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26 July 2021:
Nomachain Mabena, 86, walked for over a kilometer on difficult dirt roads to get vaccinated. Once there, she requested that someone go and vaccinate her relative, Nogamathini Mabena at their home, as she was unable to walk the distance due to bad osteo-arthritis.
Nomachain helps Nogamathini by pulling up her sleeve.
Photographer: Barry Christianson
BARRY CHRISTIANSON
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.
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26 July 2021: From left, Andile Nombekana and Sidney Zeeman carry a refrigerator to the vaccination site. The Covid-19 vaccines are collected at St Elizabeth’s hospital in Lusikisiki a few days a week and kept in refrigerators to maintain the required temperature before being transported to the different sites.
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.
26 July 2021: People wait for the mobile pay point from the South African Social Security Agency to arrive. Elderly people walk long distances to collect their grants. The pay point was meant to open at 7 am but arrived only at 10 am.
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.”
26 July 2021: Ncebakazi Qhekeza, from Port St Johns, is a locum pharmacist in the team responsible for preparing vaccine doses. Having just finished her community service, she is grateful to be part of the team of vaccinators, especially as she is able to help in her hometown as well.
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 post-apartheid 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.
26 July 2021: Majajile Mzatubana, 86, was told by her children that vaccinations were taking place at the community centre and came to get hers.
26 July 2021: A nurse waits for vaccinated people to enter the observation tent where their blood pressure gets taken and they are observed for adverse reactions for 20 minutes. In the background, Sidney Zeeman makes sure all the vaccination sites have what they need.
26 July 2021: ‘I am very, very happy to get vaccinated,’ says Zitetele Bambanani, 91. ‘I have been waiting since the first day I heard the news.’ Bambanani lives in Makwaleni, which falls under the Ingquza Hill local municipality and is 40km from the closest clinic in Lusikisiki.
26 July 2021: Mawelisile Madlebe, 56, after she got her vaccination in Makwaleni. Like many of those who came to be vaccinated on the day, Madlebe heard about the vaccinations from her neighbours.
26 July 2021: From left, nurse Sechaba Phonkontsi and data capturer Lonwabo Nyati go about their work at a homestead as neighbours look on. Sitting on the ground behind the bench waiting to be vaccinated is Mnyai Zidlele, 91. The team was asked if they could visit the homestead to vaccinate those unable to walk to the site.
27 July 2021: A man leaves a vaccination site outside Boxer, one of the big supermarkets in Lusikisiki, while others wait their turn outside. Healthcare non-profit organisation Right to Care set up the site hoping to vaccinate eligible people on the way to do their shopping.
27 July 2021: The Right to Care team erects a tent outside the community hall in Mbotyi village for their vaccination drive the next day.
28 July 2021: Residents listen as Wendy Ovens, managing director of Right to Care, explains the need for Covid-19 vaccinations, pointing out that everyone in Mbotyi had received vaccinations for diseases such as polio and measles as children.
28 July 2021: A community hall in KwaBhumbuta is packed with people waiting to be vaccinated. On this day, the demand is the highest yet and the sites run out of vaccines, requiring vaccine doses to be sourced from less busy sites.
28 July 2021: Nomaputukezi Mkovana poses proudly for a photograph after getting her Covid-19 vaccination in KwaBhumbuta.
28 July 2021: Phumlani Jani, who has just been vaccinated at Mbotyi community hall, says he was sceptical at first but became convinced when it was explained to him that had also been vaccinated as a child.
