Covid-19 Vaccine Hesitancy Among Tanzania’s Remote Communities

MAF medical flight reveals coronavirus vaccines are turned down by rural Massai due to ‘complex fears’

In November 2021, South-African relief pilot Andrew Parker departed from Arusha, North-east Tanzania, to transport three medical workers and supplies to help remote communities across the South Maasai region. On board the Cessna 206 aircraft – one of 132 humanitarian planes operated by Mission Aviation Fellowship [MAF] – were inoculations including the coronavirus vaccine.

People living in isolated parts of southern Kenya and northern Tanzania are without local medical care or reliable forms of transport, and they depend on flights made by MAF to access healthcare services, education materials and basic supplies.

It’s thought that the Maasai people occupy an area covering 160,000 square km, with an estimated population of half a million. Many Maasai still live traditional nomadic lifestyles and herd livestock across vast stretches of bushland.  

A recent MAF trip performed by Andrew revealed a resistance to the coronavirus vaccine in one region, despite doses being flown by MAF and made available at rural clinics.

The flight in November, known as a ‘South Maasai medical safari’, is a monthly shuttle service provided by MAF, which has been operating in the remote regions of Tanzania since 1977.

By maintaining reliable cold-chain conditions, MAF aircraft can safely deliver vaccines and medical equipment to harsh, isolated locations such as the South Massai, where temperatures can exceed 35֯C. Historically, jabs transported safely by MAF have helped keep highly infectious diseases under control, yet it appears that in some rural locations like this one, the formal coronavirus vaccination programmes are yet to gain traction, despite the Tanzanian government securing doses and encouraging a national uptake of the jab.

On 17 November, Andrew landed on three dirt and grass airstrips at Same, Katahe and Lesirwai – areas which can only be accessed by piki piki (motorcycle taxi) or by foot and can take many hours of difficult overland travel to reach. Each of Andrew’s flight legs lasted between 10 and 45 minutes.

During MAF medical safaris such as this one, small teams perform ‘pop up’ clinics close to an airstrip, offering vaccinations against diseases such as polio, measles, and typhoid as well as antenatal and prenatal checks. Among those who attended the November medical safari were pregnant women, mothers with young babies and children.  

Andrew – who has been an MAF pilot since 2009 and flown in various parts of East Africa including Uganda, South Sudan, and Kenya – has performed many medical safari flights in Tanzania. But his recent trip revealed fear and hesitation towards the Covid-19 vaccine among the Maasai people.

Andrew said, “The general impression seems that people are quite sceptical of the [coronavirus] vaccine itself. From my experience in Uganda and Tanzania, some people seem to believe that you can’t have children if you’ve had the vaccine, so it really makes people hesitant.

“The Lesirwai clinic was under a tree and maybe 40 or 50 people attended. Towards the end of the clinic, I went to chat to the staff and a handful of local people. The medical team were talking about coronavirus, asking if they knew people who had it, what did they think about it and whether they were scared of it.

“A team member had a little cooler box which had some Covid jabs – they were trying to get an idea of whether people were open to it. No one accepted [a coronavirus vaccine] on this occasion. Certain diseases are kept under control because of these clinics, but it seems there is a lot of misinformation about coronavirus.”

South Massai Community Development Worker Martha Katau says patients have been known to walk up to 20 or 30km to receive medical care at MAF bush clinics: “There is no school, there is no hospital, there is no transport, it’s just a remote area – I can say it is a forgotten land. People are roaming around the bush grazing cattle; they don’t see the importance of education or vaccination.

“Before [the MAF medical safaris], communities used a dispensary, women walking 20 or 30km with babies in their stomach or on their backs. Some pregnant mums give birth on the way, others are dying when they go into prolonged labour. It’s dangerous for them. There is a high need of MAF’s service, MAF helps patients who are seriously ill – they take them to hospital.”

Throughout the pandemic, MAF has transported over 10,000kg of coronavirus vaccines, PPE, and education materials about the disease to isolated locations in low-income countries including Timor-Leste, Madagascar, Papua New Guinea, and Lesotho.

But – as this flight demonstrates – getting the vaccine to an isolated location is only half of the challenge, with many complex factors limiting a widespread take up of the jab.

MAF’s editor and writer Emily Davies said, “Andrew’s account shows that sometimes getting the vaccines to an isolated location is only half the battle. There are many complex reasons behind vaccine hesitancy, some of them rooted in misinformation and fear that needs carefully unpacking. More time and education are needed before vaccines make it into arms – something MAF is willing to support alongside healthcare providers and is already delivering in various rural locations.”

Early in the pandemic, MAF prepared its operations to respond to requests for Covid-19 vaccine delivery across the low-income countries where it flies – including procedures for handling dry ice [used to freeze brands such as Pfizer and Moderna] and safe transit for equipment such as syringes and sterilising fluids. However, in recent months, last-mile delivery of the coronavirus jab has been limited, and MAF is more commonly assisting with education and medical evacuations as another way to help vulnerable, isolated communities fight against the disease.

Written By: Jo Lamb

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