The city of Surat in Gujarat is currently demonstrating a very promising test case for how hard-to-reach marginalised groups can be targeted with stigma-free COVID-19 vaccination services. Key to its success is the way in which a state government organisation and community-based groups are working closely together to limit the spread of coronavirus, each contributing their own area of expertise.
As part of the Frontline AIDS partnership’s Accelerating Innovation programme, Alliance India and the Gujarat Network of People Living with HIV/AIDS (GSNP+) have joined forces with the Surat Municipal Corporation (SMC) to set up and run a weekly vaccination camp dedicated exclusively to people living with and most affected by HIV.
The project is still in its infancy but, by offering the COVID-19 vaccine in a safe, non-judgemental space, take-up has already proved popular, with more than 500 people receiving either the Covaxin or Covicil vaccine to date. GSNP+ have mobilised their existing networks of community members to get the word out, while SMC have provided the healthcare workers to administer the vaccine.
Amrin is a community coordinator with Sahvog Mahila Mandal, a GSNP+ partner organisation working with female sex workers. She explains why some of them were reluctant at first to be vaccinated:
“There are a lot of rumours around the COVID-19 vaccine, some people said your health condition will deteriorate after taking the vaccine, some said that you might even die. But with all the motivation from GSNP+ and their advocacy activities to break the vaccine hesitancy, they eventually took the decision to have it.”
She decided to lead by example: “I took the vaccine first to show the rest of the community that it is totally safe and to encourage them to participate in the vaccination camp.”
Similarly, 28-year-old Bahutik – who lives with HIV and is a youth leader with GSNP+ – thought that the best way to influence other young people in his situation to get vaccinated against COVID-19 was to pave the way himself.
“I heard from my friend that if I take the vaccine I might die. But in my heart, there was no fear. So, I came forward and I took the vaccine so that others are also encouraged to receive it. I want to spread a message to my peers that there are so many misconceptions about the vaccine but I’ve taken both doses and am completely alright, so I’m asking others to have it.”
The mobilisation strategies employed by GSNP+ to connect people living with HIV to the vaccination camp are starting to pay off. According to Bahutik, “I reach out to the young people in my peer circle to send them messages about getting vaccinated. Because of these efforts they came to the first vaccination camp and will come back for their second dose.”
A smooth operation
The long-standing relationship between GSNP+ and SMC, and the existing level of trust between the two organisations, meant that getting the necessary authorisations to operate the camp with a nearby health facility was a relatively smooth process. Together they worked out the logistics of how the camp would function, where people could wait in a socially distanced fashion, and how best to offer refreshments.
Within two days of receiving the official go-ahead, the first camp was up and running, and more than 50 community members attended. The only hiccup proved to be entering the information needed for the national vaccination portal, a system that GSNP+ staff members were initially unfamiliar with. SMC officers swiftly stepped in to train them on how to submit real time data detailing how much of a vaccine batch had been used and who it had been administered to.
Unlike at other vaccination camps where online registration in advance is a prerequisite, people living with HIV can just turn up at the GSNP+ camp to be vaccinated on the spot. Many marginalised groups have limited or no access to online services or smart phones, and often have lower literacy levels than the general population, so not having to pre-register has been an important factor in galvanising attendance. The lack of long queues and crowded conditions also helps as it means that people aren’t having to wait for hours and risk losing their income or livelihood that day.
This was the case for Narendra and Sangheeta, a married couple both living with HIV who visited the camp together. Narendra works at a local diamond polishing factory where Sangheeta is a cleaner and had heard about the special vaccination service through their antiretroviral treatment centre. Both were impressed by the speed with which they were vaccinated as well as the tea and biscuits provided and were looking forward to returning in a month’s time for their second dose of Covaxin.
A replicable model
Her conviction is echoed by none other than the Mayor of Surat, Hemali K. Boghawala. She believes that “with this initiative, other cities and states in India can learn that this model can be replicated in other parts of the country.”
She continues: “If non-governmental and governmental organisations work hand in hand and they support each other – not only in Surat, or in Gujarat but in other parts of the country and in other countries – we can defeat COVID-19 completely and eradicate it from this world.”
SMC’s Deputy Commissioner for Health and Hospitals, Ashish Nyak, is intent on seeing as many people living with HIV vaccinated as possible. “We want to extend this vaccination programme further to rural areas because at present we’re only covering urban areas,” he says.