Health Workers complain of low turnouts
The presence of Coronavirus in Liberia has brought a drastic decline in the number of people, mainly baby mothers who, during the prenatal period, should be immunized against certain diseases and, upon delivery, take their babies to the hospital during the first nine months of birth to be inoculated (vaccinated) against different diseases including Polio, Measles, and Tetanus.
“We do not receive people for vaccines like before. Prior to the Coronavirus outbreak, more than twenty baby mothers would bring their babies to the hospital for vaccines in a day,” said Roseline Leabah, Vaccinator at the James Davis Hospital in Neezoe, Paynesville. “But the outbreak has caused some to flee to the villages to avoid contracting the disease because Monrovia is populated. This has caused the number of people coming for vaccines to drop that, in a day, now we sometimes receive ten or less.”
COVID-19 is, no doubt, a shock to pregnant women and new mothers.
Fresh memories of the Ebola virus disease still ring in the minds of Liberians, as do the precautionary measures from that experience, which still apply to the Coronavirus pandemic. Those urban residents who have fled to the villages believe rural spaces are less congested, making adherence to social distancing perhaps more realistic.
Madam Leabah further noted: “Those who get us to vaccinate almost every day now are the pregnant women coming to give birth. For them, they [have no choice but] to come because delivery comes with pain. When they come, they and their babies remain here and start their vaccines.”
According to Madam Leabah, they have vaccines in stock for diseases that are prevalent among the Liberian population and more are expected in the country shortly. “We pray that when the Coronavirus ceases, people will come. We vaccinators have not even been able to conduct public outreach since the outbreak,” she added.
Such inoculations are based on global healthcare standards that governments and health care providers adhere to to eradicate diseases like hepatitis A and B, typhoid, yellow fever, rabies meningitis, polio, measles, mumps and rubella (MMR), tetanus, diphtheria and pertussis, chickenpox, shingles, pneumonia and influenza, which continue to threaten the lives of both infants and adults. The World Health Organization (WHO) and the U.S. Centers for Disease Control (CDC) have recommended vaccines be taken against these diseases in a period of two years, for both mothers and their newborns.
Another health facility, the Benson Hospital, is also located in the populated city of Paynesville. It caters to over 150 prenatal patients monthly, and many of them, if not all, give birth at this hospital. During and after the prenatal period, they are immunized against diseases such as Yellow Fever, and Hepatitis A & B, and their babies are also registered to take vaccines prescribed for them over a period of nine months.
False, Mixed Messaging
Madam Theresa Cooper Kwalula, Nursing Services Director at Benson Hospital says: “Besides ignorance that sometimes causes people not to bring their children to the hospital for vaccines, there is information circulating that vaccine is being prepared for the Coronavirus and it is making people afraid, but nevertheless, some of them are still bringing their children.
In April this year, it was widely circulated on various media outlets that western scientists were considering the introduction of a newly developed Coronavirus vaccine to Africa to test on the population. Some variations of this narrative suggest that the vaccine would contain a kind of radio-frequency identification (RFID) chip that would store a person’s biodata, medical records and, in some cases, act as a form of advanced standardized identification.
Liberia’s population is predominantly religious — many of them are acquainted with Biblical prophecies concerning “the Mark of the Beast”. And with such information circulating, they are quickly reminded of the threat the “Mark of the Beast” poses to their belief and faith; something that also contributes to rejecting vaccines now.
However, Benson Hospital Medical Doctor, Richard Mapenza, says, “Any vaccine coming into a country is tested by the WHO to ensure that it is safe for the population, and the government will not remain here to bring vaccine that will destroy the citizens.”
A clinical staff at the Saclepea Comprehensive Health Center in Nimba County (name withheld), also explained that they have the WHO and CDC recommended vaccines in stock for diseases prevailing in Liberia, but because of the Coronavirus, many people living in that emergent city have left and gone to the villages until Liberia is declared free.
“We health workers even take vaccines for Hepatitis because we play with cases of the disease almost every day. But right now, not many people attend vaccine sessions because of the virus. As you know, people will obviously be afraid and flee to the villages because they will not want to come in contact with people who may have the virus. This is what has dropped the number of people coming for vaccines below ten in a day,” said the Midwife.
In Ganta, Nimba County, vaccinators also speak of a decline in vaccination due to low attendance. Alexander Gaye of the Power House Clinic and Yar Miaway of the Ganta United Methodist Hospital, in separate interviews, said the number of mothers and babies that used to attend vaccine sessions for different diseases have reduced during the COVID-19 pandemic.
Reports of “confirmed Coronavirus cases” in Nimba have been very controversial. All six cases recorded there were strongly disputed by families of patients claiming that those who allegedly contracted the virus and died did not show symptoms of the virus but died of different illnesses. In Nimba, Liberia’s second most populated county, there is a widespread belief that the County Health Team’s information about the Coronavirus is full of lies. As a result, many people have resorted to taking treatment in private drug stores or pharmacies, while others use herbs instead of going to the clinic or hospital.
“Some baby mothers are now saying that the vaccines we are giving for polio, yellow fever, measles and other preventable diseases are not the real vaccines but the one that is coming for Coronavirus. They say they cannot be guinea pigs to try vaccines on, said Yar Miaway.
“We will continue to tell the public that we have no other vaccines other than those we have been giving, and those few people who come, we tell them all about the vaccines and emphasize that they always come with their babies. But frankly speaking, people are not coming now as they did before the Coronavirus,” said Alexander Gaye.
The unfolding decline in attendance to vaccines is not a novel development to the Ministry of Health, the arm of the government that supervises health and its related activities.
Program Manager for Expanded Program on Immunization, Adolphus T. Clarke, said: “Due to the COVID-19 pandemic, we suspended health facilities outreach services because there was a myth that coronavirus vaccine was available and we were forcibly infecting people.”
According to Mr. Clarke, this ‘Myth’ has brought fear as well as distrust among community dwellers, thereby bringing a decline in immunization intake.
Prior to the COVID-19, the Ministry of Health recorded the coverage rate for pentavalent vaccine attendance in 2019 to be at 89.7% while MCV 1 was 89.7%, but Mr. Clarke says the coverage for the month of April in 2020 dropped for Penta 3 to 49% and MCV1 to 46%.
In order to avert future outbreak and improve immunization coverage rates, Clarke says they are carrying on a communication risk assessment study to determine the level of penetration of misinformation about vaccination; conducting Periodic Intensification of Routine Immunization and supportive supervision, and commencing health facilities outreach activities. He also named other activities as, installation of 103 pieces of new generation cold chain equipment, and procurement and distribution of Yamaha Motorcycles to 60 health facilities.
The Ministry’s Expanded Program on Immunization is dated as far back as 1978, and its goal is to reduce the morbidity and mortality of vaccine-preventable diseases in children from 0-23 months; adolescents (9 years old girl), and women of childbearing age (15-49 years).
The Liberian health system has the following vaccines available for immunization: Oral Polio Vaccine, Inactivated Polio Vaccine, BCG, MCV, PENTAVALENT Vaccine, ROTAVIRUS Containing Vaccine, PNEUMOCOCCAL Conjugate Vaccine, Yellow Fever, HUMAN PAPILLOMAVIRUS, Tetanus-Diphtheria, and Typhoid Conjugate Vaccine.