In conversation with Rusen Kumar of India CSR, Pearl Tiwari, Director & CEO, Ambuja Cement Foundation, not-for-profit wing of Ambuja Cement talks about the impact of COVID-19 on various social works of the foundation. She explained how the foundation is helping the community during pandemic. Excerpts as follows:
How ACF has played an important role in creating awareness about the pandemic and the vaccination drive in rural areas.
ACF contributed towards the National Immunisation Programme by creating awareness and educating people during phase 1 and 2. At the beginning of the year, the Government initiated the process to roll out immunization for COVID-19 from January to August 2021 in the first phase with a target to reach 30 crore people. Priority groups declared were healthcare staff and frontline workers, aged population, and population over the age of 60 years with comorbidity.
As soon as the Government declared the vaccination program open, ACF began strategizing its role in encouraging vaccination across locations in phase 1. We initiated the capacity building of our teams to prepare them, as there were many on-ground challenges our people would face.
We saw that myths around the vaccination, its safety, efficacy, and complications abounded. This was exacerbated when experts questioned phase-wise trials and the early development of vaccines – increasing the difficulty in advocating the benefits of vaccines among rural communities.
To tackle this, ACF started behavior change communication (BCC) interventions (working in liaison with respective health departments), registered the frontline workers from ACF villages, and began some initiatives to encourage vaccination. We facilitated a series of input sessions for more than 1000 people including our Pan India staff base and frontline workers. We also created 22 graphic and 2 video IEC materials in Q&A format based on government guidelines and started sharing with the community via village WhatsApp groups driven by ACF’s Single Point of Contacts (SPOCs) in each village.
Support and assistance was provided by ACF to health departments in mobilization of vaccination drive and reached out to distant geographies with mobilization. We also generated awareness and sensitized PRI members and at risk, co-morbid population of 60years plus. ACF identified elderly, comorbid population and assisted them with registration process – following up with them post-vaccination.
In the phase-2 of the vaccination drive, the Government focused on frontline workers and 45+ comorbid population. ACF continued to support the registration of the new segment of the population including its healthcare workers (Sakhis) and the elderly population. Adding on from the first phase, we activated:
Awareness coverage reached a population of 6.5 lakh families
Assistance support was provided in mobilization to vaccination centres, drinking water stations setup and seating arrangements at the vaccination centres were organized
New IEC materials were created to help beneficiaries understand the vaccination better
As a result, a total of 2.23 lakh beneficiaries have been registered for vaccination from ACF villages, along with 772 ACF staff including its healthcare workers (Sakhis).
What kind of awareness campaigns ACF had run in different regions?
In addition to the development and distribution of IEC materials, we initiated behavior change communication (BCC) interventions including ACF Ambulances to make announcements and awareness about the vaccination, its availability, and nearest vaccination centres. 121 awareness sessions carried out in ACF villages, Orientation of any new updates of the vaccination was provided to ACF’s local healthcare workers Sakhis and health teams, we have sent daily whatsapp updates to the beneficiaries, and held some virtual trainings also.
Tell us about the challenges you faced during these phases?
When the government first announced the vaccine rollout, people in rural communities were completely unaware. They had heard rumours and myths about false trials, its efficacy, the mortality rate and as a result, were not convinced to take it. And too much media exposure, WhatsApp forwards, community group meetings left them feeling confused – it was very difficult for the frontline workers to change their minds.
When the frontline and medical teams started the awareness campaigns in villages it was not received well. Villagers would chase them away, or would not open their doors to talk which was wasting a lot of time. There were also limiting beliefs about the severity and impact of COVID-19 – they thought it was just a viral cold or fever and that they could fix themselves.
Even during the group sessions villagers had vague questions that our frontline teams didn’t know how to answer or articulate effectively. To address all this, ACF organized sessions for the frontline workers with doctors from top hospitals to answer all questions and make them well-versed on the issue. This helped the frontline workers to be more confident and convincing during house to house visits.
Another challenge was the proximity of the nearest vaccination centre, which was often some distance away and it was difficult to mobilize the villagers to travel so far without proper transport. It was also a challenge for the elderly who could barely walk a few steps, to encourage them to go to those centres.
We also witnessed other on-ground logistical issues like, the summer heat saw many villagers refusing to go and wait in line – it was too hot, and there were no proper facilities. So ACF built small pavilions so that they could stand in the shade with seating arrangements for the elderly and drinking water on hand.
ACF faced the emergence of many other challenges. Villagers, especially the elderly who are not very savvy with technology or did not know how to register, were also not signing up. Many would travel long distances to come to the centre, only to find that there are no vaccines available. This was disheartening and did not motivate them to return to the centre again in the future.
Please highlight the work undertaken during the current phase of the pandemic?
Due to our longstanding programs and work, we had a vast network of beneficiaries on the ground who we had enabled via the formation of people’s institutions. So at the beginning of the pandemic we ensured that every village had a SPOC and a frontline worker to assist them, create awareness, prevent the spread of COVID-19 and today their work continues – playing a crucial role in supporting vaccination or finding medical support for villagers.
To ensure maximum coverage and awareness about COVID-19 and the vaccine it was important to reach out to all stakeholders. Awareness sessions were organized for community members, employees, truckers, Panchayati Raj Institutions members, ASHA workers and drivers. These sessions were carried out either by the health and safety team or by our frontline workers (Sakhis)
With the need for more medical infrastructure received from various local health departments and COVID-19 centres, we were able to provide assistance and healthcare support by providing Several oxygen concentrators at various healthcare centres. Our Ambulances were harnessed to create awareness about the vaccine and to transport the aged and those with disabilities to the vaccination centres. The Community Healthcare Centre in Nalagarh needed boxes to transport the vaccine for which we met their requirement by providing several vaccination carrier boxes to reach sub health centres and provided safety kits to the rural communities in Punjab and PPE kits to doctors and frontline workers in Ropar.
What is ACF’s plan for upcoming months in tackling the situation?
We are taking a 2-tiered approach to tackling the second wave of COVID-19 across its geographies – focusing interventions at both community level, and at institutional level.
Our Community Level strategy will be oriented around awareness, mental health and home isolation support in the first phase; whilst focusing on registrations and mobilization during the second phase.
The Institutional level strategy will be prioritized immediate support (mapping and providing medical requirements, provision of oxygen concentrators and cylinders) along with the long term goal of setting up several oxygen plants. During the second phase, our focus will be on carrying out registration campaigns in coordination with the health departments, listing of priority groups like elderly and critical age groups for the second dose and making arrangements at vaccination centres (social distancing, seating arrangements, tent & water provision) whilst also recording data.
The focus will continue to remain on vaccination and medical support, mainly oxygen. While we have already set up an oxygen plant in Ambujanagar, Gujarat and Nagaur, Rajasthan and provided several concentrators, we are planning to set up more plants and procure concentrators depending on the requirement of the local health authorities.
What is the impact in rural areas and how are you trying to overcome this?
We saw a drastic rise in cases from 211 cases in March 2021, to 896 cases in April 2021, which signified the entry of the second wave.
But due to the drop in cases at the village level since the height of the first wave, many temporary COVID-19 centres had been dismantled or closed. Due to the sudden rise in cases, these centres needed to be reopened as an influx of people started reaching the centres for oxygen care. It took time for the medical teams to set up these centres – leaving villagers nowhere to go.
Oxygen availability was also low along with medical infrastructure. Some patients were discharged at an early stage with no full recovery only so that beds could be made available for the new urgent cases. However these non-recovered patients needed care at home and it presented a risk to life. Our frontline workers were able to support them as they were trained to take care of home isolation patients through the past year.
We are concerned that while the demand for oxygen is very high the supply of oxygen is relatively low. For remote geographies like ours, the need for oxygen concentrators are much needed as they are easily portable and convenient to function by the local health team. However, the huge support of concentrators received has been going to big cities instead of remote geographies. We have stayed abreast of medical supply issues as we had been mapping the healthcare centres throughout, so when we received oxygen equipment from partners, we knew which centres should be prioritized.
We are continuing to create awareness and get maximum people registered and vaccinated, but alongside that, we will be setting up more oxygen plants and procure concentrators to be given to the local healthcare centres and support both the government and communities.