COVID vaccine reaches most remote communities in Lesotho

A Mission Aviation Fellowship aircraft is the only way to safely deliver COVID-19 vaccines to the mountain people of Kuebunyane.

On Tuesday 23 March 2021, Mission Aviation Fellowship (MAF) pilot Grant Strugnell delivered the first doses of AstraZeneca COVID-19 vaccine to a mountainside clinic near Kuebunyane – the most remote airstrip in Lesotho. Kuebunyane comprises several remote villages with a combined population of more than 62,000[1] and is an eight-hour overland journey from the nearest hospital facility in Qachas Nek. The journey involves a steep, four-hour hike across a deep valley to reach the nearest road, which is a further four-hour drive to Qachas Nek – a journey too difficult for the vaccines to achieve without spoiling.

Transporting three nurses from the Lesotho Flying Doctor Service (LFDS), a division of the Lesotho Department of Health flown exclusively by MAF aircraft to deliver medical care in remote areas, approximately 60 health workers received their first COVID-19 vaccination. Many recipients of the jab walked across mountainous terrain from surrounding villages to reach Kuebunyane, which is located 2,293 metres above sea level.

The 30-minute flight from the capital Maseru to Kuebunyane achieved a journey impossible by road – making MAF’s aircraft the only way to accomplish the critical last-mile of delivery. The AstraZeneca vaccine must maintain a temperature between two and eight degrees Celsius, and specially designed cooler bags were stowed alongside PPE and other medical equipment in MAF’s Cessna 206 aircraft to ensure a safe ‘cold chain’ was maintained throughout the journey.

The Lesotho government has prioritised frontline health workers and clinic staff to receive the first 36,000 doses of the Oxford-produced AstraZeneca vaccine, which arrived in Lesotho on 4th March. WHO representative Dr Richard Banda described the arrival of the vaccines as a “momentous occasion”[2] for a country which has so far confirmed 315 coronavirus deaths and 10,686 infections[3].

Lesotho’s vaccines are being facilitated by the COVAX programme, a joint venture between GAVI Vaccine Alliance and the WHO to ensure equitable distribution of COVID-19 vaccines across low and middle-income countries. The UK Government is one of the biggest donors to COVAX, contributing more than £540m to secure over one billion doses for vulnerable populations like Kuebunyane.

MAF also delivered 140 doses of the AstraZeneca vaccine to Labakeng on Monday 22 March, and a further batch of AstraZeneca vaccines and accompanying cargo to Matsaile on Friday 26 March. These two remote mountainside clinics in central and eastern Lesotho are also unreachable by road and a similar immunisation programme was achieved to immunise community healthcare workers from surrounding rural villages.

South African pilot Grant Strugnell, who has flown with MAF in Lesotho since 2018, said:

“Kuebunyane is one of the locations we fly to most because reaching this location by road is just too difficult. The clinic is located on a steep mountain ridge, four hour’s trek from the nearest road. On average MAF lands there twice a week, offering the only air service to connect this remote region to vital medical supplies and personnel.

“Some recipients of the jab were not nurses, but members of the community who have a little extra knowledge of primary healthcare, so it’s really good news that they were included in this round of vaccination.

“MAF is really grateful to be partnering with the government and Lesotho Flying Doctors Service to deliver vaccines to the harder-to-reach clinics across Lesotho. I’m pleased that MAF aircraft are so well suited to this critical last mile of vaccine transport. By offering a journey of half an hour rather than eight, these vaccines can arrive at the required temperature.”

With a history of rural vaccine delivery spanning more than six decades, MAF is ready to play a critical role in the COVAX vaccine roll out, offering cold-chain air transport solutions in 21 of the low-middle income countries identified by the scheme. MAF flights will make it possible for some of poorest and most remote communities to receive COVID-19 vaccines maintained at the correct temperature from the beginning to the end of their journey.

MAF’s International Development Manager Vaughan Woodward said: “MAF is ideally positioned to assist in more critical last mile deliveries of COVID-19 vaccines and is working directly with health authorities, NGO partners and local health contacts across the world to make this happen.

“As we speak, MAF is preparing our fleet and staff for more vaccine deliveries, including those requiring super chilling such as the Pfizer vaccine. Preparations include obtaining freezers for our aircraft, purchasing CO2 monitors for carrying dry ice, and ensuring suitable protocols to meet aviation safety regulations.

“As an aero-logistical specialist, MAF can overcome a variety of logistical challenges including secure transport of needles, syringes and safe passage for medical staff to accompany vaccines and carry out remote area vaccination programmes in inaccessible or dangerous locations. While sadly the demand for COVID-19 vaccines continues to exceed supply in the most vulnerable countries, MAF teams are doing everything they can to provide global, last-mile delivery of vaccines as quickly and safely as possible to ensure equitable access for the most isolated communities.”


[1] World Bank 2017

[2] https://www.aa.com.tr/en/africa/lesotho-receives-1st-batch-of-covid-19-vaccines/2164388

[3] https://covid19.who.int/region/afro/country/ls

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