The Washington PostDemocracy Dies in Darkness

‘They have another door’: Kenya’s vaccine rollout exposes rich-poor divide

Security guards check the details of people waiting to register for a coronavirus vaccination at a hospital in Thika, Kenya, on March 30. (Patrick Meinhardt/Bloomberg News)

NGONG, Kenya — The two schoolteachers had heard the vaccine was first come, first served and had been waiting in front of the hospital since 5 a.m. They had been given numbers in line and let their thoughts drift ahead to the now-imminent moment for which they’d waited months.

Around noon, there was a sudden hubbub. A nurse appeared at the hospital’s gate and said the doses were finished. A crowd gathered. Some said they had seen the nurses sneaking in people through a back door, the teachers recalled later.

Amid the ensuing shouts from the crowd were denunciations of a more insidious plague here in Kenya: public services that work for those with connections and money and relegate everyone else to the back of the line.

“They have another door for their friends,” said Mary Njoroge, 58, one of the teachers. “Without a godfather to help you through this process, what are you supposed to do?”

Kenya procured around 1 million AstraZeneca vaccine doses through Covax, a World Health Organization-backed global vaccine distribution effort, and began administering them free of charge last month. The scene at Ngong Sub-County Hospital was a microcosm of how some people here have experienced the rollout: slowly and confusingly if you are poor, quickly and simply if you’re not.

Coronavirus vaccines are finally reaching poor countries, but some can’t cover the cost of administering them

Margaret Kamau, head of the vaccination unit at Ngong Sub-County Hospital, denied allegations that nurses allowed people to jump the line.

Juliana Nderitu, the other teacher, said she had tried booking appointments online at private hospitals, but websites were glitchy. Tuesday was the pair’s second day of waiting since dawn, putting their trust in what was meant to be a first come, first served system for eligible recipients, a group that now includes various essential workers and all adults over the age of 58.

“There was no proper planning when it came to this rollout, and that’s why you are seeing this type of confusion,” said Chibanzi Mwachonda, acting secretary general of the Kenya Medical Practitioners, Pharmacists and Dentists Union.

In a news conference Thursday, Kenyan Health Minister Mutahi Kagwe appealed for patience.

“We are happy that there is great demand for the vaccine from Kenyans,” Kagwe said. “Let us not panic or become anxious. The government will provide vaccines for all adults in Kenya in a phased approach.”

As of Thursday, Kenya has administered first doses to just over 160,000 of its 54 million people, a relatively slow rate compared to other countries. Second-dose appointments are being given for May and June.

The country’s health ministry says it aims to fully vaccinate half of the population by June 2022, relying primarily on Covax, although donations from wealthier countries are expected to pick up once their own vaccination campaigns slow down.

Late last month, amid a surge in case numbers and dwindling hospital space that centered on Nairobi, the capital, the government reimposed domestic movement restrictions and expanded the hours of a curfew that has been in place for more than a year. For five months last year, Kenya closed its borders, but for now, international travelers can still come and go.

Like in last year’s lockdown, however, the government has offered little support to the vast majority of Kenyans who work in the informal sector and whose ability to work is severely curtailed by the restrictions, hardening a belief among many that the government’s precautionary measures are mainly meant to protect the wealthy while leaving the poor even more vulnerable.

Police killed at least 20 Kenyans while enforcing coronavirus rules. Hopes for justice are fading.

An opaque rollout of the Russian Sputnik V vaccine on the private market in March, as well as news reports that Nairobi’s large United Nations staff contingent and diplomatic corps are being offered Covax vaccinations by the government, have raised questions about the government’s priorities involving whom to vaccinate first. (On Friday, Kagwe announced that Kenya would no longer allow companies to import, distribute or administer vaccine doses.)

Last week, in an apparent promotion, two of Kenya’s most well-known and media-savvy lawyers, each with around a million followers on Twitter, claimed to be the first and second people in the country to get the Russian vaccine, which was being sold for around $100 for both doses.

The vaccine, which is not approved by the WHO, was granted emergency-use authorization in Kenya, but health officials scrambled in recent days to explain how private medical care providers administering doses to prominent personalities fell under emergency provisions.

Those seeking free vaccinations in wealthier parts of Nairobi have also simply found it easier to stroll into a hospital and get a shot without waiting in line.

Joseph Mutisya, a physiotherapist, said he breezed through the process at Nairobi Hospital, the country’s largest private health facility. He made an appointment through the hospital’s website, and being familiar with computers was less deterred by the glitches it had.

“I came in with my booking message, I showed my doctor’s practice license to qualify, they gave me a number to wait, they called it, I registered my details, and I got the vaccine,” he said. “The whole process did not take more than 45 minutes.”

Less than half a mile away, at Mbagathi Hospital, a public institution that largely serves the sprawling slum of Kibera, hundreds of people clamored outside the gate, where confusion reigned.

A security guard at the hospital, who spoke on the condition of anonymity because she wasn’t authorized to speak to the media, said crowds gather each day by the time she reports for work before 6 a.m.

“It’s how early you wake up that determines if you get the vaccine,” she said. “Many have been turned back and told the vaccines are done for the day.”

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

New covid variant: The XBB.1.5 variant is a highly transmissible descendant of omicron that is now estimated to cause about half of new infections in the country. We answered some frequently asked questions about the bivalent booster shots.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

For the latest news, sign up for our free newsletter.