For the month of July, the rural village of Mbotyi in the Ingquza Hill Municipality in the Eastern Cape has been home to the non-profit Right to Care’s (RTC) rural vaccination team. The team of about 35 consists of drivers, nurses, project managers, data capturers, IT specialists, pharmacists and an emergency medicine specialist.
After helping the Eastern Cape Department of Health with vaccinations during the Sisonke Study period, RTC has focused its efforts on vaccinating the deep rural areas of the Eastern Cape. Wendy Ovens, who is running the pilot project, chose the Ingquza Hill Municipality as its location.
“I know a lot of the population is along the coast. I also know that this area really struggles with access to healthcare services. It’s an area that’s incredibly vulnerable. It’s off the beaten track. It’s not on the N2 … you have to want to come here,” says Ovens, a former urban planner.
Vaccinating in the municipality, which has a mix of high-traffic rural towns and low-density, hard-to-reach rural villages, required a varied approach. In the towns, such as Lusikisiki, they set up vaccination sites at the municipal offices next to the post office on days people were collecting their grants, as well as outside the Boxer supermarket, a high-footfall area. In the more rural areas, such as Makwaleni, Mbotyi or KwaBhumbuta, they set up vaccination sites in schools or community halls.
Things did not always go according to plan. The riots in KwaZulu-Natal in July led to the delay of grant payments, which affected the scheduling of vaccination efforts that were to coincide with those grant payments. RTC was forced to amend their plans.
When vaccinating KwaBhumbuta, the demand was so high, they ran out of vaccines. Sidney Zeeman, the disaster medicine specialist on the team, had to reroute vaccines from two quieter sites in order to not have to send anyone home frustrated.
Other hitches involved transport to and from rural areas. According to Ovens, the team needed to replace 15 tyres in one week. Reflecting on his experience in the rural areas, Zeeman says: “A plan is a basis for change.”
Despite the long days and difficult environment, members of the team remain motivated and are energised by the knowledge of the importance of their role in responding to the pandemic.
“As is apparent in the US, Covid-19 is going to become the disease of the unvaccinated. If we don’t vaccinate in our rural areas, they’re going to become the unvaccinated; they’re going to become the next Covid-19 hotspots. In postapartheid South Africa, that would be a complete travesty. We can’t let that happen,” says Ovens.
The pilot worked well with RTC vaccinating more than 4 000 people in July. The numbers could have been higher if they were able to vaccinate everyone regardless of age in the towns and the hard-to-reach areas. National guidelines, however, mean they will have to return to the outlying areas they have already visited to vaccinate the age groups they missed in the first round.