New Delhi: Whether it is trekking for several kilometres through hilly terrains, grappling with poor network connectivity or vaccine hesitancy, teams running vaccination drives in far-flung tribal areas of the country are doing whatever it takes to ensure that every citizen gets their COVID-19 jab.

Arunachal Pradesh state immunisation officer Dimong Padung has a team of five, including porters, nurses and volunteers, who have journeyed to remote areas to ensure that the state is completely vaccinated. One such place is the Luguthang village located in Tawang district.

The village is remotely situated, over 60 km away from the nearest Primary Healthcare Centre (PHC), and is extremely difficult to reach.

“It is one of the remotest areas that my team has been to for vaccination. There are no motorable roads, so after travelling a little distance in a vehicle, we have to walk for 2-3 days.

“The only consolation is that the area is at such a high altitude, the temperature is zero almost all the time. This helps in the vaccination process as the vaccine has to be kept at 2-8 degrees celsius,” Padung told PTI over phone.

But for vaccination teams, successfully managing to reach such remote villages is only half the battle won. Getting people to register themselves for Covid vaccination is also challenging. For this, ASHA workers and local volunteers come in handy who use interpersonal communication and innovative methods to help people overcome vaccine hesitancy.

Quoting Tawang district immunisation officer Rinchin Neema, officials gave the example of a nursing assistant who went from door to door in Mago village with a picture of the Dalai Lama to convince locals to get vaccinated, and it did the trick.

Everyone in the village, except a 95-year-old, readily got jabbed.

The farther the place, the more challenges the immunisation teams have to face.

The remotest that Nagaland state immunisation officer Ritu Thur’s team has been to is the Kiphire district that borders Myanmar.

“Travelling to these places is difficult because of poor road connectivity and lack of public transport systems. We often have to walk halfway for 6-7 hours. The hilly terrain makes it difficult,” Thur said over phone.

Poor Internet and mobile network only add to their woes.

“There is Internet problem. In certain districts, the immunisation teams have to go for offline vaccination. It is troublesome,” Thur said.

In the case of offline vaccination, the data has to be uploaded on the COWIN portal latest by 5 pm the following day. For this, the teams have to travel to the nearest PHC which sometimes is 40-60 km away.

However, Thur’s team has been fortunate about encountering almost negligible vaccine hesitancy among the people in the state.

“There are a few groups who may be hesitant, but as of now there is largely no vaccine hesitancy as far as Nagaland is concerned. Rather, I have seen that vaccine eagerness is there,” the officer said.

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Earlier this month, the government said that more walk-in vaccinations were being witnessed in tribal districts as compared to the national average.

While the walk-in and online vaccination ratio nationally is 81:19, it is 88:12 for tribal districts.

Himachal Pradesh is proof of this.

There are many areas in the hilly state with limited network connectivity, making it difficult for people to register on the COWIN portal. So the immunisation team came up with a unique idea to get the job done.

Quoting Himachal state immunisation officer Hiten Banyal, the officials said that his team kept ballot boxes in different parts of districts and people were asked to drop a chit in these boxes with their names, and contact and identity details, in case they wanted to be vaccinated.

The immunisation team then collected these chits to register these people on the COWIN portal in a better network area and later vaccinated them.

Making people feel ready for vaccination is, however, not an easy task.

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Sikkim state immunisation officer Psumzay Denzong said that her team has made full use of both online and offline resources at their disposal.

“Internet is good in most parts of the state, so in such places, we create awareness through social media platforms where we publish weekly health bulletins, and vaccination slots for the upcoming week every Saturday,” Denzong said over phone.

“Besides, we have ASHAs workers in every village, and we also take help from the panchayats to reach out to the people,” she said, adding that barring “very few stray cases” the state does not have any vaccine hesitancy.

Eradicating vaccine hesitancy in Himachal’s Lahaul and Spiti required a more personal touch.

The officials said district immunisation officer Ranjit Vaid spoke for hours to three very reluctant villagers, before he could make them come around to the idea of getting vaccinated.

Participation of local religious leaders in educating people on the benefits of vaccines also helped, he said.

According to the government data, the COVID vaccination per million population (10 lakh) in tribal districts is 1,73,875, which is higher than the national average of 1,68,951, with 128 out of 176 tribal districts performing better than all India vaccination coverage.

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