A Shot in the Arm

It doesn’t take much coaxing for Navli Garasiya, 29, to break into a dance. She starts by singing enthusiastically and before you can blink, Navli is on her feet, twirling with joy. The song she is dancing to, however, is not a movie number or a folk song. It is part of an information campaign that was launched in 2021 urging people to go out and get vaccinated against Covid-19.

Navli is a Garasiya, a member of a tribal community found in Rajasthan’s Sirohi district. Around 28 per cent of the population in Sirohi, which was numbered at 1,036,346 in the 2011 Census, is tribal. The Garasiyas, quite like the other tribes of Rajasthan, are often characterised by their colourful clothing—women wear elaborate shirts festooned with ribbons and embroidered with their names as well as that of their partners, friends, etc—and certain aspects of their lifestyle. The Garasiyas are known for their—by modern standards—unconventional approach to relationships with marriage, not considered essential at all. Another aspect of their community is the belief in not piercing their body until they attain adulthood. And even after that, there are many reasons not to go near a needle. This doesn’t extend to tattoo needles, of course, but over the years, had come to exclusively mean fear of syringes. This had a tremendous impact on the immunisation of pregnant women and infants. “We have been working on the ground for three decades now, trying to bring about a community change. Over the past decade-and-a-half, we have seen more and more women shed their inhibitions as far as immunisation is concerned. They are aware of Mission Indradhanush and come to get their children immunised,” says Richa Audichya of Jan Chetna Sansthan, a NGO that works extensively with the Garasiya women. However, all the advances made since the turn of the century were in danger of being washed away with the pandemic.

Navli, educated till Class 10, has been the driving force behind opening her village’s lone school which was shut down. Her father had been a government employee and she had spent a part of her youth in different cities. “I know how important it is to be educated, especially for the girls.” She has been a ward panch for her village. Her work in this field has taken her far and wide, including to Australia for a conference. But when it came to getting the Covid shot, even Navli hesitated.

The fear of syringes in the community is a mix of suspicion and faith in the traditional healing rituals the tribe follows. Each Garasiya village traditionally had a bhopa, a faith healer, who would claim to treat with amulets and chants while also actively propagating against the use of syringes. “Most elders of the community had never got a shot. Even today, there is pushback when pregnant women come for their shot or new mothers bring children for immunisation. Children react to the shot and fall ill for a day or two and the elders say, therefore, syringes are bad,” says Audichya.

Initially, she says, there was still some enthusiasm for the shot but the side-effects—fever, body ache—coupled with the Delta wave of Covid, shook everyone. Huli Bai, at 106, is one of the oldest members of the Garasiya community in the Sirohi district. Her two Covid vaccination shots are the only time in her long life that she has been near a syringe. Kariban has been active in propagating immunisation in her village due to her association with Jan Chetna Sansthan, but even she was hesitant about taking the shot. She only smiles when asked why she was reluctant.

The Garasiyas were not alone in their vaccine hesitancy. World over there have been angry protests over the vaccines from those who remain suspicious of the shot for reasons of their own. Conspiracy theories, the likes of which are to be found all over, around fertility and longevity were rife among the Garaisyas too. Lalita Garasiya, 39, a second-term sarpanch offered to be the first person in her village to get the shot so as to disprove the rumours. “But they were convinced that my shot was special while they were going to get the one that impacts their health,” she laughs. The death of a villager—the community claims Covid was widespread during the second wave but no one got tested out of fear—would often spark rumours that it was due to the vaccine. A lot of work went into dispelling these rumours, including tracking down family members of the deceased and recording video testimonies that the individual in question had not even taken the shot. “A lot of the old fears, which we had painstakingly worked on over the past two decades, came back as if they had never left. Even routine immunisation took a hit with people becoming wary about it. In many ways, the entire process came to a grinding halt,” says Audichya. Villagers would not let people into their homes, convinced that it was the vaccine more than the disease that would kill them. By the middle of last year, vaccine coverage for the 45-plus age group in tribal districts was the lowest in Rajasthan. The state average was above 75 per cent, whereas tribal districts were struggling to cross 65 per cent.

It has been an uphill climb for everyone, from civil society to the government machinery to not just convince the tribes to get their shots but to also make it accessible to them. Garasiya settlements are usually spread over a very wide area with no two homes being adjacent to each other. Each home—mostly humble dwellings—is situated on top of a hillock with the family’s landholding spread around it. Since the terrain is mountainous and forested, elevated homes are used to keep the families and the livestock safe from the wild animals in the region. Today, it only serves to enhance the extent to which the Garasiyas remain cut off from the modern world even if there are roads leading up to their settlements. “When the vaccine drive started, we would set out early with our bag full of vials to make home visits. Getting to each home takes an hour and there was no way to determine if we will find anyone at home. Vials were getting wasted, vaccine hesitancy was running high and we were walking through forested areas for hours with nothing to show for the results,” says Dr Salim Khan, who runs the primary health centre (PHC) for Deldar village in Sirohi. The PHC caters to nine panchayats.

Health officials realised a two-pronged approach was needed; one involving local activists, and the other, incentives from the state government. According to reports, government officials were stationed at ration shops—an easy meeting point, given the scattered nature of their settlements—and names were crosschecked against vaccination records. The Garasiyas claim that threats were issued to cut off their ration if they did not take the shot, though the government has denied this claim. “We vaccinated local workers like teachers and ASHAs, influential community leaders. We asked for panchayats to be organised,” says Khan. The top-down approach worked, albeit slowly. Bhopas, who were amenable to change, were also brought into the fold. Gajaram Manpu, 65, was one such “priest”. Dressed in all black, with dreadlocks, he is a revered figure in the community, almost always on call, be it for a medical emergency or a perceived occult one. “I took the shot without hesitation. And I let everyone else also know that they should take it. This pandemic is not to be taken lightly but advice, even when good, takes time to trickle in.”

According to Khan, the first step towards convincing a community that has been on the fringes, to trust the state is to showcase the benefits they are eligible for. “Nowhere is this more obvious than in schemes like the Pradhan Mantri Matru Vandana Yojana, which promises a slew of benefits if the pregnancy is registered and the birth takes place in a hospital,” he says. Then there are schemes at the state-level like the Rajasthan government’s Mukhyamantri Rajshri Yojana, which promises cash incentives in the event of a girl child, starting from her birth and going all the way up till her enrolment in Class 11 in school. “But even to make the communities aware of these incentives, we need constant communication. Liaising plays a very important role in bringing them into the fold,” says Khan.

Today, the Abu Road block has a 93 per cent vaccination rate for the first shot and 81 per cent for both. Routine immunisation has picked up once again and steady progress towards Covid vaccinations has been made.  One thing that eventually made a difference was the vaccination certificate. The Garasiyas, once foragers are involved in manual labour today. A few of them migrate to cities for work but it is a limited number. “They realised that even for daily work the contractors were asking for certificates. So, that became the last push on top of all the other attempts which were already underway,” says Lalita Garasiya.

However, there remain concerns about the community, ranging from the education of girls to malnutrition. Marriages—or live-in arrangements as is the community’s norm—still take place at a relatively young age. Given the nature of the terrain they live in and limited mobility, contact with the outside world requires a whole day’s worth of planning. Mobile phone towers have come up, but connectivity remains an issue. Hope hinges on community leaders and sarpanches who, if committed enough, ensure that all the benefits earmarked for the men and women of the community are made available to them. One such example is that of Sarmibai, a former sarpanch of Nichlagarh, a village in Sirohi. She has been instrumental in spreading awareness about the vaccine in the face of insurmountable opposition. “I struggled a lot with the health of my firstborn because I never got my immunisation done when pregnant or got him his shots of BCG and tetanus, etc. Years of struggling with his health made me realise the importance of immunisation, and the vaccination drive was but an extension of that,” she says. In 2010, Sarmibai even met former US President Barack Obama as part of the Hunger Project, which works with elected women in gram panchayats. But both Sarmibai and Lalita, leading figures in the community, will admit that there is still a long way to go for the community, be it men or women. Education, they say, is the only way out. “And then we won’t even face issues like vaccine hesitancy anymore,” says Sarmibai.

Garasiyaimmunisationpublic healthRajasthanTribal communitiesvaccination