**Short summary of community engagement by IPH & VGKK teams for COVID-19 vaccination in Chamarajanagar district** The second wave of COVID-19 had just passed in southern Karnataka’s Chamarajanagar district. The [memory of hospital deaths due to lack of oxygen supply](https://www.thehindu.com/news/national/karnataka/oxygen-shortage-led-to-24-deaths-in-chamarajanagar-hospital-report/article34545925.ece) was still too fresh. The arrival of the vaccine was mostly received with optimism in many cities and was mostly the case in Chamarajanagar too. The [district had done quite well in the first wave of COVID-19](https://www.thehindu.com/news/national/karnataka/once-a-green-district-chamarajanagar-saw-massive-covid-19-surge-in-april/article34474776.ece) being lauded for very few reports. The 2nd wave sadly caught the district unprepared. Was it lulled into complacency by its relative remote location and larger rural and forest areas that were deemed _inaccessible_ to the virus? Within the large expanses of forests in the district’s two tiger reserves (BR Hills and Bandipur) and a wildlife sanctuary (MM Hills) live > 30,000 Adivasi people of the Soliga, Betta Kuruba and Jenukuruba communities (apart from other communities classified as *Scheduled Tribe*). Hardly touched by the first wave, and one death attributed to COVID-19 in one of the villages in Hanur in 2021, the Soliga people were wary of vaccines. After [having joined with the district health department in mounting the hospital-based response after the oxygen crisis](https://network.exemplars.health/india-covid-19-sos/b/best-practices/posts/project-chaitra-chamarajanagar-initiative-for-technical-assistance-research-and-action-on-covid-19), we were called upon to join the district administration in the community response to vaccines. This was, after all, a straight-forward problem and appropriate communication, we thought. The health department mobilised and trained health workers to be able to provide vaccination. While, urban and rural folks thronged to be ahead of the queue, the Adivasi locations reported poor vaccination numbers. There was a sense of urgency. These were communities considered _vulnerable_ - with pre-disposing medical factors such as high rates of adult & child malnutrition and anaemia already. [Many of them rightly questioned](https://www.theindiaforum.in/article/will-come-if-it-our-podu) if indeed this disease was to be considered a threat at all. “*Let it come to my doorstep and then we’ll see”, “it is still far away…it wont come into our lands”, “people like you who claim to bring health and information to us actually bring the disease, so why dont you all (health workers) stay away*” - these were the oft-heard arguments. Indeed, many others pointedly asked “*Roads and electricity to our villages save lives. Bring them first before you promise to save my life with that injection*”. However, the Adivasi communities of Chamarajanagar were not all so far removed. There was frequent visits by them to towns and cities nearby and the chances of spread among them was all too real. Core principles of public health required sharing of appropriate information that could enable decision-making in their own interest. The key was to not _adversely include_ them by using power and influence that the district administration or NGOs may have over them, but to create platforms for engagement that allowed individual Adivasi people to know about the benefits of the vaccine and to consider if they would like to receive it. Thus began the conversation with Basavaraju of *Soliga Pusumale Kalaa Tanda*. Basvaraju is a well known folk artist with his own folk theatre group. When this conundrum was described to him, he offered an ingenious framing device for a potential dance drama centred around the virus. His view was that the vaccine was a right that belonged as much to the Adivasi as to the others. "For decades we have been deprived of technology. If everyone else is thronging to get the benefit of the vaccine, my people wont be left behind", he asserted. In a matter of days, a draft script for a dance-drama called *Corona Maari* was ready. Set to a recurring 2-liner, the rhythmic song was interspersed with instances of traditional healthcare seeking and its importance for timeless “local” ailments, whereas the arrival of the *Corona Maari* from distant shores necessitated the vaccine. Using local materials, young Adivasi youth in his team ranging from 10 year old boys to elderly women, created a dancing virus and wrote song and dance sequences that enthralled Adivasi audiences. > ಚೀನಾದಿಂದ ಎಲ್ಲ ದೇಶಕೂ > > ಬಂದೇ ಬಿಡ್ತು ಕೊರೊನ ಮಾರಿ > > ಎಲ್ಲ ಮಾಯಾ ನಾಳೆ ನಾವೂ ಮಾಯಾ > > ಎಲ್ಲ ಮಾಯಾ ನಾಳೆ ನೀವೂ ಮಾಯಾ > *Basavaraju, a Soliga Adivasi poet & theatre artist from Yerakanagadde, BR Hills* <blockquote class="twitter-tweet" data-media-max-width="560"><p lang="en" dir="ltr">As I sit listening to a lovely song “corona maari” at a remote Solega <a href="https://twitter.com/hashtag/Adivasi?src=hash&amp;ref_src=twsrc%5Etfw">#Adivasi</a> village, the power of ಜಾನಪದ/folk song and theatre tradition comes alive…Basavaraju and colleagues from ಸೋಲಿಗ ಪುಸುಮಾಲೆ ಕಲಾ ತಂಡ composed this song; <a href="https://t.co/KLcfELpyJr">pic.twitter.com/KLcfELpyJr</a></p>&mdash; daktre/ಡಾಕ್ಟ್ರೇ (@prashanthns) <a href="https://twitter.com/prashanthns/status/1420072042733268993?ref_src=twsrc%5Etfw">July 27, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> Eventually, we accompanied Basavaraju’s team across over 80 villages (of the over 140 villages) of the Soliga, Betta Kuruba & Jenu Kuruba people across Hanur, Yelandur, Chamarajanagar, Kollegal and Gundlupet talukas. At each location, the dance-drama lasting about half an hour was followed by an often riveting and tense community dialogues where participants freely exchanged on the implications of his message. Eventually, we were able to also secure funding to recruit 8 Soliga vaccine volunteers from among the Adivasi people resulting in improvement of the initial dismal single-digit coverage of to >90 % evenutally. As the folk theatre unfolded, Adivasi leaders came forward to create a short film too, which was played after the performance. Watching their own leaders, kith and kin proudly claiming vaccination together with open community dialogues initiated by Basvaraju yielded results. It helped bridge ethical access to a technology which often eludes many Adivasi communities. <iframe width="560" height="315" src="https://www.youtube.com/embed/VvicSegthZc?si=DQmMYZ302ZNBpcyD" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe> ### An unstructured list of activities that are yet un-reflected/discussed critically - for future filing/discussion During the 2nd wave, Bangalore urban and many rural districts including Chamarajanagar were badly hit. Being doctors specialised in public health, Dr. Prashanth N Srinivas and Dr. Tanya Seshadri both responded in the following ways.  - Noting the lack of primary health care level preparedness early on when COVID-19 was first reported in India, they led the COVID-19 Primary Health Care Action group with several leading rural public health professionals to come up with the first-of-its-kind PHC checklist resource for COVID-19 care. The resource was translated into multiple Indian languages including Kannada, Marathi and Hindi and was later extensively adapted for use in urban primary health centres as well. Other groups have adapted this resource for deployment in schools as well. The checklists are available for download here: [https://iphindia.org/iph-contributing-to-fight-covid-19/](https://iphindia.org/iph-contributing-to-fight-covid-19/) (Scroll to section titled “Preparedness Resources for primary health center”) - Providing technical assistance to the Rural Development & Panchayat Raj (RDPR) department in improving engagement of Gram Panchayats in rural areas through timely creation of Kannada training material and resources translated into Kannada  - On request from state government’s RDPR department, PNS & TS were involved in supporting design and implementation of supplementary helplines for COVID patients struggling for finding beds. This was in coordination with several other NGO partners identified by RDPR.  - During the 2nd wave crisis, when Chamarajanagar district hospital was affected, some of the earliest oxygen concentrators donations were organised by the team. Totally over 200 OCs have been facilitated by the team.  - PNS and TS were able to mobilise and form a coalition of several NGOs in Chamarajanagar so that there is coordinated action and support to the district administration and avoiding duplication. Over 6 NGOs including [VGKK](http//www.vgkk.in), [ATREE](http://www.atree.org), [Deenabandhu](https://deenabandhutrust.org), [Punarchith](https://www.punarchith.org) and [SVYM](https://svym.org) supported this collaborative initiative that is today called [CHAITRA](https://network.exemplars.health/india-covid-19-sos/b/best-practices/posts/project-chaitra-chamarajanagar-initiative-for-technical-assistance-research-and-action-on-covid-19) (CHamarajangar Initiative for Technical Assistance, Research & Action on COVID19) - PNS & TS joined the district hospital triage team on-ground and worked during the COVID-19 peak period when the hospital was overwhelmed with patients, directly providing patient care as well as organising smooth workflow and triage systems.  - On request of the district administration, they led a team of doctors and public health professionals from IPH & VGKK who facilitated setting up of such triage units in taluka hospitals. They worked particularly closely with the Kollegal sub-divisional hospital in setting up smooth care pathway for COVID19 patients - [[COVID-19 response in Chamarajanagar|Adivasi community engagement strategy for COVID-19]] care when positive cases appeared in remote Adivasi settlements in Kollegal and Hanur. Based on their collaborative engagement with the district administration, zilla panchayat and DHO, the state’s first Adivasi community-based COVID-care center was set up in a Girijana Ashrama Shaale in Jeerigegadde podu in Chamarajanagar. This was in close partnership with the PG Palya Graama Panchayat & the Jilla Budakattu Girijana Abhivruddhi Sangha, a collective of the Soliga Adivasi community.  - With support from Azim Premji Foundation, several initiatives to improve vaccination coverage in tribal areas through vaccination promoters from the Adivasi community and in partnership with the Soliga Abhivruddhi Sangahas.  - They worked closely with the Pusumaale Soliga Adivasi Kalaa Tanda who have prepared a street theatre for improving COVID-19 vaccination coverage among Adivasis. Nearly 80 Adivasi hamlets of the Soliga, Jenu Kuruba and Betta Kuruba communities have individually been covered and vaccination rates are improving in hamlets where this team has been performing their now famous “Corona Maari nritya naataka” followed by dialogues with the community on importance of vaccination.  - **Some knowledge outputs from their work** - Detailed article on PHC resources prepared during first wave appeared in _The Fountain Ink_: [https://fountainink.in/reportage/creating-a-rural-covid-19-checklist](https://fountainink.in/reportage/creating-a-rural-covid-19-checklist) - Op-Ed in _The Hindu_ titled “Refocused vaccination campaigns are possible” [https://www.thehindu.com/opinion/lead/refocused-vaccination-campaigns-are-possible/article34792974.ece](https://www.thehindu.com/opinion/lead/refocused-vaccination-campaigns-are-possible/article34792974.ece) - Article on the Adivasi COVID care center in _The India Forum:_ [_https://www.theindiaforum.in/article/will-come-if-it-our-podu_](https://www.theindiaforum.in/article/will-come-if-it-our-podu) - Article on community engagement for COVID-19 vaccination in Adivasi communities in _The Gaon Connection:_ [_https://en.gaonconnection.com/karnataka-br-hills-tribals-covid19-vaccination-corona-vaccine-hesitancy-chamarajanagar/_](https://en.gaonconnection.com/karnataka-br-hills-tribals-covid19-vaccination-corona-vaccine-hesitancy-chamarajanagar/) - ToI coverage of the Kalaa tanda work: [https://timesofindia.indiatimes.com/city/bengaluru/karnataka-tribal-artists-street-play-seeks-to-remove-vaccine-hesitancy/articleshow/84228018.cms](https://timesofindia.indiatimes.com/city/bengaluru/karnataka-tribal-artists-street-play-seeks-to-remove-vaccine-hesitancy/articleshow/84228018.cms) - Article on COVID-19 governance reforms in the international peer-reviewed journal, BMJ Global Health: [https://gh.bmj.com/content/6/2/e004392](https://gh.bmj.com/content/6/2/e004392)