Viewan in Kashmir has become the first village in India to vaccinate all its people with the first dose against COVID-19. Peerzada Ashiq reports on the challenges faced by officials in turning a reluctant village in a remote area into a role model for the country
Across the stream, there are multiple narrow pony tracks on steep slopes. They lead to Viewan village, about 35 km away from the Bandipora district headquarters. On foot from Athwatoo, Viewan’s last house is 11 km away. From here, the glaciers feeding the stream suddenly become visible and look like shimmering mirrors.
On the pony tracks, human habitation is visible first in Tangtari after 3 km of trekking. This cluster of 12 families is in the lower flank of Viewan village.
About 2 km away, Taziyat Jan and her daughter Naziya Jan sit in a two-storey mud-and-wood house buttressed against a slope in the midst of a dense forest. In this village — quaint, inaccessible and quiet — Taziyat has received her first shot of the COVID-19 vaccine. “I had heard a lot of negative things about the vaccine. I was hesitant at first, but doctors counselled us and motivated us to take it. They said the vaccination certificates are going to be an important document to move around and visit offices. So, I agreed,” she says.
Viewan shot into the limelight on June 7 when it was declared India’s first vaccinated village against COVID-19. Everyone aged 18 and above has received their first dose of the COVID-19 vaccine. This glory has led to a big push for a pro-vaccine movement in Kashmir.
Nawab Gojri, Taziyat’s husband, got vaccinated in the first week of June. He then left on an arduous journey to G.G. Gali along with his cattle comprising 500 sheep. The upper reaches have untouched, green meadows where the cattle enjoy grazing. Back home, a ferocious dog keeps watch against any attack by bears.
“I had fever and dizziness after getting vaccinated, but it subsided quickly. My husband and I feel fine now. I am worried for my daughter who has suffered from a foot disease since childhood. The treatment is expensive, and we have dropped the idea of visiting any hospital,” Taziyat says.
Taziyat, like most inhabitants of Viewan, does not possess a radio, television or mobile phone. Only a few villagers have radio sets and trek to points where they can catch a signal. With no communication access, information about the virus trickled in through a few locals like Rafiq Rehman. A farmer in his 30s, Rafiq knew that something terrible was unfolding in the plains throughout the year and people were dying. “I first heard about the pandemic on the radio in March,” Rehman says. Rehman and his family decided then that they would not venture towards the town.
Taziyat first came to know about the virus when doctors started streaming into the village in the last week of May. “Doctors told me that there is this disease which can kill us. They said if a person contracts it, the whole village can be wiped out. But Allah will take care of us now. We had no case of COVID-19 last year or this year,” Taziyat says.
The topography of Viewan village may have helped it to escape the fast-spreading pandemic in Bandipora district. It is a small village, remote, and landlocked. But for the same reasons, it has been a daunting task for the officials to vaccinate its population.
The Deputy Commissioner of Bandipora, Dr. Owais Ahmad, believes in aggressive sampling. This is what has helped keep the mortality rate low in this district. At least 2,44,215 samples, including 1,33,152 this year, have been collected since the pandemic outbreak. The sample size is equal to 62.2% of the total population of the district.
“Around 90% of the 45-plus age group has been covered so far. Extensive sampling, isolation of positive patients and strict preventive measures have all helped the district control the spread of the virus,” Ahmad says. The district administration also worked on setting up a five-bed COVID-19 Care Centre in every panchayat.
Last year, though, things were different for the district. Bandipora was labelled the ‘Wuhan of Kashmir’ when about 90% of the population in Gund Jahangir village, which has 1,500 people, tested positive for the virus in May-June.
“I still remember when the houses in Gund Jahangir village emptied out and most of the people were shifted to quarantine centres last year. We dreaded walking through the streets and fields of Gund Jahangir,” says Dr. Masarat Iqbal Wani, Block Medical Officer, Bandipora.
Wani, backed by Ahmad, was keen to not only get rid of this label but also beat the virus. The team began to work on a model, now known as the Viewan model, to battle the pandemic. The thrust, Wani says, was to create a chain of resource persons who could dispel the various myths about the vaccine, develop a rapport with the hesitant population, and convey the importance of vaccination before convincing the people to take the jab.
“We chose Viewan among 29 other remote villages of Bandipora because even if a single COVID-19-affected person made his or her entry into these pockets, it would have been catastrophic. It would have been very difficult for the affected population to reach the nearest medical centres in the plains. Vaccinating them was like creating a buffer wall, which we did,” Wani says.
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All 267 villagers in the main cluster of Viewan village have been vaccinated with Covishield. In the other 28 villages, the 45 plus population has been inoculated with one dose.
The Viewan model
The officials decided to first sensitise the population. They chose locals to influence the villagers, initiated vaccination drives, and sent a dedicated team of medical practitioners door-to-door for inoculation. Doctors were stationed nearby to address medical complications arising from vaccination.
Around 600 people of the Bandipora health department split into 60 teams to vaccinate the population. The population aged 45 and above is nearing 100% inoculation this week. The pace of the drive for people aged 18 and above has slowed down due to a low stock of vaccines.
It was one such team comprising doctors, one auxiliary nurse midwife, an accredited social health activist worker, an anganwadi worker, a booth-level officer, teachers, sarpanchs, panchs, block development council members and voluntary influencers that visited Viewan on May 21 with a narrative and a method.
Neelofar Jan, a public health worker, vaccinates people near Athwatoo village north Kashmir’s Bandipora district on June 17, 2021. | Photo Credit: NISSAR AHMAD
“There was hesitancy among the population regarding the vaccine. They had heard that some scientist had warned that people will die within two years of taking the vaccine,” says Wani. Many men hid in the jungles to escape getting vaccinated. “We managed to vaccinate only six people in the village, including the sarpanch, on our first trip,” he says.
Bagh Hussain, the sarpanch, says he could not sleep the night after inoculation. “We had heard that our limbs would fall off, we would die, etc. I was traumatised by these thoughts. But I realised that I need to show faith in the doctors to ensure that my community is safe from the virus,” he says.
For the next 10 days after the first visit, the team did not disturb the village. It was in the first week of June that the team returned with more evidence. All the doctors and paramedical staff carried videos of people being vaccinated to earn the trust of the villagers. “Once we were back in the village, we called all the six people who had been vaccinated 10 days earlier to tell us how they feel. The live demonstration worked for the rest of the population,” Wani says.
The team had another problem: all the elders in the village would either go to the fields or the upper reaches to graze cattle during the day. “So, we decided to do door-to-door vaccination at night. The sarpanch, who was vaccinated in the first trip, accompanied us to ensure that there was no communication gap,” Wani says.
The vaccination drive would start after sundown and continue well into midnight. As there was no accommodation available in this remote village, the female staff of the health department stayed with the families, and the male staff stayed at the Viewan high school building. The building has been empty since the second wave hit India: all the 80-odd students enrolled there are at home. The entire population was vaccinated within three days and two nights.
Recalling the tour of the village, Jehangeer Ahmad, who is in his 20s, says he started trekking around 8 a.m. and reached the village around 12:30 p.m. It was not easy to develop a connection with the villagers immediately.
“We started a free medical camp once we reached the village. People started trooping in. Most women were anaemic. We addressed their chronic diseases. At the same time, we made them understand that vaccine certificates would help people access government offices in the future besides saving their lives,” Ahmad says.
Neelofar Jan, 30, a public health worker who vaccinated the villagers, has blisters from the arduous trek but that did not deter her from raising awareness about the vaccines. She says the women were very hesitant.
“We sat with them and educated them by providing a lot of details. We gave them a patient hearing. The biggest concern among women was infertility. We told them that this vaccine was like other vaccines which they had received as children to fight polio and measles. We told them that it is an immunity booster. Some people shut their doors but then, slowly, everyone started opening their doors to us,” Jan says.
The task of sensitising the population was not possible without a local influencer. Azad Hussain Sheikh, a government teacher who has worked as a booth-level officer during elections since 2008, had developed a rapport with the population. “I have visited Viewan many times. People know me and have faith in me. I used that influence to reinforce a pro-vaccine narrative. It worked,” Sheikh says.
Only 10 pregnant women could not be vaccinated in Viewan as the government has not yet approved of a policy to inoculate this segment. “When we vaccinated the entire eligible population of the village, we did not know that it would be the first village in the country to get this tag. We are very happy to achieve this feat. It was a joint effort between the top officials of the administration and grassroots representatives,” Ahmad says.
Since the village has no Internet, there was no way the team could register the details online. Details were written manually on a file at the spot. “Three days later, when the staff returned, the data were fed into the application for an official record,” Wani says.
A pro-vaccine movement
The focus on Viewan has spurred a pro-vaccine movement in Bandipora district. Majaz Hassan Khan, a candidate from Banakoot who lost the block development council polls, says he used the technique deployed during electioneering in his block to get people vaccinated. “I went door-to-door and pleaded with the people to get vaccinated, just like I would do to seek votes. When a medical team is backed by the political class in such initiatives, it does multiply the effect,” Khan says.
The Viewan model is being replicated across Bandipora. Health workers have drafted elaborate plans to go and inoculate people at night in far-off villages like Kundara, Chandaji and Sumlar where menfolk work in the fields during the day or take cattle for grazing.
“Late evening and midnight inoculations have proved successful in far-off villages. We need to design our vaccination plan according to the requirement of the population. Each village, semi-urban and urban pocket may require a different approach,” Wani says.
About 27 km away from Wani’s hospital at the district headquarters, shikaras (small wooden boats) are decked up, with blue boxes of vaccines placed safely at one end. Wearing personal protection equipment, doctors and paramedical staff have decided to create a vaccine buffer in and around Wular lake, India’s third largest freshwater lake.
At Kolhama, an island in the lake, doctors took samples to check if the population has been affected by the virus. After this examination, healthcare workers started vaccinating about 2,400 people. In another cluster of Zurimanz, 250 fishermen were vaccinated when they were out fishing in the lake during the day.
Bandipora’s influencers, like kick-boxing champion Tajamul Islam, 13, are also out on the streets to encourage those above 18 to line up for vaccination. “We can only defeat the virus by getting a jab,” Islam says.
The Viewan model has impressed the Bombay High Court too. On June 12, while hearing a petition, the court underlined the need to look at the door-to-door vaccination programme carried out successfully by Jammu and Kashmir and Kerala, with special reference to the country’s first village that has got vaccinated. “How is it that individual States like Kerala and Jammu and Kashmir have introduced and are successfully doing door-to-door vaccination? What is the Centre’s comment on the Kerala and Jammu and Kashmir pattern?” the Bench asked.
Unaware of the glory, Taziyat keeps looking at the sky-touching ridges of the Bandipora mountains where her vaccinated husband has gone to graze the cattle. “I am waiting for him to return safely with healthy cattle. We need to earn money to treat our daughter. I hope everyone gets vaccinated and the pandemic ends,” she says.
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