At 7 am, Florencia Tirkey was about to leave for the vaccination session when she received a call to attend a delivery case urgently. Posted at the village Pelma sub-health centre (SHC) in the remote hilly forested tribal Dharamjaimarh block of district Raigarh of Chhattisgarh, she delivered the baby at around 10.30 am and completed the post-delivery care by noon.
Knowing that the people at village Dagbhouna, 9 km from Pelma, would be waiting for her, she immediately rushed to the site. However, she could not even feed her lactating baby in the rush. Going door to door, she vaccinated 103 villagers, finished all the doses available to her, and finally reached home at around 10 pm.
Arun Mahant's Night-Long Struggle
Similarly, Arun Mahant, a Rural Health Officer (RHO) posted at the Primary Health Center in Khamhar, trekked uphill through forests for two hours to reach the Chuhipahad village. The village is inhabited by the Pahadi Korva community, one of the Particularly Vulnerable Tribal Groups (PVTGs).
On one of the occasions, he returned at midnight with his footwear broken and slept in the Civil Hospital to receive the vaccine supplies the following day at 5.30 am.
Despite the initial hesitancy, he was able to vaccinate everyone with the help of community leaders, through persuasion and persistence.
These examples show how the unsung heroes are turning the tides in the tribal heartland of India. Their sheer dedication, determination, and sacrifice led to the district Raigarh becoming one of the first districts in India to achieve 100% COVID-19 vaccination on 9 November, which is 298 days after the vaccination campaign started.
It required an extraordinary human effort to make the vaccines available at the last mile and convince the people to take the jab, and that too, twice. Behind India’s successful vaccination campaign – the largest globally – lie countless such stories of struggle and courage, playing out every day.
Reaching the Last Mile
Focus on convenience has been the cornerstone of Raigarh’s vaccination strategy. To ensure that nobody is left behind, sessions were planned in almost every village/ward with door-to-door campaigns. Therefore, timely movement of vaccines and other supplies to the last mile while maintaining the cold chain was a daunting task. However, drawing lessons from the routine immunisation campaign for the children, it was ensured by the team led by Vaccine Logistics & Cold Chain Manager (VCCM).
Driving through the night, the vaccine van drivers delivered the vaccines to the block vaccine stores after collecting them from the state headquarters. From there, the Alternate Vaccine Delivery System (AVD) providers, a local person engaged in the activity on a part-time basis, transported the vaccines on motorcycles to the last mile, as well as brought back the unused ones after the conclusion of the immunisation session.
They had to make multiple trips through the rugged, difficult terrains round-the-clock to ensure the effective operation of both routine and COVID-19 vaccination.
In this way, they have been critical in ‘driving’ the fight against COVID-19 in remote areas.
How Robust Networks Helped
The vaccinators, supported by data entry operators, faced multiple challenges due to limited accessibility & mobile network connectivity, scattered habitations, rugged terrain, and the large geographical extent with dense forest cover. They traversed through forests, crossed streams and trekked hills to knock at every door.
For instance, Asha Bada, an Auxiliary Nurse Midwife (ANM), battled heavy rainfall, crossed a stream knee-deep submerged on foot to reach her session site in Borla Jharia hamlet of the Gram Panchayat Newar. After finishing the day’s campaign, she was left stranded as the stream had swollen to dangerous levels. However, she used the opportunity to stay back overnight and motivate the remaining villagers to get vaccinated.
Many times, the frontline workers suffered disappointment due to the aggressive opposition by reluctant community members. But the goodwill earned through the tireless, selfless work broke those barriers. They leveraged the support of local-level leaders, including the village Sarpanch & Panch, Anganwadi Workers, ASHA workers, teachers, members of Self-Help Groups (SHGs), village secretaries etc., while motivating them to get vaccinated first.
The small wins provided the impetus, energy and optimism to go through the troubles every day till everyone was vaccinated. And it was achieved at an unprecedented scale and speed, and while ensuring essential health services.
The Architects of the Campaign
It was essential to devise micro-strategies at the grassroots, especially due to the limited availability of human resources, vaccines, infrastructure, vehicles, etc. The medical officers at various health centres, with the support from program & data managers, PADAs (Primary Account cum Data Assistants), and secretarial staff within the blocks, analysed the vaccination trends. They led the bottom-up planning and monitoring effectively.
Evaluating progress on coverage in different areas provided the basis for focused awareness campaigns and further allocation of vaccines. Moreover, the real-time monitoring led to course corrections and prompt response, for instance, providing immediate police support in case of law and order issues. This is how war room leaders worked behind the scenes to architect the campaign.
The unending nightmare of COVID-19 has given rise to warriors who radiate hope in such desperate times. By putting service before self, they are fighting against all odds through sheer zeal and commitment.
Each dose of vaccination is a testimony to the multiple battles fought and won by them. The story of the 136 crore doses is incomplete without celebrating these unsung heroes of India’s vaccination drive.
(Bhim Singh @Bhimsin30731522 is District Collector, Raigarh, Chhattisgarh. Sambit Mishra @sambitm is SDM, Dharamjaigarh, Raigarh. Dr Ravi Mittal @ravimittalid is Chief Executive Officer of Zila Panchayat, Raigarh, Chhattisgarh. This is an opinion piece and the views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)
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