The Advasi-dominated areas of Maharashtra’s Palghar district aren’t just experiencing vaccine hesitancy – they are seeing downright vaccine refusal. While people stand in long queues to get the shot barely 100 kms away in Mumbai, many vaccine centres here are deserted.

This has led to the curious situation where city residents, using the government’s Cowin app, have found appointment slots in Adivasi areas and driven there to get vaccinated. The activist in me demanded action. How can vaccines meant for Adivasis be diverted to the urban folk ?

The problem was that the Advasis themselves were not feeling cheated of their quota of vaccines. In fact, they did not want them at all. To raise their voice against the injustice of supplies being used by privileged beneficiaries from other places, people must first believe that the vaccines are good, effective and necessary.

But how can we demand the vaccine if they are living in denial of the disease itself? Despite hundreds of people suffering from high fever and other Covid-19 symptoms and a fair number succumbing to the disease in almost every village in the area, residents claim that it was merely a fever epidemic, not coronavirus disease.

‘The vaccine kills’

During the recent weeks, I and other members of the Kashtakari Sanghatna adivasi rights organisation have held more than 50 village level meetings in the four talukas of Dahanu, Jawhar, Vikramgad and Mokhada. The conversation in a typical meeting went something like this :

Local people: “We don’t want the vaccine. The vaccine kills.”

Activist: “I have taken the vaccine, and I’m very much alive. So are all the ASHAs and anganwadi workers in your village. They too have taken the vaccine.”

Local people: “You were given a shot from a good stock of vaccines. We Adivasis will be given injections from vaccines whose expiry date has gone by.”

Activist: “I took the shot in a primary health centre in an advasi area. I have suffered no side- effects.”

Local people: “Oh, effects will be seen only after six months.”

Activist: “How do you know that effects will be seen after six months? The vaccine has been administered in India for not even four months. Where did you hear about this six-month business?”

Local people: “The vaccine makes you impotent.”

Activist: “Whom do you know who has become impotent after taking the vaccine?”

As is evident, many of the fears were based on misinformation and illogic. The death of a former local MLA and at least three of his colleagues due to Covid19 has played a major role in deterring people in this area from taking the vaccine. People claimed that he died not despite taking the vaccine, but because he took the vaccine.

A discussion about Covid-19 in Murbad village in Palghar district. Credit: Kashtakari Sanghatna

People also tended to confuse all injections with the vaccine. Their logic went like this : Corona patients went to hospital. They were given injections, they subsequently died. The vaccine is an injection, I will therefore not go to a hospital and I will not take the vaccine.

So we had to deconstruct all these deductions. We printed 150 flex banners and erected them at nakas and in remote villages. The banners bore the photographs of three of our activists, who are well-known in the area, with one simple message: “People do not die if they take the vaccine. We have taken the vaccine. When will you do so?”

The Sub-Divisional Officer of the area followed a similar strategy. She instructed the Medical Officer in a primary health centre to invite “bhagats” or local medicine-men, for a discussion. Four of those who attended took the shot. The official got their interviews recorded and is now using them as a tool for awareness building about the vaccine.

Another challenge we faced was that Adivasis said that those who had contracted fever are now back on their feet after taking herbal medicine given by “bhagats” – so why did we need doctors? They said that most of those who went to hospital died anyway. Admittedly, the logic was confused, yet compelling.

When the allopathic system is unable to deliver the goods, when there is no fool-proof drug for Covid-19, when oxygen beds and ventilators are almost non-existent in the hospitals in Advisavsi areas, on what moral grounds could we advocate that they must access the modern system of medicine?

We avoided the trap of advocating in favour of or against the modern system of medicine for treatment. Our message was clear: to prevent the infection, you must take the vaccine. If you wish, take your kadha made from herbs and pounded tree-bark, or sacrifice a goat to appease the gods. But along with that, you must also take the vaccine.

A banner in Pulachiwadi in Palghar district that aims to overcome vaccine hesitancy. Credit: Kashtaka Sanghatna.ri

We appealed to people’s own lived experiences. We reminded them that vaccination as a concept is not new and that they had all taken vaccines as children. People were able to relate to the fact that both smallpox and polio have now been eradicated due to the universal vaccination programmes. People began to understand the value of a vaccine and the unmatched role it plays in preventing a disease.

But while people began to agree to what we said, they were still not ready to take the vaccine. And that’s the crux of the matter. Irrational fears do not go away by logical deduction. Perhaps one has to address fear by counter fear.

So, we talked about the impending third wave. About how the third wave is likely to strike villages in full force, while its impact in cities may be less as people there will be vaccinated. We noted that the likelihood of children getting infected was high. We explained that it was likely that only those who have been vaccinated would be permitted to be at their children’s bedside if they were admitted to hospital.

We tried all types of arguments. In one village, I even played the religious card. While referring to the fact that Covid-19 has been fairly controlled in Israel due to near-universal vaccinations, I reminded the villagers of a Christian village that Israel was the birthplace of Jesus Christ.

While people have to themselves come forward to take the vaccine, it is the duty of the state to frame a vaccine policy that is inclusive, hassle-free, decentralised and non-discriminatory. It is good that online registration is now no longer mandatory, as this was discriminatory against the poor, elderly and rural areas where internet connectivity is poor.

Youth lead the way

Primary health centre-level vaccination centres must be replaced with more accessible village level camps, as is the normal practice in other vaccination programmes. While older Adivasis here are reluctant to take the vaccine, youth are coming forward. In Advasi areas, the government should have lowered the age criterion from above 45 to above 18 years a long time ago because it is more likely that the elderly will follow once the youth lead the way.

I have never ever been so seriously challenged while discussing issues with villagers. In some villages, I felt despondent and defeated. Some villagers even told us that our role was to organise protests and not to play with their lives. Thankfully, we have not faced hostility as some government awareness-building teams did – some officials were threatened and even assaulted.

Due to our long association with the villagers, they listened intently out of respect but many remained non-committal. But it was also so rewarding when one old man said, “I was afraid to take the vaccine, but you have given me courage. I will take the vaccine now.”

Since a few people have now begun taking the vaccine, we feel that we are going forward. But with not even 0.5% of the population having taken the vaccine yet, there’s a long long way to go.

Brian Lobo is a member of the Kashtakari Sanghatna in Dahanu.