The wait is over for Sister Ntombesiko Lekhula
The Eastern Cape province in South Africa (SA) stretches from rugged coastline to remote mountainous areas, which is where the Empilisweni District Hospital is found and where iSister Ntombesiko Lekhula works. She received the Johnson & Johnson Covid-19 vaccine after a Right to Care mobile unit traversed through rough terrain to reach her hospital and vaccinate its healthcare workers. “We have been suffering with Covid-19. I have been waiting for a long time. I am so glad to have finally had the vaccine,” said Sister Lekhula on receiving her vaccination.
Pushing through the last mile to reach Empilisweni District Hospital
Healthcare workers in SA were vaccinated as part of a clinical trial in 2021 with the Johnson & Johnson’s Covid-19 vaccine. Right to Care vaccinated almost 40,000 healthcare workers in the Eastern Cape. Healthcare workers serving communities in extremely isolated parts deserved to be vaccinated too. In these areas, it is not only the roads that are poor; there are other infrastructure deficits like telecoms, power and retail outlets for essential supplies. Right to Care tackled this terrain to ensure that no healthcare worker was left behind, an undertaking enabled by USAID
The last mile is hard to reach
The last mile is all too often the difference between accessing and being denied healthcare services. It is this mile that Right to Care overcame to reach hospitals and clinics and vaccinate the healthcare workers there.
Mobile clinics, pharmacies and vaccination teams
Covid-19 vaccine distribution in remote settings is complex. Many health facilities don’t have what is required to set up a vaccination site. Hospitals may lack computers. What is needed must be brought in. The Right to Care team that travelled to Empilisweni District Hospital included a mobile pharmacy, clinic and the mobile team comprising a team leader, a pharmacist, vaccinators, data capturers and marshals. The team organized gazebos for the waiting area, mobile connectivity, emergency support and security. A dedicated vaccine pharmacy was set up on arrival.
Cold chain planning – from GIS technology to icepacks
Cold chain planning is critical to ensure vaccines remain at the right temperature. Dr Ntombi Sigwebela, chief of party for vaccinations at Right to Care explains, “To reach remote rural places, we use sophisticated geographic information system (GIS) technology to assess the route and plan the transportation of the vaccines. We establish if the hospital’s vaccine fridge was functional and if it had sufficient space. On arrival at some facilities, we found vaccine fridges holding other stock including non-medical supplies. This left limited space for the vaccines… We had to bring in cooler boxes and ice packs.”
Good cooperation from the hospitals
Sister Tinette Mooiman managed one of the mobile units. She says, “There were challenges. People were excited to receive their vaccines. We had good cooperation from most of the hospitals. We have three days left once we have completed the vaccinations at Empilisweni. I hope we can reach more healthcare workers in the time we have left.”
No one should be left out
Dr Ntombi Sigwebela says that, “No one should be left out of the vaccine programme, including those in faraway places. Vaccine distribution is complicated outside of major centres. We learned a lot during this study as our mobile teams traversed difficult terrain to reach facilities in outlying areas. We have shared our learnings with the National Department of Health because approximately 19 million people who live in rural areas must be vaccinated by March 2022.”
