Khayelitsha and Mitchells Plain have been identified as the areas with the lowest vaccination rates and registrations in Cape Town. By August 30, only 22.37% of Mitchells Plain’s vaccine-eligible population had registered. In Khayelitsha, this number stood at 12.05%.
Contributing factors include fears around public safety, misinformation, registration difficulties and vaccination sites that some say are too far from where they stay.
Issues plaguing Mitchells Plain
Speaking at the provincial government’s weekly digital conference last month, Roland Kroukamp, a family physician at Mitchells Plain Community Health Centre, said the low vaccine uptake was cause for concern.
“There are many initiatives such as pop-up sites to help people with vaccination so that they don’t have to take buses and taxis, but we continue to see low numbers,” he said.
Kroukamp said public safety has been a major concern, as people are often mugged or attacked while on their way to vaccination sites.
On the other side is a strong disinformation campaign.
“Social media is a concern. We understand there is freedom of speech, but a line needs to be drawn between fact and fiction. There are lots of misconceptions,” he said.
Ivermectin, according to Kroukamp, is the elephant in the room.
"They don’t believe in vaccination because they believe ivermectin is protecting them. There has been no definitive attempt to stop these people.”
The scientific evidence on ivermectin for the treatment of Covid-19 remains inconclusive, and the drug has disappointed in a number of studies – one of the most positive studies of the drug was withdrawn over ethical concerns.
Mitchells Plain resident Abeedah Adams, who is also a steering committee member of the People’s Vaccine Campaign, said that registration on government’s electronic vaccination data system is a concern.
Adams said a team from the People’s Vaccine Campaign called a Mitchells Plain vaccine uptake crisis meeting on August 20.
“We discovered that there was still a lot of misinformation out there about vaccination. To address this, it was decided that 30 volunteers would be trained to educate the community about vaccination. This programme will [start] soon. Some people also raised concerns about working long hours and even weekend shifts, thus not getting a chance to go and vaccinate. We will [go] to workplaces and engage employers to allow workers some time off to go and vaccinate,” said Adams.
Reverend Franklin Williams, from House of Faith Ministries in Mitchells Plain, calls himself “an ambassador for the vaccine”. Williams said when he told young people in his community to get vaccinated, they told him vaccinations are for old people.
“These remarks shocked me,” he said.
Picking up in Khayelitsha
At the Site B Community Health Centre in Khayelitsha, facility manager Desmond Grootboom was welcoming residents, mostly older people, into the facility. Grootboom said he was pleased with the growing number of people who were coming to get jabbed.
"We’ve been getting [fewer] than 100 people coming to vaccinate per day. Residents, especially the elderly, are among the majority of people we vaccinate each day. But they first interrogate the healthcare workers before taking their jabs. Some of their frequently asked questions are whether they will die soon after being vaccinated, or what can they do if their health deteriorates after vaccination. These questions often come from those residents with chronic illnesses, but we assure them they will be perfectly okay.”
Grootboom said it helps that residents don’t have to take taxis or buses to access the facility, because “it is right on their doorstep”.
But that sentiment was quickly dismissed by Princess Zibi (81), who had just been just dropped off after taking a taxi from her home in Litha Park about 10km away.
Zibi said she was not aware of the Red Dot taxi service provided by the department, which transports residents from far-away areas to vaccination sites.
Zibi further added:
Living in Khayelitsha is risky because it is densely populated, said wheelchair-bound Nontuthuzelo Chabeni (47).
“The risk of contracting the virus is very high. That’s why I decided to come and get the jab. But I was very sceptical. All the stories of infertility or dying after getting vaccinated really terrified me. But the more I saw people close to me getting vaccinated and [who were] fine [afterwards], the more I realised it is important to get jabbed. After all, it is about my health,” she said.
Healthcare worker Wandisile Mzangwe said he was delighted that more people were coming to get the jab, but he said the numbers were low for the 60 and older age group and increased again with the 50 and older age group.
“It is hard to tell what drives the numbers, really, but ever since the 18 to 35s have been allowed to vaccinate, the numbers have been climbing.”
He admits he has not been vaccinated yet: “[That’s] not to say I don’t believe in the effectiveness of the vaccines, but I am still deciding. I will definitely get vaccinated when the time is right.”
At the Athlone Stadium vaccination centre, Colin Samson (54) is walking hand-in-hand with his wife Michelle (51). Colin said he lost two brothers to Covid-19 in the space of two months.
“This has been a year from hell for my family. It pains me to see some people being hesitant to take the vaccine. This virus is deadly, we all need to heed the call to vaccinate,” he said.
Worried about coming to vaccinate alone, Agness Nyarisa, who was born in Malawi, came with her sister Margaret Agibu. Both sisters are documented foreign nationals living in South Africa. Having valid documents means they had no problem getting vaccinated. Undocumented foreign nationals and South Africans without ID books have so far been excluded from vaccination, although it has been reported that they will be eligible for the vaccine from next month. Various activists have argued that excluding foreign nationals from the vaccine roll-out undermines the vaccine strategy.
Provincial health spokesperson Mark van der Heever said the department identified the need to have everyone, especially the vulnerable vaccinated.
"This is why we already made assistance available to undocumented persons to be accommodated at our vaccination sites and through our outreach services," he said.
"Undocumented persons (those without valid identity documents) can be registered for vaccination using a paper-based registration form, where all available information of the person is captured. Following this paper-based registration, the client can be vaccinated and provided with their vaccination card. Their details will be kept and captured on the EVDS once the field is activated on the system nationally. The whole purpose is to reach the most vulnerable and not leave anyone behind."
‘I don’t want to die young’
For 19-year-old Mitchells Plain resident Azra Lakay, Covid-19 hit close to home. Her mother, sister and grandmother all contracted the virus.
“I feared the worst, but thank God everyone at home is okay now,” she said as she sat waiting for her vaccination at the Athlone Stadium vaccination site. “I don’t want to die young.”
Lakay said it irked her to see her peers still being hesitant about taking the jab: “It just makes my blood boil. We are supposed to know better. We’ve seen our parents and grandparents falling victim to this virus and we need to be the ones who say ‘it’s time to stop this virus’.”
Western Cape health spokesperson Shimonay Regter said the province recorded 69 960 vaccinations for the Khayelitsha subdistrict and 109 683 vaccinations in the Mitchells Plain subdistrict since the start of the vaccination programme in February. She pointed out that, when considering the numbers, it is important to note that people from all areas in the metro accessed sites in Mitchells Plain and Khayelitsha for vaccination, and that people from Mitchells Plain and Khayelitsha could have accessed vaccinations at a vaccination site outside of these areas.
Western Cape health department responds
Van der Heever said that, while there have been “impressive” vaccination numbers in the province, the numbers in some areas are cause for concern. He said since the start of the pandemic in March last year, the provincial government embarked on several communication campaigns in partnership with local community organisations and teams to share accurate information with citizens.
“We have also empowered our healthcare voices. Our doctors and nurses are sharing stories [about] how we are addressing misinformation and overcoming hesitancy. This is part of our ongoing communication activities to provide accurate, truthful information to our citizens. On our Facebook page there are several FAQ [frequently asked questions] videos that are addressed by vaccine experts,” said Van der Heever.
Through the health department’s dashboard and vaccine cascade, Van der Heever said it can identify areas with low registrations and intervene there.
“There are some areas with low uptake, such as Mitchells Plain, but these are being addressed through localised initiatives. We are working with a range of partners on innovative initiatives through which we can take vaccines to the vulnerable communities, making vaccination easily accessible for them.”
Van der Heever said these initiatives included the department’s outreach and community mobilisation drives, sites for weekend vaccinations, pop-up vaccinations sites in communities, and partnering with the SA Social Security Agency and stores such as Boxer. The department also has teams of health interns and community health workers who work with local neighbourhood watch members for its door-to-door registration drives.
Van der Heever said the department had also repurposed its Mobile Wellness bus, which is usually used for school health programmes, for vaccine outreach activities in some communities.
He said the Red Dot Taxi service is operating in outlying areas and, if needed, can be scheduled for the metro areas. He said some bedridden patients are receiving vaccinations at home. This is done based on need as identified through the database that health teams have, but “bedridden people can also ask the local health team to be added to this list”.
This article was produced by Spotlight – health journalism in the public interest