For rural India, it is the golden hour

Updated on May 25, 2021 03:42 PM IST

When vaccines are available, India will face a renewed challenge — of vaccine hesitancy in rural India. Tackle it now

A health worker inoculates a senior citizen with Covid-19 coronavirus vaccine at a Government Hospital at a Rajasthan village. (File photo) PREMIUM
A health worker inoculates a senior citizen with Covid-19 coronavirus vaccine at a Government Hospital at a Rajasthan village. (File photo)
ByNeelesh Misra

As it plays out, rural India will possibly be the final theatre in this round of the world’s war against the coronavirus. How we deal with it in rural India has huge implications for India’s health indicators, workforce, economic growth, Anganwadi-deprived children’s future – and the country’s politics.

For a virus that has caused devastation across much of the world, conquering rural India could be easy pickings. What can defeat it is the vaccine – whenever it is available in adequate numbers – and something else we aren’t currently working on – tackling massive vaccine hesitancy, village after village, state after state.

We might have lost a lot of time on a lot of things, but this is the golden hour for rural India.

When the Covid vaccine reaches the villages in large numbers, would hundreds of millions of people be waiting to take the jab, even if free, and protect themselves? Not at all.

I live in a village, and the kind of reports we are receiving – whether through the insights of our community resource persons in every state and across districts, or through direct messages from rural citizens to me – are a frightening clamour. Village after village is reporting large-scale prevalence of Covid symptoms, and an exceptionally higher number of deaths compared to past years. Vaccines, testing, reporting – all are in short supply.

But, despite the health scare, most people say they will not get the vaccine – and the reasons range from “we don’t need it” to “it will kill us” to “so and so fell ill or died after taking it” to “it is a conspiracy” to many other farcical reasons.

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And this is when adults have to get themselves vaccinated. Wait till it’s the turn of the children. It is clear that India is headed for an extremely tough challenge.

Here is what we need urgently to fix the vaccine hesitancy – an unprecedented rural communication campaign. Talking to rural India impactfully and with innovation through all the means available. Convincing them about the vaccine.

We need everything from street munaadi (announcements) to radio storytelling, folk songs to nautanki and local art forms, two-minute video films that can be shared on social media and WhatsApp featuring rural influencers, and lots else. Also, all the knowledge and diktat does not have to come top-down. Local community leaders, and rural influencers, can guide authorities on how to best get the communication across on getting tested and vaccinated.

In my experience, Indian media planners and information department officials in governments often get the definition of an “inflluencer” wrong in a rural context. They spend thousands of crore of rupees targeting the wrong audiences.

So who is the person to whom communication should be targeted at in this emergency, who can become aware and further make many more people aware? The most effective rural influencers aren’t village headpersons because Pradhans and Sarpanches are often seen as corrupt or hustlers. The best rural influencers are, according to me, the students from Class 9 to Class 12 and after, who know how to use Youtube or Facebook or Whatsapp and are very aware. It is this band of tens of millions of youth that could help target vaccine hesitancy and they are the ones who the communication has to be addressed to.

Can good rural communication by governments save lives? Of course it can. India has done it earlier and can do it again.

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The first example is India’s huge effort to eradicate polio. In 2009, India had 60% of the world’s polio cases. India has not had a single case of polio since 2011, was declared polio-free in 2014 and strict surveillance since has prevented its return. India did it with the world’s biggest vaccination campaign against the wild polio virus (WPV), done against the backdrop of an almost non-existent public health system that is hardly any better today.

There was then very strong opposition to the vaccine, especially among many sections of the Muslim community. A multi-level communication strategy and a massive social mobilisation campaign were at the heart of that success – achieved despite severe odds. Imagine how many polio-affected children India would have had if health workers and officials had not worked relentlessly at the time on the vaccination programme. It saved millions of childhoods.

The second example is from my home state of Uttar Pradesh, where, until a few years ago, more than 600 children died every year due to Japanese Encephalitis and later Acute Encephalitis Syndrome (AES). “Operation Dastak”, a door-to-door campaign over the past three years to ensure immunisation of all under-15 children and a mass village-level communication campaign, has shown extraordinary success. Encephalitis cases are down by 85%, government officials say.

India has to draw on successes like these as it stares at a new vaccination crisis. Despite its vast challenges, our frontline health workers and a political resolve have in the past helped overcome these obstacles.

We are back in that moment. We are in the golden hour, and the clock is ticking.

Neelesh Misra is an audio storyteller and the founder of Gaon Connection

The views expressed are personal

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