Sabah healthcare staff roughing it to vaccinate remote villagers

Another major hurdle they have to clear is convincing the villagers to come out of their houses to get the vaccine.

There are a host of other challenges as well but regardless of that, the dedicated healthcare workers have only one thing in their mind: vaccinate as many eligible people as they can to ensure the success of the National COVID-19 Immunisation Programme.

Earlier this month, this writer had the opportunity to join a team of medical and healthcare personnel from Hospital Kinabatangan on their two-day/one-night mobile vaccination mission, organised by the Kinabatangan Area Health Office, to the three interior villages of Kampung Sri Ganda, Kampung Tundun Bohangin and Kampung Abai that are only accessible via river transport.

The "expedition" to the interior started in Sandakan, about 70 kilometres from Kinabatangan town, for this writer and a dozen other Hospital Kinabatangan staff who reside in Sandakan. Travelling in a speedboat, they first crossed the Sulu sea before entering the waters of Malaysia's second-largest river Sungai Kinabatangan.

All in, it took about two hours for the team - led by Hospital Kinabatangan medical officer Dr Maini Sabait - to arrive at their first stop Kampung Sri Ganda, a tiny dwelling of about 200 people located on the banks of the river.

A group of villagers who turned up to greet the team led them to an open area where a makeshift vaccination centre - a wooden structure with an atap roof - had been set up.

They then waited for the arrival of the Sinovac vaccine vials from Hospital Kinabatangan, which is a three-hour boat trip from Kampung Sri Ganda. The villages in that area are not accessible by road from Kinabatangan town.

Hospital Kinabatangan pharmacist Thiam Kah Kit, who was in charge of transporting the vaccine and was accompanied by members of the Civil Defence Force and Eastern Sabah Security Command (ESSCom), told Bernama the most challenging part of the long journeys to remote areas was keeping the vaccine safe.

To maintain the vaccine's efficacy, the vials have to be kept in a cool box with its temperature maintained at between two and eight degrees Celsius.

Whilst driving from village to village in the Kinabatangan area on the rough and bumpy roads (which can get muddy and slippery when it rains) in their four-wheel-drive vehicle, Thiam sometimes had to tell the driver to slow down as he feared that the vials may break.

"We have to be careful as the bottles can break. Some of the bridges there looked like they were going to collapse... I was so afraid they may not be able to bear our weight!" he said.

For overnight stays in a village, Thiam would request the headman to provide him with a refrigerator in order to prepare ice cubes which are then transferred into another special cool box or portable freezer. The ice cubes are needed to maintain the temperature of the cool box, where the vaccine vials are stored, at the desired levels.

He said if a village does not have electricity supply, the remaining vaccine vials will have to be taken back to Hospital Kinabatangan the same day and brought back again the following morning to proceed with the vaccination programme.

Vaccinator Rohana Salim, a nurse at the Kinabatangan Area Health Office, said one of the first questions the villagers would ask her nervously is, "Is it painful, is the needle big?"

"But after the jab is given, most of them would say they didn't feel anything," she said.

For Rohana and her fellow team members, the "expeditions" to the remote villages can be physically and mentally taxing and even terrifying, no thanks to the perilous journeys they have to undertake to reach the interior areas.

According to nurse and vaccinator Friscilla Duanik, their major challenge is not putting up with the antics of the villagers or coaxing them to take the vaccine, but the boat rides.

"Whenever it rains or a big wave hits our boat, we get drenched. Then, we have to cram into a 4WD vehicle to get to our destination.

"After roughing it for hours in a small boat and on road, it's an anticlimax when we reach our destination and receive a lukewarm reception from the locals. It's their responsibility to make the necessary preparations (for us) even if only one person is given the vaccine," she said.

Apparently, many villagers staying in remote areas are falling for rumours and fake news concerning the COVID-19 vaccine despite attempts by their headman and the village development and security committee to educate them on the benefits of getting the vaccine.

Unlike most Malaysians who are required to register for the vaccine through their MySejahtera mobile application, the registration process for these remote villagers is done manually.

Said senior community nurse Lampai Idris: "We have no other choice but to go from house to house to talk to the residents and tell them about the vaccine. But it's not easy to convince these people."

Staying overnight in a village bereft of basic amenities and facilities is also challenging for the members of the mobile vaccination team. They can consider themselves lucky if they get to spend the night in a government training centre or research centre but most of them can only accommodate a limited number of guests.

Most of the time, the healthcare staff end up sharing a room and sleeping on the floor while the boatman and security personnel would sleep in hummocks outdoors with mosquitoes and insects keeping them company all night.

Meanwhile, 102 doses of the Sinovac vaccine were administered by the mobile vaccination team during their recent trip to Kampung Sri Ganda, Kampung Tundun Bohangin and Kampung Abai.

So far, the team has given a total of 1,886 doses to villagers in seven oil palm estates and three villages since the mobile vaccination programme for the Kinabatangan area started more than two weeks ago.

Dr Maini, however, said the number of doses administered so far was far below the target they had set.

"We will have to increase our efforts and convince more people to take the vaccine," she said.

The Kinabatangan Area Health Office is targeting to immunise 24,000 people living in remote villages in Kinabatangan district - which currently has the lowest vaccination rate in Sabah - that have no access to health facilities.