How does a 5-year-old non-profit organisation conduct Covid vaccinations for more than 45,000 (and counting) migrant workers in one district? It is just one of the many initiatives at my host organisation – the Centre for Migration and Inclusive Development (CMID) in Kerala.
These vaccination drives under National Health Mission are one-of-a-kind focused health interventions for migrant workers in the Ernakulam district.
In October this year, I jumped into their moving train, post the (real) vaccination rush. In Kerala, through the Department of Labour and Skills, the government had been conducting free vaccination camps specifically for migrant workers.
As a part of it, CMID assisted in daily camps for more than 1000 people. However, the department stopped the active organisation of immunisation camps.
If We Don’t, Who Will?
One of the biggest reasons for doing these specific camps is that every day and hour of work is crucial for workers to earn their livelihoods. It’s not easy to take a leave and commute to the government hospital, which may not even have the vaccine available when they reach there.
Hence, the CMID model involves going to their workplace or residential areas and conducting drives even if only two people are in a company or factory.
The process involves team members conducting outreach activities to discover these factories in an area. It requires getting details about the number of people to be vaccinated, and if second doses are to be administered, then which vaccine out of the two (Covishield and Covaxin) is required.
Then we coordinate with the National Health Mission, who ask us to collect the vaccine from a specific PHC (Primary Healthcare Centre) or a public hospital. They also provide us with details to start the day as a ‘Vaccinator‘ on the Cowin portal.
Two cars, each with a doctor, one or two nurses and coordinators, then take a car trunk full of paraphernalia, including everything from table cloth to emergency kits, three coloured bags for biomedical waste and even a printer to give copies of the certificate wherever required.
What these concerted efforts needs is an accurate database for each day. Hence, every day we note the number of people vaccinated for each dose in age brackets and send their complete details to the appropriate authorities.
While I summed it up in a couple of paragraphs, it is challenging to do it every single day.
Practical Challenges
- One of the biggest hindrances is not having the actual number of workers. The lack of data, allegedly due to deflated numbers provided by the companies to the labour department, grossly affects the work.
- The process is thus time intensive. Places that say they have ten people have 50 or vice versa, and hence, sometimes an entire day goes in figuring out these essential details. As the balance vaccines have to be returned to the PHC on the same day, we also have strict time constraints. So on days when we barely do 50 vaccinations, there creeps in a feeling of guilt for under utilising the resources we have.
- There is a general disinterest in getting vaccinated now, especially by the employers, so that the working hours are not spent on anything else. Many of them had an issue with providing a 30-minute rest period after the shot when we conducted drives in their company itself. Many workers have registered in groups, either by themselves or on behalf of their company, using one single phone number. This prevents them from getting their vaccination certificates as the online portal does not allow us to change the mobile number once given. Additionally, if the vaccinators like us mess up a digit, the worker will not get the message or access their certificate. This is where giving copies on the spot becomes beneficial.
- In places where we cannot print the certificates, for anyone with a different registered number or just generally unaware about getting the certificate from the website, we send it to their phone immediately through WhatsApp or Bluetooth.
- There is unawareness and ignorance about the disease and the need for vaccination. Many of them are getting vaccinated to travel at ease or not get harassed by police. It thus also becomes our responsibility to conduct these drives and ensure health awareness simultaneously. Many of our camps are thus followed with a visit to our Bandhu Clinic, a unique medical unit and India’s first mobile Covid screening unit for migrant workers.
- Our overall data has only a few numbers of women migrants. While accessing details, we observed that the female family members registered with the workers were not fully vaccinated. There have thus been added efforts to be more inclusive. We ensure travelling to industries such as fish processing with many women workers. We also try to ensure privacy while vaccinating, wherever possible.
The challenging nature of the drives ensures that we always try to think a step ahead. Of course, we make mistakes and learn each time, but the fact that we continue to reach out to 200-300 people every day in one district proves that there is still a lot of work to be done.
If you wish to know more about our programmes or contribute to help us reach the maximum number of workers, please get in touch here.
About The Author: Disha Devdas is an India Fellow working with CMID (Centre for Migration and Inclusive Development) in Ernakulam, Kerala, as a part of her fellowship. She is helping the team make possible adequate access to healthcare for the community.
India Fellow applications are now open for our 2022 cohort.
The post was previously published on India Fellow’s website.