Written by Tendai Machingdaize, MD, Global Health Scholar from Zimbabwe and Global Health Program Site Director for the University of Zimbabwe

On March 30, 2021, I jumped into the car with my younger brother and my cousin to go to Wilkins Hospital in Harare. We had heard through the grapevine that vaccinations for COVID-19 were now open to all citizens over the age of 18. There had been no official announcement on television or in the newspaper that we came across - one of my friends had posted photos of her getting her first dose on facebook and I had come across them in my News Feed. Two weeks prior my parents had rushed to Parirenyatwa Hospital to receive their first shots after my mother heard from a friend at church that vaccinations had opened up for those over the age of 60. This was the "broken telephone" manner in which the Zimbabwean public first found out about the availability of vaccinations in their own country.

We knew that the Zimbabwean government had received doses of Sinopharm and Sinovac from China, and would later receive vaccines from India, Russia, and through COVAX. It was the subject of every news headline, the leaders of the country reassuring the masses that they had everything under control. What we didn't know was how many doses were currently available in the country, when they would run out, and when the next batch would be available. As such, we immediately recognized the urgent need to get to a vaccination center as soon as possible.Vaccinations in Zimbabwe first opened up to groups such as healthcare workers and teachers, and then to those over the age of 60, beginning in February 2021. Word around town was that due to vaccine myths and misinformation, even among healthcare workers, the vaccination rate was much lower than expected in the first groups to be offered the vaccine, so much so that all hospitals and municipal clinics administering the vaccine were free to give shots to anyone eligible who showed up, regardless of age, profession, or health status.

Zimbabweans refusing free vaccines. I was surprised. Why? Because of what we in Zimbabwe call the "baby card." When a mother takes her baby to her local clinic for the first time, she is given a baby card. Back in 1982, my mother received such a card for me at the Mount Pleasant Clinic. It was a distinctive yellow card where at every visit to the clinic, nurses charted my height and weight; developmental milestones such as when I first sat and walked, and my first words; and most importantly my completed vaccinations according to the schedule set out by the Ministry of Health & Child Welfare.

No matter how remote the setting, every mother in Zimbabwe knows about the baby card. In the 80s and 90s, Zimbabwe was a trendsetter in Africa when it came to education and healthcare. Through television and radio PSAs, local clinics, and community health workers, the Zimbabwean public was well-informed about availability and access to healthcare. Moreover, there was a collective "faith" in doctors and nurses and the services they provide. It was a rare thing indeed to come across a mother who did not believe wholeheartedly in the importance of the baby card for the well-being of her child. Without fail, she would strap her baby to her back and make it to her local clinic for every scheduled weighing and vaccination.

So how is it that today in 2021, when the power of the baby card still holds strong, Zimbabweans are refusing the COVID-19 vaccinations? When did Zimbabwean doctors and nurses lose the trust of their patients? When did the healthcare system falter in educating its people?


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