PORT-AU-PRINCE, Haiti — Underneath an open-air awning with aluminum ceilings and fans, on the outskirts of Haiti’s capital, patients trickle in to get a much awaited jab of a COVID-19 vaccine.
The list of takers at St. Damien Nos Petit Frères et Soeurs pediatric hospital in Tabarre includes a university professor, a nurse who works in a COVID-19 ward and an accountant. There are older people too, as well as young mothers accompanied by their children.
Despite the lines, Haiti’s vaccination rollout has been slow, prompting the World Health Organization’s Americas region office this week to call on Haitian authorities and the country’s partners to “work together to intensify COVID-19 vaccination efforts.”
“Increasing vaccine uptake is important to protect the country from COVID-19 transmission,” Dr. Carissa Etienne, head of the Pan American Health Organization, said as she asked the international community not to forget about Haiti.
Etienne’s plea comes as Haiti and international partners struggle to respond to last month’s deadly earthquake that struck the country’s southern peninsula. Humanitarian aid efforts continue to be hampered by the ongoing presence of armed gangs blocking the main road connecting the capital to the hard-hit regions and as health officials confirm the presence of the highly contagious Delta and Mu variants in the country.
In July, seven days after the shocking assassination of President Jovenel Moise, Haiti became the last country in the Americas to receive a shipment of COVID-19 vaccines when 500,000 doses of Moderna shots arrived from the United States via the United Nation’s vaccine-sharing program known as COVAX.
The rollout, which started two days later with support from UNICEF, looked promising, with health workers at St. Damien receiving at least 100 people a day, and the number of people coming to get vaccinated surpassed expectations. The U.N., initially concerned about how to get vaccines to communities outside of the capital, reported success in getting them there by road, despite the presence of armed gangs.
At the time, the COVID-19 situation was no worse than it had been, but officials were concerned because of the presence of the delta variant in Florida and elsewhere in the Caribbean.
Now the highly contagious variant is present and the country is embroiled in a deepening political crisis and the ongoing quake response. To date, Haiti’s government has managed to vaccinate less than 1% of the country’s 11.5 million people.
“So far Haiti has administered some 52,000 vaccines and many more people need to be vaccinated,” she said, adding that less than “1% of their population covered with an available 500,000 doses is totally unacceptable.”
Dr. Laure Adrien, the director general of Haiti’s health ministry, acknowledges that the rate of vaccination is low. Haiti was in the midst of beefing up its vaccination program in rural outskirts when the ground buckled on Aug. 14 in its South, Grand’Anse and Nippes regions, he said.
The disaster brought the vaccination campaign to a halt. Not just because the quake prompted other emergencies, with the deaths of more than 2,240 Haitians and injuries to over 12,700 but the temblor damaged 62 health facilities, including 28 that were severely damaged.
“Already the population was not very receptive to vaccination, which now makes the task even more difficult,” Adrien said.
Back in July, before the earthquake, Adrien was keenly aware of the challenges but the ministry was working on creative ways to get the word out. While hospitals like St. Damien opened their facilities for vaccination, the health ministry launched a pilot mobile vaccine unit using its meager resources.
So far, the mobile units are working, Adrien said, adding that “the goal is to extend it to other departments.”
“The ministry does have new awareness plans for the vaccination campaign because we believe that we must reach the population,” Adrien said. “We must use mass media and use influencers. For this we need the means.”
But this and a plan to launch a new vaccination campaign requires financing, something aid groups looking to assist with vaccination efforts say has been hard to come by.
While grateful for the U.S. vaccine donations, which have been the only ones so far, Haitian authorities they bemoan the fact that there has been no money for campaigns to convince the population to get vaccinated, especially in a country where the anti-vax movement is strong and many either don’t believe in the existence of the disease or seek traditional medicine to counter the virus.
“I’ve never taken vaccines, even when they had other vaccinations,” said Elifet Petit, a mason who lives in the capital.
Petit, walking through the Pelerin neighborhood one afternoon, said while he knows that COVID-19 exists he prefers to rely on his traditional medications of plants and shrubs.
Gertrude Jean, 48, said that she also takes the disease seriously even though others do not. At church, she said, mask wearing is still the exception rather than the rule.
Her reluctance to take the vaccine, she said, is based on reports that the first batch that Haiti received were no good.
That kind of misinformation and others are among the challenges authorities and aid groups here face.
“I believe the marketing is almost non-existent and that too many health professionals are hesitant and don’t give the good examples,” said Jacqueline Gautier, executive director of St. Damien.
Jean Marc de Matteis, the chief executive officer of the Albert Schweitzer hospital in the Artibonite region, said while the only way out of the COVID-19 pandemic is vaccination, getting the vaccines is only half of the equation. The other half is funding.
While the hospital is showing positive results with its vaccination rollout, de Matteis said challenges remain. One of the biggest, he said, is logistical.
“You have a country embroiled in a political crisis; we can’t get food to the south, people can’t get to their work. So the idea of telling somebody, ‘Hey, there is a free vaccine on a corner... that’s a big challenge and big commitment for them, to go and get vaccinated in this environment when maybe they haven’t been able to leave their house for five days to get food because there’s gang violence all over their neighborhood,” de Matteis said.
But some people have braved it. Marie Claudece Joseph, 60, was among the first to get vaccinated, showing up at St. Damien’s in late July after reading various articles about the COVID-19 vaccine.
“It was after I read them, I made the decision and said, ‘I am going to get vaccinated,’ she said. Other factors that prompted her to get the shot was her age, her diabetes and her teaching job. “I am always in contact with people,” she said.
As of Sept. 8, Haiti had 21,244 confirmed cases of COVID-19 and 596 deaths. Although authorities acknowledge they aren’t testing extensively, the pandemic has not spread like it has in other parts of the Caribbean region, which has made convincing people to get vaccinated even more challenging.
The Biden administration has said it wants to send more vaccines to Haiti, an official said recently. But some of the current doses from the first delivery will expire in October, while the rest will expire in November, Adrien said.
“Having vaccines is great, but the important thing is to put in place all of the strategies to be able to use them on time,” Adrien said.
Still, there are encouraging signs in Haiti, where one vaccination site was so crowded that those seeking to get their shot had to come back another day.
And after a year in which many Haitians did not believe in the virus, shunned masks and weren’t sold on getting a vaccine, there is a sign of progress — more Haitians are masking up.
