Nilgiris, in Tamil Nadu’s Western Ghats, is home to many tribes (Toda, Kota, Irula, Kurumba, Paniya, and Kattunayakan) and approximately 500 tribal towns spread across its historic hills and forests.1
During the first wave of the COVID-19 pandemic, from April 2020 to November 2020, the district of Nilgiris was relatively unscathed; its highest seven-day average case load was 131 cases per day, compared with the state average of approximately 6,800 cases per day.2 However, the second wave, from March to July 2021, severely impacted the tribal communities in Nilgiris, which had a high seven-day average case load of 558 cases per day (four times the caseload during the first wave).3
When the COVID-19 vaccination campaign began in January 2021, the initial response in Nilgiris was lukewarm. In general, the participation of the Indigenous population in vaccination camps across the country has been low, but the story from Nilgiris in recent months offers a counternarrative. The Nilgiris district administration, in collaboration with local nongovernmental organizations (NGOs), used a creative technique to raise awareness among tribal communities. These NGOs, which had been working with local residents for years, helped get the COVID-19 vaccines to people living in the remotest corners of the region.1 Due to these efforts, on June 30, 2021, Nilgiris became the first district in Tamil Nadu to provide the first dose of the vaccine to 100% of the eligible tribal population (18 years and older) and 100% of eligible tea-estate employees.4
How can you replicate/implement this promising practice?
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What are the lessons learned from this bright spot?
Rumour-mongering and fake news on social media such as WhatsApp and Facebook had instilled fear and made people more hesitant to get vaccinated. In Nilgiris these fears were largely related to death and impotency in men post-vaccination.
“Like it was in rural hinterlands across the country, fake social media posts, WhatsApp forwards and rumours, fuelled fears and there was a considerable reluctance.” — J Innocent Divya, District Collector, Nilgiris1
Awareness-raising campaigns
The district administration was aware that persuading people from tribal communities to get vaccinated would not be easy, as they were not comfortable visiting health care facilities. Hence, the administration requested that community leaders get vaccinated first to instill confidence, faith, and optimism in the rest of the community. Teams consisting of volunteers from NGOs, doctors, and ASHA workers were sent to persuade the village leaders, and every town and community went through the same procedure.5
“We felt that Adivasi communities should not be asked to visit their local PHCs [primary health centres] or hospitals, as this might make them even more hesitant to take the vaccine, so we are taking the vaccines to them in their own villages.” — Supriya Sahu, Principal Secretary to the Tamil Nadu Government, Environment, Climate Change & Forests Department, and CEO of INDCOSERVE6
Targeted vaccination drives
The vaccination campaign was carried out in stages, with the nomadic tribal people (Todas and Kotas) living in the upper reaches of the Nilgiris the first to be inoculated. Then the campaign was extended to people living on the plateau, including the Paniyas, Kurumbas, Irulas, and Kattunayakans. These were the people who had the most apprehension about the vaccine. Here, the NGOs played an instrumental role in social mobilization and creating awareness.6
Out of 27,032 tribal people in the district, 21,435 were eligible for vaccination. The targeted efforts paid off, with the entire eligible population among the tribal communities, barring those with contraindications, receiving their first dose by June 30, 2021. Thus, according to the Nilgiris collector J Innocent Divya, Nilgiris accomplished nearly 100% immunization of adults over 18 years old.7
How was this promising practice implemented?
“It was very difficult to convince them. We sought the help of NGOs who were working among the tribal population. Since they trusted the NGOs, they listened to them and agreed after much thought and persuasion. The role of NGOs is crucial in this achievement.” — J Innocent Divya, District Collector, Nilgiris7
Fostering collaboration and partnerships
District administrators contacted key personalities, such as Supriya Sahu, the CEO of INDCOSERVE, India’s largest tea cooperative federation; Dr. Tarun Chhabra of the Toda Nalavazhvu Sangam (a local NGO); and M. Alwas of the Nilgiri Adivasi Welfare Association (NAWA), who contributed resources and infrastructure to facilitate vaccination drives. Every village went through the same procedure. Representatives from local NGOs held a meeting with community leaders from each village. They explained the benefits of vaccination and requested the leaders to educate their own community members to get inoculated. The teams then encouraged the village leaders to be vaccinated first to instill faith and optimism in the rest of the community.6
“When teams from PHCs and health workers from the government did not meet with much success in the tribal communities, the collector co-opted the help of NGOs in the district that worked on the field for better reach and result.” — M. Alwas, Secretary/CEO of the Nilgiris Adivasi Welfare Association (NAWA)1
Under the stewardship of Supriya Sahu, the monitoring officer, the following steps were taken:
Providing social messaging in local languages
The NGOs enlisted the help of community members to write songs in tribal languages to share the benefits of getting vaccinated. The district administration also recorded statements from village leaders in their own languages, regarding the vaccine’s effectiveness, and broadcasted the messages throughout the district’s different villages. When people observed that their leaders were fine after vaccination, and heard them address misconceptions, they were more open to the idea of getting inoculated.1 One of the awareness campaign’s punch lines was “Vandhu vaccination podu, super starra thirumbi po” (Come, be vaccinated, and return as a super star).8
Conducting door-to-door vaccination drives
Door-to-door vaccination campaigns and special camps were organized around the tribal communities’ work areas. To reach these areas, health workers had to travel for hours through thick jungles and cross tough hilly terrain.1 But they persisted in their efforts, took the necessary precautions, and overcame the logistical barriers to successfully implement the vaccination drives. These vaccination campaigns also addressed nutritional needs by providing food and dry rations during the door-to-door visits.9
Supplementary material
Sources
- Srinivasan P. In the Nilgiris, local NGOs roped in to vaccinate tribal communities at their doorstep. Gaon Connection. June 14, 2021. Accessed July 22, 2021. https://en.gaonconnection.com/tamil-nadu-nilgiris-covid-vaccination-tribal-communities-second-wave-corona-vaccines/
- Government of Tamil Nadu. Daily report on public health measures taken for COVID-19. Media Bulletin 31.05.2020. Published May 31, 2020. Accessed August 13, 2021. https://stopcorona.tn.gov.in/wp-content/uploads/2020/03/Media-Bulletin-31.05.2020.pdf
- Government of Tamil Nadu. Daily report on public health measures taken for COVID-19. Media Bulletin 31.05.2021. Published May 31, 2021. Accessed August 13, 2021. https://stopcorona.tn.gov.in/wp-content/uploads/2020/03/Media-Bulletin-31-05-21-COVID-19-1.pdf
- Koushik J. Nilgiris inoculate all eligible tribals with first dose of Covid-19 vaccine. Indian Express. June 30, 2021. Accessed July 22, 2021. https://indianexpress.com/article/india/tamil-nadunilgiris-covid-19-vaccine-7383177/
- Goode N. How Tamil Nadu’s Nilgiris vaccinated all eligible tribal people with first dose. The News Minute. Published June 30, 2021. Accessed July 22, 2021. https://www.thenewsminute.com/article/how-tamil-nadu-s-nilgiris-vaccinated-all-eligible-tribal-people-first-dose-151510
- Coronavirus | Efforts taken to overcome vaccine hesitancy among Adivasi communities in the Nilgiris. The Hindu. May 13, 2021. Accessed July 22, 2021. https://www.thehindu.com/news/cities/Coimbatore/coronavirus-efforts-taken-to-overcome-vaccine-hesitancy-among-adivasi-communities-in-the-nilgiris/article34549313.ece
- Sivapriyan ETB. Nilgiris almost completes vaccination among eligible tribal population. Deccan Herald. June 29, 2021. Accessed on July 22, 2021. https://www.deccanherald.com/national/south/nilgiris-almost-completes-vaccination-among-eligible-tribal-population-1002943.html
- All eligible tribals in Nilgiris get first dose of Covid-19 jab. Times of India. June 30, 2021. Accessed July 22, 2021. https://timesofindia.indiatimes.com/city/coimbatore/all-eligible-tribals-in-nilgiris-get-first-dose-of-covid-19-jab/articleshow/83969436.cms
- Chandrababu D. Almost all tribals in Tamil Nadu’s Nilgiris vaccinated for Covid. Hindustan Times https://www.hindustantimes.com/india-news/almost-all-tribals-in-tamil-nadu-s-nilgiris-vaccinated-for-covid-101625076862586.html. Published July 1, 2021. Accessed on July 22, 2021