In the remote Mon district of Nagaland on the Indo-Myanmar border, officials are busy arranging for the four-by-four vehicles locally. These vehicles would ferry the Covid-19 vaccines on some of the dirt tracks connecting villages once the front-line health workers are vaccination in the first phase, and the programme moves on to the other sections of the population.
Bad roads, poor internet connectivity, minor glitches in the vaccine management application and possible resistance from the mostly tribal population: These are only some of the bottlenecks that officials in the Northeastern states expect to encounter as they prepare to roll out the Covid-19 vaccination drive on January 16. Health workers have vast experience from the universal immunisation programme, but this is much larger in scale.
Aircraft carrying boxes of vaccines started arriving throughout the region on Tuesday. Airports Authority of India officials said a Spice Jet flight carrying 20 boxes with 12,000 vaccines each landed in Guwahati, the nodal hub. Seventeen of these boxes are for Assam, while the remaining three for Meghalaya. Nagaland officials confirmed receiving 26,500 vaccines.
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The region did not see too many positive cases as state governments and local communities came together to prevent the spread. As on Tuesday, the total number of positive cases stood at 2,16,690 positive cases and 1,064 deaths in Assam, 13,651 cases and 143 deaths in Meghalaya, 11,997 cases and 84 deaths in Nagaland, 33,306 cases and 385 deaths in Tripura, 16,782 cases and 56 deaths in Arunachal Pradesh, and 28,725 cases and 365 deaths in Manipur. Mizoram has reported only 4,293 cases and nine deaths.
Sampath Kumar, the top health department bureaucrat in Meghalaya, credits the state’s early push for Covid-appropriate behaviour. “We were the first state to do so,” Kumar told EastMojo.
The small, tribal-state had its share of issues after the first fatality when a well-known doctor died of the infection and the local communities created ruckus over his last rites. The state has come a long way since, Kumar explained, as the officials and communities embarked on a massive sensitisation drive.
Kumar said a multi-level programme is ongoing to prepare the state and the community for the vaccination.
“We are making sure that they don’t get carried away by any inauthentic news and only have access to scientific information,” he said, adding the state had enough capacity and is beefing up infrastructure.
Meghalaya will vaccinate 16,000 health care workers in the first phase.
There are, however, some areas of concern. Aman Warr, the Director of Health Services of the state, said they are concerned about the South West Khasi Hills district.
In the East Garo Hills District, Deputy Commissioner Swapnil Tembe said there are 200 villages with network issues and more than 100 villages get cut-off during the monsoons. But he said that would not be an issue during the first phase of the vaccination drive, as the district administration has only received information about the first phase where healthcare workers would be inoculated at the government healthcare facilities.
In Manipur, the new district of Noney is facing similar issues. The dry run was done on January 8 at the PHC in Noney and the CHC in Nungba with 25 beneficiaries. According to CMO of Noney district Dr Majachungliu, despite internet issues at the initial stage, helped by Tamenglong District Immunization Officer (DIO), the vaccine dry run was successful.
She, however, pointed out a lack of proper facilities in the area, since Noney is one of the newly-created districts in the state.
She said that since the two vaccination centres are located on the main road, challenges were less with regard to transportation. However, for subsequent phases, there would be massive transportation issues.
“For the second and third phases, the centres are located in remote areas. Though roads do exist there, but the terrain is bad and there are bound to be difficulties in terms of transportation,” she said.
“So far, for the two centres that were part of the dry run, the internet was fine. But going in interior areas, there would be internet issues and they have to find an alternate way to sort out the issue,” Dr Majachungliu told EastMojo.
The CMO also pointed out how there are not enough vaccinators under Noney district and no staff under the family welfare department, but they are taking assistance from Tamenglong.
“There is one storage facility for vaccines at Noney PHC,” she said. There are over 700 beneficiaries for the first phase.
There is only one storage facility in Kangpokpi district, too, officials said. Officials said 300 beneficiaries in Kangpokpi district would be given the jab in the first phase.
There are 35 vaccinators that have been engaged, but the district health department is planning to upgrade to the number to 45, as per the people’s demands.
“Road and internet connectivity issues are common challenges faced in all hill districts. We have fortunately managed to upload the information on the portal on time for the first phase, but some parts of the district continue to have poor internet connectivity and we are little scared that we will face internet issues there,” Kangpokpi DIO Dr Touthang told EastMojo.
Road connectivity is likely to be a major challenge in Ukhrul as well, local officials said.
In Nagaland’s Mon, a senior district official told EastMojo how remoteness of some villages could be the biggest challenge in the subsequent phases of vaccination. The district is arranging for four-by-four vehicles available with the community to aid transportation.
A second official pointed out how, even for routine immunisation, nurses have to walk substantial distance due to the absence of roads. Moreover, the district also has a manpower issue with fewer healthcare workers.
Like many other districts in Nagaland, healthcare facilities are scarce in Mon. There are 2 CHCs, 15 PHCs and 50 sub-centres, many of which are functioning out of makeshift houses.
This official explained the problems they faced during the dry run in Tizit and Aboi areas due to patchy internet connectivity. During the pandemic, the district administration came up with mobile applications to reach out to the population. This mobile application would be used for sensitization during the vaccination exercise as well, the first official said, adding that they were expecting some resistance from the community in light of the misinformation about vaccines doing the rounds on social media platforms.
In Noklak, Reny Wilfred, the deputy commissioner told EastMojo that the first phase of vaccination would give them a fair idea of the issues that could come up in the subsequent phases.
Officials in Tripura’s Ambassa pointed out how some beneficiaries did not even receive text messages through the CoWin application during the dry run. Another official from North district pointed out to the coordination issues during the dry run in the hospital at Dharmanagar.
The National Health Mission (NHM) Director Dr Siddharth Shiv Jaiswal said the issues would be ironed out. He said the dry run was conducted in 152 session sites to review the situation. District taskforce meetings have been held in all the districts to review the effectiveness of the CoWIN application.
In Assam, a top health department official explained how each step has been charted out. “The biggest bottleneck is, since it is a new thing, troubles of infancy will be there. We are not very worried about the challenges. It is doable,” the official said.
“This is unlike the normal immunisation, where you give the location, and anyone who comes with the baby and the immunisation card is vaccinated,” the official said, explaining the process.
But health officials on the ground claim to be prepared for it.
“We have been able to achieve 94% coverage in the universal immunisation programme. We will do this as well,” Imdad Ullah, Joint Director Health, Dhubri, told EastMojo.
With inputs from Medolenuo Ambrocia in Nagaland, Princess Giri Rashir in Meghalaya, Chandan Panday in Tripura and Vangamla Salle K S in Manipur.