hifa logo webhifa titleNGWERERE, Zambia — Four people turned up at a health clinic tucked in a sprawl of commercial maize farms on a recent morning, looking for Covid-19 vaccines. The staff had vials of the Johnson & Johnson vaccine stashed in the fridge. But the staff members apologetically declined to vaccinate the four and suggested they try another day.

A vial of the Johnson & Johnson vaccine holds five doses, and the staff was under orders not to waste a single one.

Ida Musonda, the nurse who supervises the vaccination effort, suspected that her team might have found more takers if they packed the vials in Styrofoam coolers and headed out to markets and churches. “But we have no fuel for the vehicle to take the vaccines there,” she said.

They did vaccinate 100 people on their last trip to a farm; the records from that trip sat in a paper heap in the clinic because the data manager had no internet connection to access an electronic records system...

“I’d like to get it but I work Monday to Saturday, and I don’t know if they vaccinate on Sunday,” said Bernadette Kawango, who supports a large extended family with her wages from an auto-parts store in a low-income neighborhood on the edge of Lusaka, the capital. She has heard many rumors: that people who receive the vaccine will die in two years; that the vaccine is part of a plot by Europeans to kill Africans and take their land; that Bill Gates is on a campaign to reduce the world population... Covid is not at the top of her list of health care worries. “It’s cholera season, and people have malaria, and there is H.I.V. and TB,” she said. She does not know anyone who has been diagnosed with Covid.

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