Vaccinating Colombia’s remote, Indigenous communities against covid-19
LA GUAJIRA, Colombia — The vaccination team had spent an hour bouncing and bucking down a dirt road and over train tracks when the van driver issued a warning.
It was the last part that would prove to be most difficult.
Two women held onto their cushions, as the van jostled. Then they climbed up a mountain of dirt and then fishtailed through the muddy mud. As he drove along a trail of only tire tracks, driver Toto Girnu honked and snarled at the goats. He spotted menacing, dark clouds in the distance.
If there were members of the group, If you are lucky enough, the journey through this desert remote would only take about four to five hours. The drive could last longer if it was raining, just like Girnu did it earlier in the trip.
This was however the only route to get to Indigenous families living in the north department of La Guajira. There aren’t any roads or electricity and there is no way for them to access the vaccines they need.
Travel is only part of the challenge confronting the team, one of many contracted by the Colombian government to deliver vaccines to some of the country’s remotest peoples. A lack of information on the coronavirus is common, as well as hesitation about vaccines and general distrust of authorities.
The van, “Route of Hope” written across the windshield, came upon a roadblock. The road was blocked by children and adults who strung ropes to the side of their vehicle, which could be lifted in exchange for cash, food, or water.
“Are you vaccinated?” vaccine team coordinator Katherin Gamez shouted to a young man. Girnu gave him a thumbs up, gave him water, and then translated his question into Wayuunaiki (the language spoken by the Wayuu indigenous people).
“For what?” he asked.
The Andes is a region where there have been reports some of the world’s Teams are traveling to remote areas in search of isolated vaccines. Community.
Colombia is a nation of over 48 million inhabitants. 16 percent live in rural areas, which are often neglected. The government was not involved in more than 50 years of conflict.
Magdalena’s northern district is home to a vaccinator who rides on horses up a steep mountain and then takes off on foot. One team travels by boat for days in Amazonas. In Chocó, criminal groups add another challenge.
About 35 percent of Colombia’s population has been fully vaccinated, according to the Health Ministry. More than half of residents in major cities — 62 percent in the capital of Bogotá — have received at least one dose.
But in La Guajira, home to the country’s largest Indigenous population, only 38 percent have received at least one dose. Other departments have rates as low as 20%.
Many Wayuu have mistrust for the system of health because they’ve witnessed years of mismanagement and abandonment by government officials in La Guajira. Human Rights Watch says that 41% of Wayuu residents have no access to safe water. reportedLast year, 77 percent Indigenous households were food insecure. Alta Guajira is home to the most Wayuu population. There’s only one hospital and it provides only basic healthcare. For specialized care, people must travel up to six hours from Alta Guajira to Riohacha.
“By the time a lot of them get to care, they’re so near death … there’s this perception that maybe the care didn’t help,” said Shannon Doocy, an associate professor of international health at Johns Hopkins who co-wrote the Human Rights Watch report.
The lack of testing in La Guajira rural makes it hard to determine the true impact of this pandemic. However, one thing is for certain: If someone falls ill in Alta Guajira with covid-19 it can be difficult to access the necessary care.
That is why van went to the tip of the North. This is the Department.
“We’re getting close,” Girnu told Gamez and Eliana Andrioly, the team’s Indigenous leader. As they raced down the salt flat, their views were obstructed by miles of sand and distant bays.
Yout was late afternoon when the group arrived at a medical center in the Bahía Honda area. Waiting for them was a team of nurses assistants as well as a doctor. They spend fifteen days in a dormitory. The next-door neighbor, who sleeps in hammocks while showering with buckets full of water to carry out daily medical missions to surrounding villages, is also a volunteer.
The organization, IPSI Palaima — “land of the sea” in Wayuunaiki — was founded in 2007 by an Indigenous woman who grew up in the area. Alta Guajira is the only area that has a vaccine fridge, and it’s powered entirely by solar power.
Daniela Vergara was this week’s team member responsible for shots. She is a 21 year-old nursing assistant and had never been in Alta. Guajira, before she applied to the job.
LEFT Daniela Vergara (21 years old) rests on a hammock in the same room as two other Edita Freyle de Andrioli Health Center staff. READ: The IPSI Palaima team travels by boat to reach a small community in La Guajira’s Bahía Honda area. Vergara has an item in her bag which contains the cooler that holds vaccine vials.
Each day, Vergara aims to vaccinate at least 10 people — a modest goal that often requires a massive effort.
She hadn’t yet made it to her goal on Monday. She packed her cooler — a blue backpack filled with vials of the single-dose Johnson & Johnson shot that has been a godsend to rural vaccine teams — and set out for a community across the bay.
The fastest way to arrive would be by boat, so Vergara and the other members of the IPSI Palaima team packed into Girnu’s van and drove the 20 minutes to a dock. The boat took them up to a rock cliff with views of the turquoise sea.
A member of the local community then offered to ride the truck on its wooden back.
They traveled to the gathering spot where they were hoping to meet others interested in the vaccine.
“There’s no one here,” Vergara said. “We got here too late.”
Local leaders suggested that they move house to house. When it was dark, team members asked any person 18 and older whether they were interested in the vaccine.
Soon, a woman told of a common rumor that had circulated: outsiders wanted to create a deadly vaccine for the Wayuu people.
This woman was a Spanish-speaking teacher and knew exactly what was at stake. The virus had struck her a few months prior to this, following a trip from Uribia. The virus left her with chest pains, severe headaches, intense cough, and loss of smell and taste for over a month. Traditional Wayuu remedies were used to treat her. It was her concern about the 66 year-old neighbor that had not expressed an interest in having a shot.
“Many people are dying from this disease,” Juan Larrada, a Wayuu doctor in the group, said in Wayuunaiki. While side effects may occur with the vaccine, they would be protected from more serious illnesses. Amaita Uriana was asked why she didn’t want the vaccine.
“Because I was afraid of getting sicker,” she said. “I really feel very sick. There are many pains in my body. That’s why I refused when a girl came here for the same reason. Plus, she was extremely pretentious. And we had already heard about the experiences of other Wayuu who had been vaccinated and become ill.”
“The vaccine can have those effects,” Larrada agreed. “Fever, muscular pains, that’s normal.”
Uriana understood the doctor’s language and agreed to speak with him. She Vergara shut her eyes, and she emptied the Syringe into Vergara’s hand.
TVergara pulled her hair back and took a bottle of water with her to the gym.
As the driver drove along the coast and across the desert, she held onto one hand while holding on to the cooler in the other. Vergara asked her driver to blast. vallenato — the Colombian folk music popular along the Caribbean — so she could sing along. Trailing her, on the back of another motorbike, was Micaela Epieyu, the team nurse in charge of children’s vaccines.
Vergara was worried that the outsider would distrust them if they didn’t speak Wayuunaiki as their first family. Epieyu who can fluently speak the language, offered to translate.
Although soft-spoken, the 29-year old was timid. The family became more like hers when she started talking with most mothers. Epieyu, who was under 12 years old, stayed with her mother in Maicao. Vergara is a single mom with a one-year old son who lives with his grandmother. They were both counting down to the day when they would be able to return home.
Vergara was able to vaccinate five individuals in under a minute.
Just a few minutes away, they discovered a large family of over 10 people living in an old home built of sticks and wood.
“Vaccines deceive,” Cristina Pushaina told Epieyu. “A month ago, our uncle died from being vaccinated.”
According to her, a young girl in the village died after she was taken to an faraway hospital. The funeral for her traditional Wayuu was held at the home of her relatives.
Pushaina used a fish bone to scrape a fruit peel known as a taza de mono — a monkey’s cup — to extract a juice used in traditional medicine to treat stomachaches and child malnutrition.
“We trust the medicine made by our own hands,” she said. Not the medicine of an “alijuna” — an outsider. “This liquid that you want to inject in us, we don’t know who prepares it or how.”
“With any type of injection,” she said, “the Wayuu always die.”
Their fears were like those of others around the world who have rejected vaccines — fears based on misinformation, disinformation or lack of trust. The rumors spread even though there is no electricity or cell phone reception and locals seldom interact with outsiders.
Alta Guajira’s mistrust is deeper than that. It’s a community that has for generations suffered from malnutrition and food insecurity made worse by corruption– Mismanagement of both the local and regional governments, as well as in public funded health-care providers.
Families here have survived almost entirely on their own relying on fishing and goat herding for food — and on medicinal treatments passed down by their ancestors.
“If our grandmothers had been alijunas,” Pushaina said, “we wouldn’t exist.”
Vergara, Epieyu didn’t try to press the family further. It was their choice.
The nurses realized that they had limited options and missed an excellent opportunity. It would have been impossible to convince everyone, no matter how many times they drove from one house to another in the desert.
After completing the ride, they got on to their motorbikes again and headed for home.