As of 22nd April 2021, 83% (883 out of 1060) of health workers in both public and private health facilities in Tororo district, had received their first dose of the AstraZeneca vaccine which provides protection against severe COVID-19 disease, hospitalization, and possibly death in some instances. This is a resounding success considering that in many districts, the exercise has been hindered by hesitancy, even among health workers leading to poor coverage. 

Tororo district hosts the Malaba border point of entry which is the gateway from the Republic of Kenya to South Sudan, Rwanda, Burundi and the Democratic Republic of Congo. It also hosts several cement industries and food stores of the World Food Programme among others. 
 
With the ongoing second wave of COVID-19 in the Republic of Kenya and a beehive of business activities, Tororo district could potentially be the main entry point for a new variant of COVID-19 into Uganda. This geographical location and the economic and social interactions are enough cause for anxiety and worry for public health experts dealing with a very unpredictable disease. 

Dr David Cyrus Okumu, the Tororo District Health Officer reminisces with apparent pride the preparatory work they did in anticipation of a widespread outbreak.  “WHO had in a special way supported the district with preparedness, readiness and response planning during which period a lot of technical capacity was built in the local health workforce and this has served us very well during the ongoing vaccination exercise,” he says.

Indeed, a lot of preparatory and capacity building work was done despite inadequate financial resources which seem to be a major barrier in many districts. “Money should not be the driving force for COVID-19 interventions, we are here to save lives,” adds Dr Okumu when asked to explain how they achieved the feat where many of his contemporaries have failed. 

The robust use of the mass media with airtime generously donated by the Resident District Commissioner (RDC) and other implementing partners played a pivotal role in raising the population’s risk perception and hence the high uptake of the vaccine. Added to this was the innovation to integrate COVID-19 response interventions into routine activities.

Right from the outset, the Tororo District Task Force (DTF) for COVID-19 where WHO is a member and provides technical guidance, realised the value of a multi-sectoral approach in responding to the outbreak. In that regard, they ensured the active and regular participation of all department heads, the business community, religious leaders, and others in all DTF meetings and planned activities. Another blessing was the availability of technical guidance, which, was provided by the WHO field team resident in the neighbouring Mbale district. 

In the planning meetings, the DTF set ambitious yet achievable tasks including building trust among the population and health workers who are the service providers and the vaccine recipients. They also ensured easy access to the vaccine by the target groups and to credible information which meant dispelling rumours and misinformation at every opportunity. 

In addition, the DTF cultivated collaboration and networking among a multiplicity of partners and stakeholders who are committed to safe and accessible COVID-19 vaccination. The district leadership engendered inter-generational trust in vaccination by raising awareness, providing and activating action by arming stakeholders, partners, the media and the public with up-to-date facts.

This approach to the Response raised the risk perception of the public so high that the issue of consenting to the vaccination has not been a challenge.

Nurse, Agnes Athieno, who was the first to get vaccinated at Mukuju HCIV in Tororo District was so confident about the safety of the vaccines to the extent of declaring to her colleagues that, “if the vaccine kills, let me die for you my friends, and if I die, don’t take the vaccine, WHO cannot recommend and approve a bad vaccine and the Ministry of Health cannot procure a vaccine, which is bad for the people.”  Of course, nurse Athieno is still alive and working hard to ensure that all eligible people in Tororo district get vaccinated before the second wave gets worse. 

This public display of confidence coupled with the vaccination of the entire Tororo District leadership at the launch of the Vaccination exercise sent a clear message to health workers and the other target groups that all was well with the vaccine. No wonder overall coverage has been impressive in Tororo district and has been achieved within a short time.

At the same time, COVID-19 surveillance and contact tracing have not been ignored which has enabled people in the urban and rural areas to appreciate the intensity and seriousness of the pandemic. All these interventions have massively contributed to the population’s high-risk perception and eventually high uptake of the COVID-19 vaccine.

The Resident District Commissioner Mr Nixon Owole attributes the impressive work done in Tororo district on COVID-19 to teamwork. “This success is attributed to teamwork, transparency, commitment and the open policy that has been firmly embraced by the district,” he said in a recent interview.  

Indeed, the results of this teamwork are there to show as attested by Mr John Henry Ariong a retired teacher who while about to receive his COVID-19 vaccine at Tororo General Hospital noted that, “I have only been focusing on information from the Ministry of Health, the District Police Commander and twice I listened to a radio talk show on Rock Mambo FM conducted by a team from WHO. I was convinced that the Vaccine is safe. I also watch the BBC for authentic international news.”

There is an unwritten approval of the work being done by the Tororo DTF to ensure that no one is left behind and that the pandemic does not devastate the district. But from many people, it is easy to discern nods of appreciation, praises and applause for the district leadership on the work being done.