This story first appeared in The Star newspaper.
The focal point of Kaego informal settlement, in Kisumu town, is the boda boda (motorbike taxi) stop at the junction of the tarmac road and the earth track that leads through the settlement. Young men sit on their bikes under the shade of a wooden roof, waiting for customers. Washing hangs on clotheslines, criss-crossing the narrow side streets with bright colours. Schools are out and young children run between the houses, rolling old car tyres or playing with homemade balls made from plastic bags and string. Their cries and laughter mingle with the rumbling of motorbike engines.
Opposite the boda boda stop, market vendors have set up makeshift stalls selling fish, vegetables and water. Moving among the stalls is community health volunteer (CHV) Daniel Akothee. A respected member of the local community, he is well known for his work to link up families with the nearby health centre. Daniel stops to talk to the vendors and their customers about COVID-19, asking them if they have been vaccinated. If not, he asks their reasons why and gently dispels any myths with the correct information.
Daniel stops at a water point, where heavily pregnant Anne Atieno, 28, is filling yellow jerrycans with water for sale. With support from another market vendor, Prisca, who has already been vaccinated, he convinces Anne to get vaccinated.
“Things have been hard for me financially since COVID-19 arrived,” Anne says. “The price of goods has gone up and it’s become more difficult to provide for my children. I haven’t had the COVID-19 vaccine yet because I was worried it would make me sick and then I cannot work. I depend on my income to get food for my children. But Daniel has convinced me that the vaccine will help keep me and my baby safe. Once I realised that Priscilla had been vaccinated and is OK, I thought I can do it as well.”
UNICEF is supporting the Kenyan Government’s response to COVID-19, both at the national and county level. Since March 2021, the children’s organisation has been transporting vaccines into Kenya and supporting their distribution to regional depots, including Kisumu. Initially, demand for vaccines was high but after vaccinating people who were willing to come to health centres, it became necessary to go out into communities and persuade people to be vaccinated.
“COVID-19 has hit Kisumu very hard,” UNICEF Health Officer Camlus Odhus, who is based in Kisumu, explains. “During the Delta wave, we lost a lot of people here, including health workers. People lost their jobs and livelihoods because of the economic impact and travel restrictions. And children missed out on education while schools were closed.”
Camlus says that the health response was complicated by vaccine hesitancy. “There are a lot of concerns in the community due to myths about COVID-19 vaccines,” he says. “Sometimes this comes from religious or cultural beliefs, or because of rumours and misinformation spread on social media. In other cases, low-income people live far from the health centre and cannot afford to travel there. We also have a lot of casual workers who don’t want to lose a day’s work in order to get vaccinated.”
Community health volunteers have proved to be an important part of the solution. “CHVs are respected members of the community,” Camlus explains. “People know and trust them. They can talk directly to community members, person-to-person. Through our trainings, UNICEF is helping to ensure that they are empowered with the knowledge to convince people.”
A calling to health
Sat on a plastic chair in one of the washing-lined side streets, Daniel explains why he followed “a calling” to become a CHV. “I am very proud of the work that we do,” he says. “During COVID-19 there were a lot of deaths in this community. Most families lost jobs and children lost parents. Teenage girls got pregnant during school closures. I was so sad, I lost so many friends. The impact was so heavy.”
Daniel was trained by UNICEF given information on how to counter the prevailing myths. Armed with this, he went door-to-door through Kaego community, seeking to change minds and behaviours. “I talked to households about what they could do,” he says. “I challenged the myths and misconceptions. For example, boda boda drivers had been telling people that if you get the COVID-19 vaccine, you cannot get pregnant. I told people that this is not true – the Government would not approve a vaccine that can harm you like that. I wiped out the myths one by one each day.”
Once Daniel has persuaded someone to get vaccinated, he either takes them to the nearby health centre or brings the vaccine to them. “Kuoyo Health Centre is just 15 minutes’ walk from here,” he says. “But people are busy, so for those who don’t want to go, I coordinate with the health centre. Once I have 30 people ready to be vaccinated, I call them to come to Kaego. The health workers set up a stall in the community and they vaccinate people here.”
Convincing 30-year-old Janet “Prisca” Achieng to get vaccinated was a big breakthrough for Daniel. One of the most vaccine hesitant people in Kaego, she had been listening to the myths and putting other people off. But once Daniel had convinced her to get vaccinated, she turned around and became an advocate, helping him to convince other market traders like Anne and their customers.
“Before I got vaccinated, I was very afraid,” mother of four Prisca explains. “People said if you get the vaccine, you will get sick, you will not be able to have any more babies and in two years’ time you will die. But Daniel convinced me that this was not true. He explained that the vaccine will keep me safe from COVID-19. It’s important for me because I interact with so many people on my vegetable stall. So, I went and got vaccinated. Afterwards, my husband waited to see if I would die. When I didn’t, he got vaccinated too. Now I feel much safer, and I don’t worry when people come to my stall.”
Getting the shot
Later the same morning, Anne arrives at Kuoyo Health Centre to get her first COVID-19 vaccine shot. The health centre is busy, with mothers and young children waiting on benches in the shade. There are COVID-19 safety messages on the walls, and everyone is wearing a mask, unlike in the community. Before entering the compound, Daniel and Anne wash their hands thoroughly and have their temperature checked. Because she’s seven months pregnant, a nurse also checks Anne’s blood pressure.
Inside the vaccination room, another nurse removes a vial of Pfizer-BioNTech COVID-19 vaccine from the fridge, where they have been stored since being defrosted and shipped from Kisumu regional warehouse. Anne rolls up her sleeve, turns her head away, and closes her eyes as the nurse plunges the syringe into her upper arm. Afterwards, she waits outside for 15 minutes to ensure that she has no immediate side effects.
“I am happy to have been vaccinated,” Anne says afterwards. “It hurt a little bit at first but now I am OK. I’m very glad that my baby is protected.”