To seek and not to find
My quest for vaccinationMonday, April 19, 2021
Despite all my experiences to the contrary, I retain optimism that things will go smoothly for me in Jamaica. It is because of this (unfounded) optimism that I am not one of the 100,000 plus residents who have been reported as being vaccinated.
When I heard that the Mona Ageing and Wellness Centre was registering The University of the West Indies (UWI) retirees for vaccination I viewed this as positive. I hold the view that the more the vaccination process can be outsourced, the better, as this approach will place less strain on the health-care system and workers. The UWI has the capability, so it made good sense that it be allowed to vaccinate its population, according to the Government's priority ranking. So I registered.
Having not heard back after a while I followed up and was told that I needed to register on the Ministry of Health and Wellness's (MoHW) site. This surprised me. If multiple sites were doing registration it seemed to me that the process should be designed to allow electronic merging of the databases. I admonished myself. “Yours is not to reason why,” I argued, and registered for Wednesday, April 14. I was very impressed when, in short order, I got a text message confirming date and time. Optimism reigned.
On Monday afternoon, my young friend, who holds a far more realistic, not to say pessimistic, view of Jamaica than I, called to say there was some problem with expiry dates and I should go right away to get my shot as she was sure vaccines would run out. I was not perturbed, since my appointment had been confirmed, but it provided a valid reason to get out of the house, so I headed up to The UWI. There I was directed to the Old Library. It seemed that by this time most of Kingston and St Andrew and a good part of St Catherine had got the news and headed there as well.
I wandered around for a while and then spotted a Jamaica Defence Force soldier handing out forms. He directed me to the students' union to get registered. Off I went, to be greeted by a line that left the students' union building, snaked around the side, and was lost to view. Little attention was being paid to physical distancing. I didn't see much prospect of leaving there before late evening and, I reasoned, I had a confirmed appointment for Wednesday, so I decided to leave.
I got another call from my young friend. On hearing the situation with the crowd she said that the National Arena was much better, so I should go there. I didn't hold out much hope of a smaller crowd, but I headed there. On arrival, I couldn't even get into the parking lot. There was a line waiting to enter from both directions. I gave up and went home, figuring that if there was a problem with my getting the jab on Wednesday the ministry would let me know. And so it did. On Tuesday I got a text message saying my Wednesday appointment had been cancelled and I should reschedule for Thursday.
On Thursday morning I went to Mona only to find that no vaccinations were being done. We were advised to follow instructions from the MoHW. “Actually,” I pointed out, “I am following instructions from the MoHW, that's why I am here.” My optimism was beginning to wane.
On Friday, having received no instructions, and seeing nothing helpful on the MoHW website, I called the hotline. A very polite young woman apologised for the inconvenience and said the vaccine was finished and I should wait for instructions.
On hearing from a friend that the chief medical officer stated on air that there are additional vaccines for the elderly I called back. The person who answered was unaware of any additional doses but suggested that I re-register in order to try to get my shot. So, in summary, here I am, deregistered and un-vaccinated despite being in a priority group, and despite having done everything asked of me. Yet, for me, this is merely an inconvenience. I have my own means of transport and can afford to go vaccine-chasing.
I will re-register and hopefully I will eventually get my shot. I heard of an 84-year-old woman, with mobility challenges and not much income, who faced a similar situation. She was redirected from site to site but could not afford the taxi fare and, after the second redirection, got totally discouraged and gave up. Will she try again? Will she be vaccinated?
These situations led me to reflect on how the client experience could be improved. Here are my suggestions:
1) Better on-site information:
Set up a clearly marked entrance with a flow chart showing the entire process. Throughout the site directional arrows and signs would help to streamline movement. The signs need not be expensive. They could be printed on a plotter or large format printer and placed on display boards. These can be accessed from government entities.
An information desk staffed by individuals who can give accurate information is needed. A friend who has some physical challenges stood in line for nearly an hour before a kind stranger, seeing her distress, went in search of help. It turned out that there was a facility for getting vaccinated in cars, but this information was not easily available at the site.
2) Maintain the priority ranking:
Each site should have a dedicated line/area for priority groups. Within the priority grouping there could be further differentiation. Priority could be given to the elderly/aged and people with disabilities, for example.
3) Better communication and sharing of information with the public:
The system of text messaging works well. It allows targeting of specific groups, as well as differentiation of messaging and does not require a smartphone, Internet connectivity, or maintaining social media accounts. A text message can reach large numbers in a very short time. More information should be shared by this means. For example, although I was registered I did not receive any guidance on whether I should try to join the blitz or wait for my appointment. Nor did I get information on the early closing of sites on Tuesday. The text which informed me of the cancellation of the appointment could have said why it had been cancelled. Other texts should have been sent to the same group explaining the no-vaccination on Thursday and advising of the steps to be taken in order to get vaccinated.
4) Accommodate the most vulnerable:
If an aged/elderly person arrives at a site which is not giving vaccinations the approach could be that someone at that site does the searching and directs the person to a site where he/she is sure to be accommodated. A call or text to that receiving site explaining the situation would smooth the way for the person.
In any response operation, plans will be derailed and unexpected challenges will be faced. Those of us who have managed response operations know well the truth of Moltke's statement: No battle plan ever survives contact with the enemy. Managing a pandemic is a new experience for us. Things will not go perfectly. However, the protracted nature of this event provides the opportunity for feedback, review, evaluation, learning, and improving plans and procedures even as the response unfolds. Shall we grasp it?
Dr Barbara Carby is a former director general of the Office of Disaster Preparedness and Emergency Management and a former director of hazard management, Cayman Islands.
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