Yunusa Bawa, a community health worker, rides on a motorbike with a box of AstraZeneca coronavirus vaccines. Photo / AP
Yunusa Bawa, a community health worker, rides on a motorbike with a box of AstraZeneca coronavirus vaccines. Photo / AP
Yunusa Bawa rolled his motorcycle away from the healthcare clinic where he works in Kuje, southwest of Nigeria's capital of Abuja, and secured a black box of Covid-19 vaccine for the rough ride ahead.
The rocky and rugged pathway — Bawa described it as a road that "will make you tired" — was the least of his worries. Kidnapping along the route by armed gangs is rampant, he added.
But such trips are essential if Africa's most populous country is to reach its ambitious goal of fully vaccinating 55 million of its 206 million people in the next two months.
As the emergence of the Omicron variant underscores the importance of inoculating more people to prevent new mutations of the coronavirus, Nigeria also is facing a difficult path: Only 3.78 million are fully vaccinated.
Going directly to the villagers is one way to overcome any hesitancy they might have in getting the shots, said Bawa, 39.
"When you meet them in their home, there is no problem," he added. "Everybody will take (the vaccine)."
Yunusa Bawa, a community health worker, injects a man with AstraZeneca coronavirus vaccine in Sabon Kuje. Photo / AP
On December 1, Nigeria began requiring government employees to be vaccinated or show a negative test for the virus in the past 72 hours. Although authorities emphasise the country is capable of getting the Western-manufactured vaccines to everyone, healthcare workers in rural areas are struggling, mostly because of delayed government funding.
At the Sabo health center in Kuje, a town of about 300,000 people near Abuja's international airport, Bawa and three colleagues work in dilapidated buildings with worn-out office equipment. In the past three months, only two of them have received compensation from the government, getting about 10,000 Nigerian naira (about $24).
That's barely enough to cover the gas for Bawa's personal motorcycle — "the one we are using to move around and inform them that we are coming on specific dates", he said as he held the hand of 75-year-old Aminu Baodo before giving him a shot.
On a good day, he can get to about 20 people, but usually it is five or fewer. Many rural residents are poor and spend most of their time on farms scattered across the countryside, rather than in their homes in the village.
That often means a long day for Bawa and his co-workers, in addition to the risk of violence and waiting weeks for paltry compensation. He said he is unsure when he'll next be paid by the government for his efforts or how long his personal finances will hold out.
A 20-year-old colleague, Yusuf Nasiru, said he hasn't been paid or reimbursed for expenses since starting the job in November.
"If you should work on weekends, you should be paid," said Dr Ndaeyo Iwot, executive secretary of Abuja's primary health care agency, which oversees vaccinations in the capital. He added that government workers who go out on mobile teams should have logistical support.
Yunusa Bawa, a community health worker, carries a box of AstraZeneca coronavirus vaccine, in Sabon Kuje. Photo / AP
Armed groups in northwestern and central parts of Nigeria have killed hundreds of people this year and kidnapped thousands, seeking ransoms.
In areas not beset by violence, delayed payments to workers who transport and administer the vaccine remains "a big challenge for us", said Dr. Rilwanu Mohammed, the top government official leading vaccination efforts in Bauchi state in Nigeria's northeast.
"They won't pay the money until when the people have finished the work, and there is no money for movement from one point to another," Mohammed said, noting that he had to find funds himself to pay workers' expenses.
Others criticise the government for not adequately funding a campaign to inform people about the coronavirus and the need for vaccination.
"Nobody around here knows anything about the vaccine to be frank," said Omorogbe Omorogiuwa, who lives in Adamawa state, which borders the country of Chad in northeastern Nigeria. "Nobody is saying you should go and take it. In fact, it is assumed that (the pandemic) is over."
In an interview with The Associated Press, Dr. Faisal Shuaib, executive director of Nigeria's National Primary Health Care Development Agency that oversees the vaccination program, blamed "poor planning (and) poor coordination that results in difficulties or challenges in making sure that the vaccines actually get to rural areas."
Officials also have to battle scepticism about the vaccine in many parts of Nigeria, a deeply religious country where some religious leaders spread misinformation about the virus and the vaccine to their millions of followers.
In addition to false information spread on social media, some in northern Nigeria remember the 1996 deaths of several children from meningitis during a Pfizer clinical trial for an oral antibiotic, resulting in a legal battle with the pharmaceutical giant that won payouts for some families.
Authorities have been engaging with traditional and religious leaders to get the truth about the vaccine to their followers, Shuaib said.
"But clearly, a lot of work still needs to be done by some states in ensuring that these vaccines get to the communities," he added, noting that Nigeria has 30 million doses on hand, with many more arriving in the coming months.
Adewunmi Emoruwa, the lead strategist at Gatefield, an Abuja-based consultancy group, said the government should be more focused on "promoting vaccine safety and efficacy", rather than implementing a mandate for state employees. Public servants will spread the word about the vaccine if they are "convinced" it will work, he added.
Musa Ahmed, an immunisation officer in Kuje, said "social mobilisation has not been taken place ... and that is (why) some people are still doubting the vaccine".
That has left a large part of Nigeria's population unvaccinated and at "very great" risk of exposure, said Dr Richard Mihigo, immunisation and vaccines development programme coordinator for the World Health Organization's Africa regional office.
"As much as we give the opportunity to the virus to continue to circulate in a naive population, we give the virus the opportunity to mutate," Mihigo said in an online briefing.
On December 1, the Nigeria Center for Disease Control said the Omicron variant was found in three travelers who arrived in the country late November — the first in West Africa to have recorded the Omicron variant since scientists in southern Africa detected and reported it.
In Kaduna state, which neighbours the capital region, Bitrus Maiyaki is another healthcare worker taking the risk to carry vaccines to rural communities beset by violence.
"In order to support the activities of the government, we have surrendered (our lives)," Maiyaki, 41, told AP in a telephone interview from Jama'a, where he oversees vaccinations. "And we want to save lives. … We have taken an oath to serve our fatherland. We just take the bull by the horns."
