Community Based Care & Support for COVID-19
Tanya Dhingra, #COVIDActionCollab
December 1, 2021
There are many vulnerable communities that have been alienated from the overall vaccination drives. #COVIDActionCollab (CAC) has been organizing special camps for these communities. There were a series of such camps organized specially for the transgender community by CAC partners Swasti and Samara. Hareesh BS, Sanjeev G Pujar, and Narayanagowda KV from Swasti have been deeply engaged with many such camps. Tanya Dhingra from CAC spoke with them after one such camp in Bengaluru, which successfully vaccinated over 200 trans people. The excerpt is here:
Community Based Care & Support for COVID-19
Tanya: What do you think are the reasons for vaccine hesitancy in the transgender community?
Hareesh: There are three reasons. One is that most transgenders consume alcohol regularly and there is information [going around] that you cannot take alcohol [for] 20 days [after] vaccination. Even though there is no data to back this information, there is still speculation and that’s why they have some questions and reservations. The second thing is [that] many trans people take hormone medicines, so they have some doubts if there are any side effects [contraindications] with that if they take the vaccination. And the third reason is that HIV prevalence is very high among transgenders [for which] they are on antiretroviral treatment. So that is another confusion if there are any side effects [contraindication] with the treatment and vaccination. So these are the three major reasons for them to be a little reserved about the vaccination.
Narayanagowda: If this kind of false information comes straight from the heads of their gharanas [community households] it’s followed by everyone. Trans people depend on sex work and begging for livelihood. They know that after taking vaccination, they will have fever and body pain, and lose earnings for a few days. So for that reason, most of them are not willing to take the vaccination.
Tanya: What are some barriers that the transgender community faces in getting vaccinated?
Narayanagowda: From what we have seen, trans people don’t like going to PHCs, which were vaccination [centres], because they are identified as a third gender. They don’t like facing personal questions from people about their gender.
Hareesh: From a previous program with transgenders on primary health care, we understood that even for their primary health care, they don’t go to any hospitals nearby. They go to the hospitals referred by their community members that are sensitive and treat them well. [Usually]if they go to the other hospitals, most of the medical service providers ask unnecessary questions and make unwanted advances. So, that is true [even for] vaccination. The second thing is the Co-Win registration which is a digital barrier for them.
Tanya: How did you encourage the community to get vaccinated in these special camps?
Narayanagowda: We told them it is necessary because the infection rate of COVID-19 is high and it can be life-threatening, and once they take the vaccination, their friends and family members are going to be safe. They also go out for begging and sex work, so [we explained how] if they are not vaccinated, their chances of getting the infection from clients is high. After understanding these risks, they were willing [to come and get vaccinated]. And there is motivation from their community leaders and friends. [For example,] in one particular trans group, 60% of them were educated. They were getting their information from news and print media and with their influence, others were willing to take the vaccination.
Hareesh: A huge part was [played by] the community organization called Samara. The head and the staff of the organization came forward to [motivate by] saying that they were also vaccinated and encouraged [the] heads of gharanas to get vaccinated. Also, 15 days before the camp, Dr. Swathi from PCMH did a webinar on vaccination to address the concerns and issues raised by the transgender community. Trans people rarely go to the nearby PHCs even though they get vaccines [there]. One reason is [the] discomfort in standing in the queue with the general community. If you observe, they don’t travel in public transport, very rarely do they use the BMTC bus. They have had bad encounters with the public, that’s why normally they use their own autos. And since the special camp was [not far]and there was no long queue [with the general public]. So these things made them come for a vaccination.
Tanya: What do you think can be the way forward in vaccinating the community? What steps can CAC take to ensure that more members of the community have access to vaccination and they have more accurate information on vaccination?
Hareesh: One is to make sure their leaders are convinced about the vaccination and they are getting the vaccination first so that they can share their experience. Their positive experience will encourage others to come forward to take the vaccination. The second thing is to make sure these camps are conducted in nearby places because they don’t use two-wheelers or four-wheelers or any public transportation. It should also not be early in the morning because many community members who practice sex work work till midnight, [so] you have to start [vaccination camps] after 10:30 am.
Narayanagowda: It’s very important to involve a community organization because they will act as a bridge with the community.
Tanya: What drives you people to go out and work with the communities? We know these are scary times and there’s always a risk. So what drives you to continue working as you do?
Sanjeev: What is driving us is ownership, passion and positive energy. We are healthcare workers, if we are at home, then who will serve?
Hareesh: For the last 20 years we have been doing community interventions and this pandemic is a one-time opportunity for us to serve the community. When you see the community, when you’re with them, you understand their needs and look at the possibilities of what can be done. It strengthens you to do something and motivates you to do 100 times [more]. And you don’t need any other motivation. As development professionals, it is our role. [Also] when the community leaders are there with us and also want to do something for their own community, that is another motivation for us do more and more for the community.
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