Vaccinating Colombia’s remote, Indigenous communities against covid-19

LA GUAJIRA, Colombia — The vaccination group had spent an hour bouncing and bucking down a mud street and over practice tracks when the van driver issued a warning.

The hardest a part of the drive was nonetheless to return.

The 2 ladies gripped their seat cushions because the van jolted, climbed a mound of filth and fishtailed within the slick mud. Driver Toto Girnu honked at passing goats as he adopted a path blazed solely by tire tracks. Within the distance, he noticed darkish, menacing clouds.

If the group was fortunate, the drive by this distant desert would take 4 or 5 hours. If it rained, because it did when Girnu made this journey just a few days earlier, it may take greater than 10.

However this was the one solution to attain the Indigenous households who dwell on this arid swath of land within the northern division of La Guajira, the place there aren’t any paved roads, no electrical energy, no working water and no different entry to the vaccines that may shield their communities.

Journey is barely a part of the problem confronting the group, one in every of many contracted by the Colombian authorities to ship vaccines to among the nation’s remotest peoples. There may be additionally a lack of expertise concerning the coronavirus, hesitation round vaccines and a normal distrust of authorities.

The van, “Route of Hope” written throughout the windshield, stumbled on a roadblock. Adults and kids right here string ropes throughout the street, to be lifted solely in trade for water, meals or money.

“Are you vaccinated?” vaccine group coordinator Katherin Gamez shouted to a younger man. Girnu gave the person a fist bump, tossed him a small bag of water and translated the query into Wayuunaiki, the language of the native Wayuu Indigenous individuals.

“For what?” he requested.

Throughout the Andes, a area that has reported among the world’s highest covid-19 loss of life charges, groups are traversing deserts, mountains, rainforests and rivers to vaccinate remoted communities.

Such groups are notably energetic in Colombia, a rustic of greater than 48 million individuals, the place about 16 % of the inhabitants lives in rural areas that had been usually uncared for by the federal government throughout greater than 5 many years of armed battle.

Within the northern division of Magdalena, a vaccinator on horseback rides up a muddy mountain, then dismounts to finish her journey on foot. In Amazonas, a group spends days touring by boat. In Chocó, felony teams add one other problem.

About 35 % of Colombia’s inhabitants has been totally vaccinated, based on the well being ministry. Greater than half of residents in main cities — 62 % within the capital of Bogotá — has acquired a minimum of one dose.

However in La Guajira, residence to the nation’s largest Indigenous inhabitants, solely 38 % has acquired a minimum of one dose. In different departments, the speed is as little as 20 %.

In La Guajira, years of presidency abandonment and mismanagement have brought on many Wayuu residents to distrust the well being system. Solely 4 % of individuals right here have entry to wash water, Human Rights Watch reported final yr; 77 % of households are meals insecure. In Alta Guajira, the place the biggest variety of Wayuu individuals dwell, there is just one hospital, and it provides solely fundamental care. Individuals who want specialised remedy journey six hours or extra to the departmental capital of Riohacha.

“By the point a whole lot of them get to care, they’re so close to loss of life … there’s this notion that perhaps the care didn’t assist,” mentioned Shannon Doocy, an affiliate professor of worldwide well being at Johns Hopkins who co-authored the Human Rights Watch report.

An absence of testing in rural La Guajira makes it tough to know the complete impression of the pandemic on these communities. However one factor is evident: If a group member falls in poor health with covid-19 in Alta Guajira, it’s practically unattainable to rapidly entry the care they would wish.

Which is why the van was headed to the northernmost tip of the division.

“We’re getting shut,” Girnu instructed Gamez and Eliana Andrioly, the group’s Indigenous chief. They sped down a salt flat, their view miles of sand and the distant bay.

It was late afternoon when the group arrived at a medical middle in Bahía Honda. A group of nursing assistants and a physician had been ready. The suppliers spend 15 days at a time dwelling in a dormitory subsequent door, sleeping in hammocks and showering with buckets of water, to stage day by day medical missions to the encompassing communities.

The group, IPSI Palaima — “land of the ocean” in Wayuunaiki — was based in 2007 by an Indigenous girl who grew up within the space. It is likely one of the solely suppliers in Alta Guajira with a everlasting vaccine fridge, in a medical middle powered by photo voltaic panels.

The group member in command of photographs this week was Daniela Vergara, a 21-year-old nursing assistant who had by no means been to Alta Guajira earlier than she utilized for the job.

LEFT: Within the late night, Daniela Vergara, 21, seems to be at her cellphone and rests in a hammock within the room she shares with two different workers members at Edita Freyle de Andrioli Well being Heart in La Guajira, Colombia. Every month, the only mom works for 15 days on the well being middle, away from her 1-year-old son, whom her mom takes care of. RIGHT: The group from IPSI Palaima embarks on a small boat to achieve a small group in Bahía Honda. Daniela Vergara, who has a bag containing a cooler the place the vaccine vials are saved, will perform vaccinations in La Guajira.

Every day, Vergara goals to vaccinate a minimum of 10 individuals — a modest objective that usually requires an enormous effort.

On this Monday, she had not but reached her goal. She packed her cooler — a blue backpack stuffed with vials of the single-dose Johnson & Johnson shot that has been a godsend to rural vaccine groups — and set out for a group throughout the bay.

The quickest solution to arrive can be by boat, so Vergara and the opposite members of the IPSI Palaima group packed into Girnu’s van and drove the 20 minutes to a dock. A ship carried them to a rocky cliff overlooking pristine turquoise waters.

From there, a member of the group supplied the group a experience on the wood again of his truck.

They drove to a gathering place the place they hoped to satisfy individuals within the vaccine.

“There’s nobody right here,” Vergara mentioned. “We received right here too late.”

An area chief prompt they go home to accommodate. As darkness fell, the group members requested anybody who seemed 18 or older in the event that they wished the vaccine.

Quickly a girl recounted a rumor that they had heard many instances: Outsiders had been pushing a vaccine that was sickening members of the Wayuu group.

The girl, a trainer who spoke some Spanish, knew what was at stake. She had contracted the virus just a few months earlier, after a visit to the city of Uribia. For a month, she suffered chest pains, complications, an intense cough and the lack of style and odor. She was handled solely with conventional Wayuu treatments. She nervous a couple of 66-year-old neighbor who had no real interest in getting a shot.

“Many individuals are dying from this illness,” Juan Larrada, a Wayuu physician within the group, mentioned in Wayuunaiki. He mentioned the vaccine may have unwanted effects, however it will shield them from severe sickness. He requested Amaita Uriana why she didn’t need it.

“As a result of I used to be afraid of getting sicker,” she mentioned. “I actually really feel very sick. I carry pains in my physique. That’s why I refused when a lady got here right here for a similar cause. In addition to, she was very pretentious. And we had already heard concerning the experiences of different Wayuu who had been vaccinated and turn out to be in poor health.”

“The vaccine can have these results,” Larrada agreed. “Fever, muscular pains, that’s regular.”

Understanding the physician as he spoke to her in her personal language, Uriana assented. She closed her eyes; Vergara emptied the syringe into her arm.

The subsequent morning, Vergara collected her hair right into a ponytail, chugged a plastic bag of water and hopped onto the again of a motorcycle.

She held on with one hand and managed a cooler with the opposite as the driving force sped throughout desert and alongside shoreline. As all the time, Vergara requested the driving force to blast vallenato — the Colombian folks music standard alongside the Caribbean — so she may sing alongside. Trailing her, on the again of one other motorcycle, was Micaela Epieyu, the group nurse in command of youngsters’s vaccines.

As the ladies approached their first household, a bunch of girls in floral attire on a entrance stoop, Vergara nervous they’d not belief an outsider who didn’t communicate Wayuunaiki. She requested Epieyu, who speaks the language fluently, to assist translate.

The soft-spoken 29-year-old was shy. However as she started speaking to the ladies, most of them moms, the household felt very like her personal. Epieyu had three youngsters beneath the age of 12, staying along with her mom within the metropolis of Maicao. Vergara can also be a single mom, with a 1-year-old son again residence along with his grandmother. Each had been counting down the times till they might return to their households.

Inside minutes, Vergara had vaccinated 5 individuals.

A brief motorcycle experience away they discovered a household of greater than 10 dwelling in a house fabricated from wooden and sticks.

“Vaccines deceive,” Cristina Pushaina instructed Epieyu. “A month in the past, our uncle died from being vaccinated.”

She mentioned a lady from the group went to a hospital far-off and died. Her family needed to pay to deliver her physique again for a standard Wayuu funeral.

Pushaina used a fish bone to scrape a fruit peel often known as a taza de mono — a monkey’s cup — to extract a juice utilized in conventional drugs to deal with stomachaches and baby malnutrition.

“We belief the drugs made by our personal palms,” she mentioned. Not the drugs of an “alijuna” — an outsider. “This liquid that you simply wish to inject in us, we don’t know who prepares it or how.”

“With any sort of injection,” she mentioned, “the Wayuu all the time die.”

Their fears had been like these of others world wide who’ve rejected vaccines — fears primarily based on misinformation, disinformation or lack of belief. Even right here, in a spot with no electrical energy and little cellphone reception, the place locals not often work together with individuals outdoors their households, the rumors nonetheless unfold.

However the roots of the distrust in Alta Guajira are a lot deeper. It’s a group that has for generations suffered from malnutrition and meals insecurity made worse by corruption and mismanagement in each native and departmental governments and together with in publicly funded well being care suppliers.

Households right here have survived virtually solely on their very own, counting on fishing and goat herding for meals — and on medicinal therapies handed down by their ancestors.

“If our grandmothers had been alijunas,” Pushaina mentioned. “We wouldn’t exist.”

Vergara and Epieyu didn’t attempt to push the household any additional. Their determination was made.

It was a missed alternative, however the nurses understood there was solely a lot they might do. Even when they traveled home by home throughout the desert, even when they defined the vaccine to group members in their very own language, it will not be sufficient to persuade some.

The ladies hopped again on their motorbikes and drove to the following residence.

About this story

Reporting by Samantha Schmidt. Pictures by Nadège Mazars. Picture enhancing by Chloe Coleman. Video enhancing by Alexa Juliana Ard. Design and improvement by Allison Mann. Copy enhancing by Dorine Bethea. | Vaccinating Colombia’s distant, Indigenous communities towards covid-19

Huynh Nguyen

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