Vaccines for the street dwellers

Point of View

No one is safe until everyone is safe. The government is now slowly giving vaccines to minors. The more we vaccinate, the higher the chance of achieving herd immunity. But even with this additional group being vaccinated, thousands are still left out. We see them under bridges, in the corners of private buildings, under sheltering trees or just on the hot pavements. We see them but they seem invisible even though they may qualify under the priority list for vaccination.

So why would they be left out? Since they are in a constant flux, most likely they are not registered in any specific barangay. They would not have government-issued IDs, a basic requirement to access the vaccines. They are homeless – and their address is where their karitons or pushcarts are parked for the day where they try to earn a day’s wage, or for the evening where they rest their tired bodies. It is hard to estimate how many they are because they keep moving. In Metro Manila alone, the best estimate would be 4,000 to 5,000 street families.

Martha’s Hot Kitchen (MHK), a volunteer group that provides warm breakfast meals to homeless people in the streets of Quezon City, together with Kariton Coalition, teamed up with the World Health Organization, United Nations Population Fund, the Coalition Against Trafficking in Women-Asia Pacific (CATW-AP), the Philippine Disaster Resilience Foundation and the University of the Philippines (UP) to provide the jabs to more than 600 street dwellers in one morning.

Giving the jabs to street dwellers was not easy. But it was done and it can be replicated. It needed a lot of hard work, coordination, patience and prayers, though.

Here are some lessons from MHK’s experience. We need more groups to reach out to this vulnerable sector.

Seek partnerships. The work is tedious and needs many volunteers. It also needs financial resources. In this case, CATW-AP, MHK and UP worked together to hire jeepneys to ferry the vaccinees, feed the volunteers and street dwellers, and give away masks, face shields, paracetamol and other medical kits provided by the Office of the Vice President. The Kariton Coalition composed of 10 organizations, of which MHK is a part, had 17 volunteers on the day of the vaccination. More people were involved in the preparations, as resource mobilization, planning and coordinating had to be done weeks before the actual day. This is a testament to the bayanihan spirit of the volunteers who were also busy with their own work and families.

Build trust. Work with organizations or groups trusted by the street families. These groups are familiar with the terrain – where to locate them and how to approach them. MHK, for instance, has been providing warm breakfast to street dwellers since the pandemic began last year. So it was easy to trust them.

Plan, organize but be flexible. MHK’s strength is its ability to plan but they were flexible, too. At the last minute, some street dwellers backed out or came late on their appointed time. One was late because he insisted to take a bath first. What was planned to be done in four hours was extended by another two hours. Patience and prayers helped.

Inform and educate. Many of them were hesitant because of many unknowns. Be ready to respond to questions or give easy-to-understand information materials about COVID vaccinations.

One of the anticipated challenges was tracing and gathering them again for their second jab as they might have moved locations. So for future attempts, the health authorities could explore if the Johnson and Johnson vaccine, which is given only once, might be more appropriate for street dwellers. This might be against the current protocol of not announcing the vaccine to be used but this is worth exploring to ensure that the street dwellers will be fully vaccinated.

If resources allow, the vaccination may be done closer to where many of the street dwellers are staying. Specific spots maybe identified where the street dwellers and medical staff can meet. MHK and its partners will be trying mobile vaccination in the months to come.

With these lessons, other groups can follow and do similar operations. Equitable access requires partnerships, hard work and innovative approaches. Not only do these marginalized people benefit. The whole country does.

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Leonora Aquino-Gonzales teaches at the College of Mass Communication, University of the Philippines. She used to work at the World Bank as a communication specialist.