Residents in North India’s rural Kangra district say they have been anxious to get vaccinated for COVID-19 after a second wave of the pandemic created havoc and ravaged villages last month.
While tech savvy, digitally aware city dwellers have managed to get shots, millions in rural areas are being left behind because of a technology barrier. Registering on the official website called CoWIN, they say, has been a challenge for many residents like Harnam Singh — who only has an old-fashioned feature phone and no internet connection.
“I have a simple phone. I don’t even know how smart phones operate,” Singh said with a shrug.
After widening its inoculation drive to all adults last month, the government in India made it mandatory for those between 18 and 45 years old to register on a digital portal for a shot. The move created a divide between people in towns and cities at an advantage in getting shots while millions in rural areas were jostled out of vaccine lines because they did not have smart phones or adequate resources.
Criticism that the digital divide was excluding millions from its inoculation drive prompted the government to act. This week, all those eligible for vaccines will be allowed to walk into health centers for appointments, according to authorities.
India’s vaccination program is gaining momentum — the country administered more than eight million shots on Monday as it offered free vaccines to all. But sustaining that record pace, especially in vast rural areas, remains a challenge as demand for vaccines continues to outstrip supply amid shortages.
Residents in Kangra however say not much has changed for them with the new policy because only limited numbers could walk to vaccination centers. On the other hand, those with access to an online booking are assured a shot.
That means people like Manoj Sharma, who don’t own a smart phone, are still scrambling to get an online slot, usually turning to friends for help. “The government should facilitate this process for us,” said Sharma, who works as a driver. “I am driving all day and providing an essential service. Being on the road, I worry about getting the virus.”
The technology barrier prompts about 15 people a day to walk to Lok Mitra Kendra, a local center that offers assistance. “The registration on the official website is a problem because many people in villages are not very educated and struggle with the online process,” said Vijay Kapoor, who runs the center.
Public health experts say ensuring equal access to rural areas could be critical in ending the pandemic, especially in the wake of warnings of an impending third wave.
“Two thirds of India is rural. If you do not vaccinate them in adequate numbers, there will be a huge reservoir of susceptible persons which the virus or any new variant can attack and then come back to urban areas,” said K. Srinath Reddy, president of the Public Health Foundation of India.
India’s Supreme Court had also flagged concerns earlier this month about the technology-driven vaccination drive. “It is the marginalized sections of the society who would bear the brunt of this accessibility barrier,” a three-judge bench had said.
Even educated rural residents with smart phones have struggled to get a vaccine — patchy internet connections and poor network coverage in remote areas mean that the tech savvy in nearby towns grab coveted vaccine slots faster.
“Even if I register on the website, I can’t find a vaccine center close by,” says Vivek Chand, a poultry farmer. “The only place where vaccines were available in the district when I checked today was about 50 kilometers away. Those too were restricted to above 45.”
The underfunded and ill-equipped rural healthcare infrastructure puts villages at a further disadvantage. India has allowed the private sector to administer shots giving people in cities the option to pay and get a shot at a private hospital, but rural areas have few such facilities.
Such challenges have led to growing calls for administering shots closer to village homes, especially as authorities expect vaccine shortages to ease substantially in the coming months — the government has said it will have enough shots to vaccinate all adult citizens by the end of the year. So far India has administered about 300 million shots. Those vaccinated with two doses add up to about 5% of the country’s population.
“Centers should be opened in each village for people to get vaccinated. This will remove all the hurdles they are facing,” said Kapoor as he tried to help out people at the Lok Mitra Kendra center.
Health experts say giving India’s vast countryside easy access to vaccines should be a priority. “Ultimately, when in India’s election we manage to reach the ballot box to the remotest area, including the interior of the forest, we ought to find ways in which we can carry vaccines to such places,” said Reddy. “We may have to think of innovative ideas such as taking mobile vans to villages. Some states want to use drones to deliver vaccines to remote areas, but they will also have to ensure there are also people to administer the vaccines there.”
That is what village residents in Kangra want — an easily available shot for which they don’t have to struggle online or trek for kilometers, just to find out if a vaccination center will allow them to walk in for a shot.
