Transport issues putting brakes on vaccination efforts in rural Free State

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By 10 August, 476 497 Covid-19 vaccinations have been administered in the Free State. This means around 16 jabs have been administered for every 100 people in the province, although some people would have received two jabs. South Africa, and the country’s provinces, are aiming to vaccinate around 67% of the country’s adult population.

So far, only 22 078 vaccinations have been administered in the province’s rural districts. This works out to around one jab per 100 people in these districts. Based on Statistics SA estimates, we calculate that there are around two million people living in the province’s rural districts.

The slow pace in rural areas, unions, some residents, and opposition parties say, is due to poor planning since many rural communities cannot afford transport to vaccination sites.

According to the Free State Chairperson of Denosa Thibogang Thole, many low-income and senior citizens in rural areas do not have transport to go to vaccination sites. Thole says the provincial department of health has failed to include people in rural areas and small towns in its planning.

“We still have the senior citizens living in villages, farms, and small towns that are not yet vaccinated because they do not have capacity to reach vaccination sites. These people do not have resourced families or friends that will transport them to vaccination sites for free, which means that they have to spend the little money that they have on transport so that they can [get] vaccinated,” he said.

Both the Economic Freedom Fighters and the Democratic Alliance in the province called on the provincial health department to address the transport challenges rural communities face in getting vaccinated.

Expensive travels

64-year-old pensioner Morwa Mohlomi from the Tiger River Trust, a rural village in Thaba Nchu, east of Bloemfontein, tells Spotlight getting vaccinated came with many challenges.

Tiger River Trust is one of the 36 rural villages in Thaba Nchu. Thaba Nchu has a population of 701 118, with only one designated vaccination site at the J.S. Moroka District Hospital.

Mohlomi is among the many older persons in the Free State rural areas who had to travel long distances and had to spend money to get to a site for her jab.

Although her closest vaccination site was at the J.S Moroka District Hospital in Thaba Nchu, she was notified to get vaccinated at the Botshabelo District Hospital, which is over 100 km away from her home.

She says for her to get the two doses of vaccine she had to spend R300 on transportation alone, with her second dose received on 3 August.

“I heard about vaccination on the radio station and right there I knew that I had to vaccinate. I know as a person over 60 years I am a high-risk, so it is important for me and other pensioners to get vaccinated,” Mohlomi says.” “When I received a message on my phone that I must go to Botshabelo, I knew that it was impossible for us to get vaccinated in Botshabelo because it is too far [and] would be very expensive.

She says after getting the confirmation message she went to the Moroka Hospital which is much closer to her village.

“I showed them my message and told them Botshabelo is too far for me. They agreed to help me at Moroka Hospital and they said I can come back for my second dose on 3 August.

Mohlomi says she is happy to be vaccinated. “But I am also very hurt that I spent so much money on transport only. This is money that I could have used to buy some food for my house and because it costs so much money to go to vaccination sites, I know that there are some of the community members in my village that did not get vaccinated because of [a] lack of money.”

Vaccination a two-way street

“The non-provision of transportation by government in rural areas is slowing down the vaccination process and it opens up room for people to change their minds about vaccination. This also puts pressure on us, nurses, because it means we will be unable to reach herd immunity at the set deadline,” Thole said.

“Another burning issue in other parts of the Free State, especially Bultfontein [in] Lejweleputswa [District] when it comes to vaccination is that there is a heavy demand and a short supply of the vaccine,” he said.

The union claims people who travel from places like Bultfontein to Welkom end up being sent home without being vaccinated as they are cut off from the long queues because vaccines were finished for the day and that they should come back the next day.

“Now these people who would have travelled long distances and spent a lot of money to get to a vaccination site sometimes have to find themselves being returned home without being vaccinated because there is often not enough supply of vaccine in small towns.”

Government response

But spokesperson for the Free State Department of Health Mondli Mvambi says the vaccines cannot wait for the people.

“Vaccines are very sensitive and have to be placed in a place with adequate temperature. It is not like bread where it is just placed there in the sun waiting for people to arrive,” he said.

Mvambi says the government is doing everything in its power to ensure that vaccinations are accessible to people.

“The reality of the matter is that we cannot fetch every person from their homes. Farm areas are scattered and [it] will be impossible for us to go to each household. Also, people must understand that vaccine is a two-way street. People should make an effort to ensure that they get vaccinated.”

Mvambi says the department has placed vaccination sites at a place that is central for all the people in the area to access.

“Government is doing all it can to make the vaccination accessible to all the citizens of the Free State by doing outreach programmes which include pop-up vaccination sites in those communities. We work hand-in-hand with different non-profit organisations,” said Mvambi.

Responding to claims of vaccine demand outstripping supply in some rural areas, Mvambi says, “The point is we cannot [risk having] wastage of vaccines. It is a risk to have an oversupply of vaccine in small towns because sometimes there are many people and sometimes not. We have to be very cautious when it comes to the vaccines.

"So with Bultfontein residents, I will have to verify and address the matter with district officials to see how best this matter can be tackled without running the risk of wasting vaccine.”

Pop-ups

The South-African Red Cross Society in Free State is one of the main organisations that are working with the provincial health department to provide vaccinations.

Provincial manager of the Red Cross Society Claudia Mangwegape said the organisation has pop-up vaccination sites in the rural areas around the province where people can just walk in to be vaccinated without having registered.

“What we do is that we drive around the different villages and [with loudhailers call] on older citizens who have no access to transport. We have a minibus taxi that we use to collect them from their homes to the vaccination site and back again to their homes. This is a strategy that is currently working especially in the villages of Thaba Nchu,” Mangwegape said.

“This week we are doing the same thing in Fezile Dabi District at the different farms around Viljoenskroon and Parys. We are doing this as an organisation because we know that the farm communities are not able to access the vaccination sites,” she said.

The organisation has so far done 45 pop-up vaccination sites in villages including Thaba Nchu, Steynsrus, Koppies, Viljoenskroon, and surrounding farms. Mangwegape says they vaccinated about 100 people a day at these sites since the beginning of July.

*This article was produced by Spotlight - health journalism in the public interest.

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