Voices of health experts, refugees, community mobilisers on the heightened COVID-19 vaccination

UNICEF recently received funding from the Swiss Government and European Commission to support Uganda's Ministry of Health to accelerate COVID-19 mass vaccination of refugees and host communities. On 13 June, 2022, UNICEF, UNHCR, Ministry of Health, district local government authorities and partners were in various refugee settlements conducting outreaches and mass vaccination exercises to ensure equitable vaccination reach of the refugee and host community population with the COVID-19 Vaccination ‘Leave no one behind’.

This is part of the global COVAX Humanitarian Buffer, a mechanism established within the COVAX Facility to act as a measure of ‘last resort’ to ensure access to COVID-19 vaccines for high-risk and vulnerable populations in humanitarian settings. The Humanitarian Buffer is only to be used where there are unavoidable gaps in coverage in national vaccination plans and micro-plans, despite advocacy efforts.

We bring you voices of health experts, refugees, host communities, community mobilisers about the exercise:

Kyegegwa District Health Officer – Dr. Tedson Kandole:

 “When vaccination started in March 2021, the response was lukewarm, because we seemed to be managing the prevention of the coronavirus transmission well anyway. The other reason keeping people away were the myths against the vaccines. Only the elderly seemed keen. The rest, including health workers were resistant!

“We engaged the local leaders who were helpful. I went with them to the radio stations to campaign for vaccination as gatherings were not possible under lockdown guidelines.

“Other health services were badly affected by the lockdown. Child health services and routine vaccinations declined sharply. Overzealous police officers were even stopping women in labour from proceeding to hospital! We engaged the political leaders and started overruling the enforcement personnel.

 “Now there is a resurgence of Covid-19 cases and in three weeks we have registered 60 new cases in the district, 41 of whom are refugees in the refugee settlement. Of the affected 19 nationals, seven are teachers in the refugee settlements. So we have now mounted a fresh vaccination campaign, majorly supported by UNICEF. We launched yesterday and the response is good.” 

Nursing Officer Daphne Namusoke - Kyegegwa District

“Our target is to vaccinate 56,612 adults and 17,369 of the 12-17 age category. There was a lot of resistance to vaccination the first time because of myths and propaganda against the vaccines. But this time we have done a lot of sensitization. There was the undeniable sticking point of side effects which people were citing and I had to think hard, how to simplify and compress the science of initial reaction to a vaccine for our people.

“Finally this is what I said and what we have used to win them over: If a stranger suddenly enters your house, you react by fight fighting him. But when you realise he came to train you how to fight a big real enemy who has already entered your village, you become friends and learn the fighting tactics, that is multiplying anti-bodies, so when the enemy reaches you house, you stop him successfully.

“We registered all eligible people and the response is good; we shall hit the target.”

Kyaka II Refugee Settlement Programme Manager, Rachael Kyalokoba

“We are very grateful to UNICEF for the support that has made the care for so many refugees including their vaccination here effective.”

Geoffrey Ochan – Public Health Officer Bujubuli HC III plus 8 health outposts in Kyaka II Refugee Settlement

“Our target was 58,000 and we have managed to vaccinate 37,000 with the first dose. To cover more people and have all return for the second dose, we opened 16 vaccination sites so everyone can reach a site by walking on foot. We also formed a mobile team to vaccinate in hotspots like markets. We have received enough vaccine doses and have no worry about the supply. For completion of the doses, we are very happy that UNICEF has introduced to us the smart paper technology, which has eliminated the tedious recording process that used to take so much of the health workers’ time. The old manual process had created a big delay in updating the central vaccination records so it was difficult to tell who has had what dose and who had completed or has had the booster.

Neema Kabirigi, Pregnant Refugee Mum of Four – Resident of Itimbabininga

I am 31 years old with four children, we live here with my husband and are expecting our fifth as you can see, I am five months pregnant. When I had my first jab I had no problem and did not fear anything. But when we were encouraged to go for a second jab, I was afraid because I had got pregnant. I feared that the vaccine could adversely affect my unborn baby. But then I saw another woman with a pregnancy far bigger than mine who had taken the jab and was not affected. So I went and had mine yesterday. I felt a bit weak and sleepy yesterday but now I am okay. I am confident that I will deliver a nice baby like the other four.”

Devoter Arinaitwe, Itambabiniga Health Outpost Team leader

“We are three health workers here and we have two VHTs who link us to the people in this zone whose total population is 1,800 people. At first there was reluctance to accept vaccination because of the negative rumors that it was dangerous. But we did considerable sensitization and at least 70 percent got the first dose. This time we have been vaccinating at least 200 people per day.  So after the seven days, at this rate, we should have served some 1,400 clients, and we expect that half of the zone will have had their second dose. Then we shall be left with continuing to remind the remaining minority through the VHTs to come for their second dose at the right time, and for the special categories including the elderly to continue with getting booster doses.”

Theresa Wanjiru, Mukondo HCII Clinical Officer in Charge

“This is a small facility but quite busy with maternal services. We deliver five babies a day on average. We have always been immunizing against Covid-19 twice a week, on Wednesdays and Thursdays. Now we are immunizing daily under this exercise and the response is good as you can see. The main challenge we used to have was over the second dose, as people would come and not finding the particular vaccine they had for the first dose. That was sorted out and we usually have all of the vaccine types at any given time.”

Nginari Kahiro - Community Mobiliser, Kakoni Outreach

“For the five years I have been a refugee here, the Covid-19 outbreak has been one of the toughest challenges we have encountered. I volunteer as a community mobiliser and people were suspicious of the vaccine’s efficacy and purpose. What strengthened our campaign was people seeing top leaders taking the jab. They then believed that the vaccines are safe. When it came to children, the safety questions arose again. I tell them that if we had the vaccine and did not die, and it is the same vaccine the children are getting then it is okay; but that if they don’t get the vaccine, COVID-19 will get them and it can be fatal.”

Rachael Kichoncho - Clinical Officer, Rwamwanja Refugee Settlement HCIII

“Here at Rwemwanja refugee settlement of Nkoma Katalyeba Town Council in Kamwenge District, we have a population of 183,000 with a mix of 51 nationals to 49 refugees. Unlike in the in the past year when uptake of Covid-19 vaccination was slow because of negative propaganda, this time we are off a heady start we have done enough mobilization by giving people the right information on the safety and need for vaccination.  We are running six vaccination centres in the settlement, and have daily been vaccinating an average of 650 persons with the first dose plus 970 persons with the second dose. We have no fear of stock outs of any one of the vaccine types because preparations were done well.”

Dr. Eva Kabwongera – Team Leader Immunization, UNICEF Uganda

“This humanitarian buffer programme was conceived out of the vaccine shortages experienced at the beginning of the vaccination drive and yet the whole country needs to be covered.  The key players are the Ministry of Health with UN High Commissioner for Refugees Office of the Prime Minister, GAVI as the main funder and UNICEF, working in the COVAX arrangement and support.

Because of their mobile nature, we prefer to administer the single dose Johnson& Johnson the refugees, but of course those who had a first dose are given the same type for the second.

A teenage Congolese refugee, 16-year old Tuyambaze Ahishakye

“I study at Nkoma Church of Uganda Primary School. My family has been here for four years. Yesterday I got my shot of Pfizer and I don’t feel pain. I shall come back after three months for my second dose. My parents already had their two doses each.”

45-year-old Joseph Safari, Ahishakye’s father

“My wife and I have six children, Ahishakye is the second born. His big brother already had his two vaccine doses. My family has embraced vaccination because it doesn’t make sense to fear a small injection more than death by Covid-19.”

Ibrahim Bigirimana, Muslim Cleric in Nakivale Refugee Settlement

“I used to preach to my audiences that the Whites were inserting microchips in people during vaccination so as to control them like robots. I also believed this having been misled by what I saw on social media on the phone. My opposition to vaccination started changing when I met a health worker called Abraham who engaged me patiently for weeks and eventually convinced me that the anti-vaccination campaigns on social media were based on falsehoods.

Pr Jean Paul Karimunzira, head of Pentecostal Fathers in Nakivale settlement

“I used to preach against vaccination, saying the governments of Uganda and Congo wanted to kill Congolese refugees if they did not return to home. I picked these poisonous ideas from social media. Then I met a Health worker who showed me photos of Uganda’s president taking the jab, and other pictures of important people being vaccinated. Eventually, I took the jab in full view of my followers. My wife also accepted to be vaccinated and we have since been convincing people to do the same.