Vaccination in Yaounde

How Poor Access, Storage; Slow Covid-19 Vaccination In Cameroon Crisis Regions

By Leocadia Bongben

The two Anglophone regions are among the bottom four regions where the COVID-19 vaccination rate is still very low.

Mary Wirdin, 35, mother of two, and primary school teacher, set out to take a jab of the COVID-19 vaccine, but after trekking for 10k from Wahsi to the Jakiri Health Centre, she could not get the vaccine. 

It is Friday, August 13, Bamenda Northwest Cameroon, and roads leading into the regional capital are blocked.

“I wanted the Johnson & Johnson vaccine, but could not get it, I was told due to roadblocks, vaccines have not been sent to the district hospital, so, I have to wait”, Wirdin, said. 

It is not the first time roads have been blocked, but a constant phenomenon since 2017 when the Northwest and Southwest regions turned into an armed conflict till date. 

With the roadblocks around major towns, Bafut, Bali, Kom, Wum, Banso, and Ndop, general access to healthcare is problematic.

Patients have pushed trucks to the Bingo Baptist Hospital. access to the Banso Baptist and Shisong hospitals, some of the reputable hospitals is blocked.

There has not been a movement of vehicles, hence, not much activity concerning COVID-19 vaccination.

Dr. Cornelius Chebo, Chief of the Northwest regional Covid-19 Incident Command Centre says with the roadblocks there is nothing much they can do but wait till when the roads are opened. 

Cameroon has received more than 1,204,300 vaccines, 200,000 doses of Sinopharm, 300,091 doses of AstraZeneca, 303,050 doses of Johnson &Johnson, and 158,400 doses from ECA -Afriximbank. 

According to Dr. Chebo, the format or line of vaccines in the country is the same for COVID-19 since their integration into the Expanded Programme of Immunization, EPI. 

“Vaccines are delivered in the central pool and taken from Bafoussam in the West region by the Covid-19 incident command center in Bamenda”. 

COVID-19 vaccine cold room at the Northwest Regional Delegation of Health

After collection, the vaccines are registered and distributed according to requests from the districts. 

The chiefs of district health centers then collect for their units and down to the population. 

The challenges

In the region, it is very challenging to transport and stock vaccines, because the distance has increased drastically for some districts due to the crisis. 

For example, officials from Donga Mantung Division used to pass through Kumbo but the road is no longer accessible. They have to go through Magbwa in the Adamawa before they get to Ndu, Nwa, and Ako, Chebo explained. 

In other areas, the Ndop, Fundong, Bali, and Kumbo roads are blocked and vaccines cannot go as armed groups imposed recent roadblocks.

“There is a need to wait until the roads are opened for the vaccines to reach the areas and this slows the vaccination process”, Chebo says.

According to Chebo, the transport fare that used to be FCFA 2500 is now 10,000 from Kumbo to Nkambe. A Nkambe man who used to pay FCFA 5,000 now pays FCFA 25,000. 

Ako-Nkambe used to be FCFA 4000 and today the distance is paid at FCFA 10,000, he laments. 

The district hospitals have been paying more to transport the vaccines. It has been tough but the goodwill of the managers at the district level has been overwhelming- they incur charges but they still take the vaccines, Chebo stated. 

Dr Cornelius Chebo, Head of Northwest Regional Covid-19 Incident Command Unit

80 vaccines destroyed

To scale up vaccination, following hesitancy, Cameroon organized the national vaccination days from 7-14 July. 

During the campaign, some vaccines were seized and destroyed in Kumbo East, Batibo, and Bafut. According to Chebo, “80 vaccines were intercepted and destroyed”.

But, this has not only happened to COVID-19 vaccines but with other vaccines within the context of the ongoing crisis, he added.

Electricity pools destroyed 

In some parts of the Northwest region, armed groups destroyed the electricity grid lines and even in Bamenda there has been constant outage with the central cold room, not an exception, Chebo said. 

“We used to stay here more than 10 hours without electricity, and it was difficult to respect the 8 degrees Celsius to store vaccines.

“Once the cold room reaches 10 degrees Celsius, it signals. When the outage has lasted for more than ten hours, it is not a good sign when keeping vaccines”, he stressed.

The challenge was more in April 2021, with more than eight signals a month, which meant we were out of electricity for more than ten hours, he adds. 

Standby generator to serve when there is no electricity

To salvage the situation, health authorities brought in a generator and have been supplying fuel. 

“But the challenge still lingers in some districts, and they had to resort to using fuel-powered generators too,” Chebo explained.

“Nkambe has not seen electricity for more than a year; Wum has also had no electricity for about two years and now runs their cold chains on solar or fuel.

However, the good thing is that the districts are looking for ways to overcome the challenges. “Most health facilities in Fundong, Ndop, and Nkambe are using solar energy to maintain their cold chains, a recommendable effort, Chebo said.

Regrettably, Batibo has solar fridges, but the panels were vandalized within the context of the ongoing crisis.

“If the facilities are not in a secure zone, there is a risk of them being vandalized,” Chebo maintained.

Despite the challenges in the Northwest region as of June 8, 2021, statistics from EPI were in the fourth position in the overall vaccination table. Presently, the Northwest has vaccinated more than 12664 people.

Data from the Northwest COVID-19 Incident Command Center shows that some of the areas where vaccines were destroyed have low vaccination rates, except Kumbo East.

The bigger challenge, however, is that many people in the Southwest region are reticent about taking a jab and prefer to take their local herbs.

The situation is not different in the Southwest region where access and storage remain a major hindrance to vaccination, especially in remote areas.

“I don’t think I will take the vaccine if I am not forced, I rather go for local herbs”, Njie Lyonga John-Paul, a resident of Bokova, in Buea in the Southwest region, stated.

Cameroon vaccinated 400,000 persons on August 14, according to a tweet from the Minister of Health, Dr. Manaouda Malachie.

However the latest information from the Expanded Programme of Immunization (EPI, shows the total number of persons vaccinated by region.

The crisis hit Northwest and Southwest regions are among the bottom four least vaccinated of the Cameroon ten regions. The ongoing conflict may in part, have contributed to the slow vaccination. However, the South region is the region with the least vaccinated population.

"This OUTBREAK story was supported by Code for Africa’s WanaData program as part of the Data4COVID19 Africa Challenge hosted by l'Agence française de développement (AFD), Expertise France, and The GovLab"