Nepalis overseas get first vaccinations

Long before Nepalis in Nepal will be vaccinated against the coronavirus, Nepali frontline workers around the world are already receiving their first jabs.

The most optimistic prediction for a vaccine to arrive in Nepal is mid-2021, but with countries around the world prioritising medical workers, many Nepalis who work in the healthcare sector overseas are starting to get vaccinated.

The globalisation of the Nepali workforce became even more apparent during the pandemic: a Nepali doctor in the UK could be using medical gloves made by Nepali workers in a Malaysian glove factory while vaccinating a Nepali nurse.

“We always knew healthcare workers would be in the priority group, but the general understanding was it would still be a few months into 2021 that the vaccines would reach us,” said Binaya Raman Dahal, a Nepali hospitalist in North Carolina who got his first injection last week, and said it was like taking any other flu shot.

Dahal recalls how his colleagues would fall ill, and hospital staff had to step in even during off days. The first couple of months into the pandemic, personal protective equipment ran out, and there was a rush of patients following the July 4 and Labour Day weekends.

“There is a big sense of relief that the vaccines are here,” Dahal said over the phone, adding that he will still have to careful because of the risk to family.

Srijana Panta Rokka, has been a nurse in the UK since 2004, and considers herself fortunate for being one of the first recipients of the vaccine. “It was like taking a flu-shot. Others report sore arms, temperature and headache as side effects, but for me I just felt tired and my eyes ached that day,” she recalls.

Her General Practice has largely avoided in-contact patients since March, and has moved to tele-medicine, while only taking emergency in-person patients. But from 1 January, she will be serving as a vaccinator, after being trained in administering the Pfizer vaccine.

“I was one of the nine nurses in my practice who got vaccinated so we could vaccinate others,” Rokka said in a phone interview. Most patients eligible for vaccination will be above 80 years.

There are fears about side-effects and long-term implications of the vaccine, and Rokka has had to counsel fellow Nepalis working in elderly homes in the UK who are eligible for the vaccine, but are reluctant to take it. She thinks information campaigns to assuage people’s fears will have to be a part of vaccination drives.

Another Nepali clinician in the United States, Yagya Raj Bhattarai, says the past year has shown that Covid-19 spared no one. “I had a 20-year-old patient who suffered the worst outcomes, including heart failure and anoxic brain injury. Then, I had a 100-year-old who was positive but completely asymptomatic,” said Bhattarai, who self-isolated in a room throughout the period to keep his family safe.

Bhattarai’s hospital in North Carolina participated in vaccine trials, and says the efficacy of the first dose is 52%, and it is 95% after the second shot. He experienced mild local pain in his left arm and no other side effects.

Across the United States in Nebraska, cardiologist Khagendra Dahal recalls long periods of self-isolation and the difficulty explaining to his young children why he was staying separately.

“Even after being vaccinated, we will still need to continue to wear our protective gear because it is not known whether we are transmitters of the virus even if we ourselves are safe,” Dahal says.

Another country with a sizeable Nepali caregiver population is Israel, and it has started a massive vaccine campaign for health workers, those over 60 and at high risk. Nepali caregivers are considered frontline workers.

Nischal Shrestha (pictured above) has been living in Israel for the last 11 years, and takes care of a 91-year-old woman who she took to the hospital to vaccinate last week.

“I was not expecting to be given the shot because we were told that the priority would be health workers and the elderly. But my employer got the hospital to also get me immunised,” says Shrestha, who says her arm and body ached for a day or two, but she is fine now.

Deepika Bhusal also works as a live-in caregiver for an elderly couple in Israel. Her employers got their first doses of the vaccine on 25 December, and there was much celebration in the house.

“I trust the health system here. Even the Prime Minister went on live television to take his first shot publicly,” says Bhusal, who is getting her own shot on new year’s day.

“We live in the same house so compared to elderly care institutes or live-out care workers, we were in a much safer position,” Bhusal explains. “But we had to go outdoors often for therapy or exercise, or to shop, so there was always a risk,” she adds.

The UAE is another popular destination for Nepali workers, and the first country to approve the Chinese Sinopharm vaccine which is said to be 86% effective after trials around the world. The UAE is providing the vaccines free to residents and citizens.

Kisan Magar works in a car showroom whose employer got him and his European and Filipino colleagues vaccinated recently. He says he has been getting lots of congratulatory messages from family in Nepal, while compatriots in the UAE have been querying him about how to enrol for the vaccine.

Navaraj Ghimire, another UAE-based Nepali who got his first jab says: “We work in security and are exposed to risk, and 33 people in my company have been infected so far." Some of his colleagues, however, refused to be vaccinated because they did not trust it.

Back in Nepal, the best-case scenario is for the first vaccinations to start in mid-2021. Health experts say Nepal was late in the game to start ‘vaccine diplomacy’, and there is a fear that even when the vaccines do arrive the poor in remote areas will be the last in the queue.

The vaccines that Nepal will acquire will have to be the ones that require less sophisticated cold storage systems which are currently in Phase 3 trials in India and China. Till then and even after being vaccinated, Nepalis have to keep wearing masks, avoid crowds and wash hands.

According to Ministry of Health and Population, the Government plans to vaccinate 72% of the country's population, as 28% are below 15 and therefore excluded. An estimated 20% are expected to be vaccinated through the WHO-initiated COVAX facility, while the remaining 52% will be through government-to-government mechanisms.