Maverick Citizen

COVID-19

How Vaxi Taxi is repurposing public spaces and partnering with Western Cape communities to bridge the vaccination gap

The Vaxi Taxi campaign is an initiative by the Western Cape government to bring vaccines to people who normally would not be able to access existing vaccination sites. (Photo: Ashraf Hendricks)

There is a widespread perception that people do not want to get vaccinated against Covid-19. While this may be true in certain communities, in many historically underserved areas of the Western Cape, the challenge is access to vaccines. Bridging that divide is no simple task, but a simple yet powerful initiative is solving this conundrum: The Vaxi Taxi campaign run by the Western Cape government’s Emergency Medical Services (EMS) is getting vaccines to people by partnering with local community kitchens and using public space.

On a sunny Saturday morning in December, an EMS team arrives in three ambulances in the informal settlement of Europe in Gugulethu and sets up a vaccination site right outside the local community kitchen with chairs, tables and shade. In a few hours, it effectively changes the future of this community. At least 213 people have been vaccinated at this kitchen and, while the number sounds small, these people would probably otherwise not have been able to access these life-saving vaccines.

Shahnaaz Taliep, an EMS paramedic who spends her weekends as a vaccinator, calls it a “vaccination site on wheels” and that is literally what it entails: two ambulances travelling with a team to a previously identified location. Shahnaaz proudly highlights that since its inception, the initiative has reached 40 communities, in both urban and rural areas across the province, with nearly 5,000 people vaccinated so far since the first Vaxi Taxi was launched in October this year.

The brilliance of this initiative lies in bringing services to those who need them most by maximising the material and social resources already available. Even where the physical environment is not conducive because roads are narrow or shade isn’t readily available, working with trusted local people and groups has enabled EMS teams to be flexible and creative, and provide sites that are appropriate, safe and inviting. 

EMS paramedic and volunteer vaccinator Shahnaaz Taliep says Vaxi Taxi is a win-win: it keeps people safe and reduces the load for EMS in the long term. (Photo: Ashraf Hendricks)

Creating and repurposing spaces

Wayne Philander, mobile vaccination project leader at the Western Cape government, points to the resourcefulness and “wonderful innovative assistance” made available by the communities they have visited to overcome challenges such as inadequate access to roads and overhead electrical cables. It helps that the team has been testing the model since July this year and has established measures and methods that work in similar environments. 

In fact, they have produced a toolkit which they hope others will use to help increase vaccination rates across the province and beyond. It also helps that, in the context of Covid, working outdoors is the safest way to engage the public, maintain physical distance and create the type of visibility that will encourage others to join in. The EMS team consistently endeavours to keep the procedure as safe as possible by keeping ambulances well ventilated, ensuring mask-wearing and providing portable hand-sanitising stations.

In Europe informal settlement in Gugulethu, EMS has partnered with Siyakula community kitchen to build on existing relationships and trust in the community. (Photo: Ashraf Hendricks)

Working with community structures 

Dr Leanne Brady from EMS says “we knew that taking our vaccination programme to the streets would be more challenging than at our fixed site and, in some neighbourhoods, finding a suitable space has been a bit tricky. But, our intention is to take vaccinations to where people live and using public space has also pushed us to be more creative. So, narrow roads in some townships or on the Cape Flats presented an initial challenge, but many residents have opened up their homes to us and arranged to use public space for a few hours while we vaccinate. We work closely with trusted community leaders, so that makes the process much easier, and much more meaningful.” 

Whereas the physical infrastructure might not be comparable to purpose-built venues, the social infrastructure enabling this initiative highlights how public health and other services can be profoundly improved. The Vaxi Taxi campaign in Europe informal settlement, for instance, was possible because of the collaboration between EMS and the local Siyakhula community kitchen, whose founder Betty Duli-Mkinasa helped to arrange plans for the day. 

Duli-Mkinasa explains the kitchen started in April 2020 with the support of the Gugulethu Community Action Network (CAN), one of the many community groups that sprung up at the beginning of Covid as a social response to the pandemic. Since then, Betty has been working to ensure her community is “safe and healthy”. In the early days, this entailed helping to feed those who had nothing and is now focused on helping people get vaccinated before they travel back to the Eastern Cape for the holidays, she says.

Betty Duli-Mkinasa runs Siyakhula community kitchen in Gugulethu. (Photo: Ashraf Hendricks)

Access, equity & safety 

For many residents across the province, getting to a vaccination site entails long and multiple trips, leaving children alone, missing out on work and many other circumstances that make it virtually unattainable to get vaccinated. The Vaxi Taxi initiative helps to balance this inequity by ensuring people are not left behind because of where they live. 

Access is not only physical however. Dr Brady explains that trust is fundamental to bring vaccinations, or any public initiatives for that matter, into a community. The EMS teams visit proposed sites in advance and go door to door explaining what the campaign entails with a CAN volunteer who already has the trust of neighbours. During these visits, people have the opportunity to ask questions and dispel some of the misinformation being circulated on social media.

Access is also about safety, which has long been a challenge for the EMS team, with a history of ambulances being a target for violence in “red zones”, which are the areas where vaccination is most needed. Similarly, residents who experience security issues daily feel nervous about attending public events. This is where collaboration with existing structures such as neighbourhood watches is critical and Dr Brady points to the importance of connecting with those who, in her words, “are already keeping each other safe all the time”.

The Vaxi Taxi initiative is rolling out Covid-19 vaccination efforts across the Western Cape in rural and urban areas, and has reached close to 5,000 people so far. (Photo: Ashraf Hendricks)

Building back better

Besides increasing vaccination rates, the Vaxi Taxi campaign is creating temporary safe spaces which help to strengthen the relationship between residents and public servants. According to Philander, “this is an opportunity to strengthen the links between EMS and the communities we serve”. This is crucial to continue the work and to prepare for future crises.

Similarly, the collaboration with community kitchens can pave the way for public participation that advances a holistic approach to public health. Pamela Silwana from the Gugulethu CAN points out that “community kitchens serve more than food. They are sites of support to the community more broadly.” It is those relationships which provide the most conducive environment to maximising the physical and social resources available in different communities across Cape Town and the Western Cape.

With the arrival of the fourth wave, the emphasis must continue to be on ensuring more people are vaccinated while observing physical distancing and other preventive measures. This is not a simple case of issuing a vaccine mandate. As Dr Brady points out, strengthening existing relationships and planning together, even under a highly pressurised environment, is not only required to protect against the current wave, it can show the way for better and more intentional public participation. Public space, as usual, is the perfect platform to showcase how this is done and the Vaxi Taxi campaign is showing that a set of wheels and a committed team can help bridge the vaccination gap. DM/MC

Marcela Casas works as a programme lead for the Western Cape Economic Development Partnership. This work was supported by the Heinrich Böll Stiftung Southern Africa.

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