected leader and an influential voice in advancing development causes in their community.
Abhar knew that for a tight-knit community like theirs, it would be actions, rather than words, that would convince more people to get vaccinated. As the only fully vaccinated individual in his family then, he first turned to his wife and children to start encouraging and slowly normalize COVID-19 vaccination in his community.
When the pediatric vaccination for COVID-19 started, Abhar made sure that his daughter would be among the first to get the jab, setting an example for other members of their community. “My wife and daughter were also hesitant at first, but I was able to convince them that the vaccines will protect our family,” recalls Abhar. “Through my family’s vaccination, I wanted to show our neighbors that it’s now their turn to protect our community by also getting vaccinated.”
Abhar also facilitates continuous dialogues with local officials to implement localized solutions such as assisted registration and house-to-house vaccination, to address his practical barriers to vaccination. When available, he personally accompanies and guides some of their community members to the vaccination site, helps with the registration, and explains the vaccination process.
Since UNICEF and HDES started supporting Barangay Bolong in Zamboanga City on generating demand for COVID-19 vaccines, at least 400 eligible individuals in Sitio Pitas have been vaccinated.
With support from USAID, UNICEF and HDES partnered with Zamboanga City and six municipalities in Region IX in increasing vaccination coverage for COVID-19 and routine immunization. Social mobilizers in these areas worked closely with local officials, community leaders, and health workers in updating local communication plans, engaging community-based groups and influencers, awareness-raising, and addressing vaccination hesitancy.
“I am thankful that as a social mobilizer promoting COVID-19 vaccination in my own community, I can use my voice and influence to help save the lives of those who are most in need, and also those who are closest to me.”
