Vaccine Positive Pacific Voices with Will Genia, Dr Edith Kariko and Francyne Jacklick-Wase

Welcome to Episode 27 of Contain This, brought to you by the Indo-Pacific Centre for Health Security. This week we bring you a special episode on the Covid-19 vaccine rollout in the Pacific Region, brought to you by two podcasts - Contain This, and Vosa, supported by the World Bank in the Pacific and Papua New Guinea. This episode is hosted by regular Vosa host Arieta Rika, and will be published across these two great programs. 

In this episode, we’ll speak with Will Genia, Australian Rugby Union Player and UNICEF Ambassador, Dr Edith Kariko, World Bank Senior Health Specialist in PNG, and Francyne Jacklick-Wase, Deputy Secretary, Office of Health Planning, Policy Preparedness and Epidemiology in the Ministry of Health and Human Services. Together, we’ll look at what the vaccine means for the Pacific region, and what it means for each of our guests personally. 

We hope you enjoy the episode. Be sure to check out previous episodes on Vosa via the link below.

For more information about the Indo-Pacific Centre for Health Security, visit our website indopacifichealthsecurity.dfat.gov.au/vaccine-access

Connect with us on Twitter via @CentreHealthSec and @AusAmbRHS

Links:

Vosa: https://podcasts.apple.com/au/podcast/vosa/id1529975088

WHO PNG: https://www.who.int/papuanewguinea

PNG Government’s Niupela Pasin guidelines: https://covid19.info.gov.pg/files/July%202020/07072020/Niupela%20Pasin%20%20Transition%20to%20New%20Normal%20handbook.pdf

Transcript

Arieta Rika  00:01

Welcome to a special episode on the COVID-19 vaccine rollout in the Pacific region, brought to you by two podcasts Contain This from the Australian Government's Indo-Pacific Centre for Health Security, and Vosa, supported by the World Bank in the Pacific and Papua New Guinea. This is the first simulcast we've aired, whereby we're publishing the same episode across these two great programs. You can learn more about both Contain This and Vosa in the show notes. I'm Arieta Rika, the regular host of Vosa. 

Will Genia  00:33

As this episode is released, COVID-19 vaccines have begun arriving in Papua New Guinea with the support of the Australian Government. Meanwhile, the Republic of the Marshall Islands has been administering COVID vaccines since last December with great success.  Yeah, so I've been playing rugby for the last 16 years now. And I was fortunate enough to play for 10 years in Australia, then I've played for two years, three years in Paris, in France. And then another two years in Melbourne, on the back of obviously the first 10 year stint. And I'm now in Japan. Rugby is given the opportunity to come live here and travel here. And I'm very grateful for that. And as far as I guess my role with UNICEF, it's certainly something that I see myself being involved in long term is giving back to my country, helping the people that back home. But beginning I'm very grateful that I'm a part of the team and moving forward.

Arieta Rika  00:49

In today's episode, we look at what the vaccine means for our three guests. Joining us is Will Genia, Dr. Edith Kariko, and Francyne Wase-Jacklick. Will Genia is a Papua New Guinea-born Australian rugby union player and proud UNICEF ambassador. Dr. Edith Kariko is the World Bank senior health specialist in Papua New Guinea. And Francine wasa Jacqueline is Deputy Secretary Office of Health Planning, Policy Preparedness and Epidemiology in the Ministry of Health and Human Services in the Republic of the Marshall Islands. As always, I hope you enjoy this episode.

Will, thanks for speaking with me today. Can you tell me a little bit about you? And in your role as an ambassador with UNICEF?  Do you think positive health messaging has taken on a new importance recently in Papua New Guinea and elsewhere?

Will Genia  01:29

Yeah, I think it's massively important. I think just because there's a lot of misinformation out there. You know, that's the way the world works now, with social media, a lot of the times people, especially the younger generation, get their information from social media. And I think as you know, as a lot of people know, you can put anything on social media, whether whether it's Twitter or Facebook or Instagram and people take it as gospel. So I think the messaging particularly around the times that we live in now, it's so important to get out the right information besides the details and incoming from the people who know all that information.

Arieta Rika  02:50

Moving towards Papua New Guinea now. Will, can you tell me how has your own family been affected by COVID-19?

Will Genia  02:57

My family live in Port Moresby, my mum, my dad, my older brother, his wife, and his three kids all still live back there. And we all go back there twice or three times a year for Christmas, or just just to spend time together. So it's very much home. Port Moresby is very much home. My brother actually tested positive for COVID and my mom had close contact tracing with someone who tested positive in the bank as well. So they're in an isolation period at the moment, two weeks, which is pretty scary, especially for my mum. She's... my mum, she's stressing a little bit. But yeah, that doing well back home.

Arieta Rika  03:32

Of course, Will our thoughts are with your family and the rest of your community at this time. And, with that in mind, can you tell me what does the COVID-19 vaccine mean for you and your community?

Will Genia  03:44

Honestly, I think it's huge. I think the way that we are as people in Papua New Guinea, we're pretty pretty laid back people, we always tend to think it's gonna be okay. Don't worry about it, we'll be fine. We'll get through it. But you've seen on a global scale, and obviously now with everything escalating in Papua New Guinea, but you know, it's not I think it's we have to take this seriously and sort of dispel the misinformation and misunderstanding around the vaccine. Because I know from having spoken to a lot of people, again, it comes back to that laid back mentality where we'll be okay. It's just like the cold. But if you look at the hard facts, the science and the information behind it, you know, it's obviously something that's affected so many people's lives, whether it's through the tragedy of death, or just people being being ill.

So I think it's so important, the vaccine, that people take the vaccine seriously. But I think the more important thing is just the information around it. I think it's something that UNICEF has been doing really well. They've got people on the ground, whether it's through fact sheets or speaking to people and speaking to communities around, again, going back to the science and the actual information around it, to make people understand that look, this you need to take this for your health.

 But I think also, the other thing I'll come across is, you tend to there's there's kind of two realities to it. You've got the reality of people who say we'll be okay, it's just a cold. Then you've also got the reality and the fact that this is just the way the world works. Now, in a practical sense moving forward. If you look at people's jobs, it's affected. You have to work from home, or you can't put yourself out in social environments or social settings, you can't travel. The most urgent is to make people understand, right, you can have your beliefs, but you have to understand there's science behind it. And if you want to be a part of the way the world functions and moves forward, now, the vaccine is so important. And the hard part about obviously, Papua New Guinea is that it's not like countries like Australia or New Zealand, or, you know, other big countries in the world where you can put in place restrictions, you've been put in place protocols around, you can't do this, you can't do that, because of the nature of the fact that it's a third world country. And a lot of the way that they live is around communal living, it's hard to put those things in place. Because we just don't have the resources and in the infrastructure.

So I think people have to take it upon themselves to take it seriously. And listen to the information, listen to the science and listen to what the government and what the people in power are telling them in order to help curb the spread. Okay, so how do you think we can support the spread of accurate information on a COVID-19 vaccine, and in particular, combat some of the misinformation and conspiracy theories that are spreading? Honestly, I think, having been back there recently, a lot of a lot of the younger generation spend a lot of time on social media on their phones. When I was a kid, back then, I didn't even know what a mobile phone was. But nowadays, everybody has one. Everybody's on social media, everybody's on Facebook.

And I think if we didn't take an active step on social media to make sure we're publishing the right information, the right science behind things so that these younger generation reads it, but then spreads it, whether it's to their parents, their grandparents, the kids, nieces, nephews, whatever it might be.

I think what what UNICEF is doing is just being on the ground, speaking to the communities, whether it's through fact sheets, or just presenting the information, again, as you said, to dispel that misinformation around the vaccine. Papua New Guinea is such a diverse country with over 800 language groups. It's incredible.

Arieta Rika

And so do you think it's even possible to create health messaging that works for everyone?

Will Genia

Honestly, it's a very difficult thing to do because, as you said, with the with the language barrier around how many languages we do have in the country. But I did see that in the the NCD, the governor of the National Capital District, there's a slogan that he put out saying Harim Tok, which means Listen, and it's kind of a saying, we say, harim tok, like my parents said, Are you harim tok? Like, it's a stern thing of saying listen. It's just the messaging around listening to what they're saying, as far as again, like the procedures and protocols that they're putting in place. And while there are all these different languages, Pidgin is essentially the national language where everybody listens to. Again, it's a hard one, because the individual has to take it upon themselves to really take it seriously. You know, what I mean? Like, the people in power can only do so much, because as I said, the nature of the country with communal living and the lack of resources put in place or the right infrastructure, it's quite hard. Unless the individuals do take it seriously.

Arieta Rika

And now Will, in terms of looking to the future. What's your hope for the Pacific as vaccines do begin to roll out across the region?

Will Genia

Well, I think all we can hope for is that you go back to some sense of normality. I mean, there's a bit of a struggle between, obviously, Australia and Papua New Guinea. And I feel that in the sense that I want things to go back to normal so I can go right. I want things back to normal so I can go visit my family, see my my relatives, my country. It's simple things like that, that you you tell people, you know, at the moment, we may not feel a whole bunch of restrictions, because again, like, we're pretty isolated in terms of being a third world country. But if you look around globally, so many people have lives have been affected in terms of their livelihood, travel, all these sorts of things. And it's about making people realize, if we don't take this seriously, we those things will affect us as much as it has affected everybody else. And then I guess, just pushing that message. I think people just need to have an open mind and listen to what the information and what the science is telling you.

Because I certainly was someone who thought "everything's going to be alright". I think, you know, it's just like the flu, just like the coal but then when you actually read the information, and you see how tragically it's affected so many people's lives, it's it's incumbent upon us as people to actually take this seriously and gain a better understanding of it. Because if it affects us because of the nature of the disease and the virus being so contagious, it's going to affect all those around us.

Arieta Rika

And if you could take back any home messages or final reflections for those back at home in Papua New Guinea? Will, what would you say?

Will Genia

My thing is to just have an open mind, listen to the information, listen to people's experiences and stories. And make your decision based on that. And for me more often than not, if you do that, and have that open mind, you'll see that the vast view, especially in terms of us returning to some sense of normality, and going back to life as it was. I think it goes without saying that you're looking forward to receiving the vaccine. Yeah, I'm excited because I want to go home and see my family. I'm in Japan and even even being here in Japan, like we've had breaks we've had two or three weeks off and my fit my wife and daughter in Australia have not been able to go back. Because of the travel, because of the virus and because there's we don't have the vaccine yet, which will allow us to travel. So yeah, I think people need to be open to it. And personally, I can't, I can't wait for it. And hopefully, because of it, I can travel, see my family and go back home to Papua New Guinea.

Arieta Rika

Thank you, Will. It's been really great speaking with you today. I really appreciate your time. Thank you so much.
 
Will Genia

That was Will Genia, former captain of the Wallabies and a UNICEF ambassador. Now you'll hear from Edith Kariko. World Bank senior health specialist in Papua New Guinea. Edith, thanks for speaking with me, how do you feel about the arrival of COVID-19 vaccines in Papua New Guinea?

Edith Kariko  11:31

I think for me personally, and you know, as a public health specialist, it's it's exciting to get a response so quickly, in this time of surge for Port Moresby and Papua New Guinea as a whole. So there are concerns that we won't be able to, particularly for our system to cater for the deployment of vaccines. Papua New Guinea, of course, has child vaccination programs, and this is going to be the first adult vaccination program. So with it comes to these challenges. We we remain forever grateful for the response that we getting from DFAT as always, for us for Papua New Guinea, in terms of responding in our time of need. So the deployment aspect of it is of course concerning on my part.

Arieta Rika  12:23

So this will be the first time a nationwide adult vaccine has been rolled out through Papua New Guinea.

Edith Kariko  12:31

Yes, and you know, we have adult vaccines, but these are just one off. The patient presents to clinics, not the mass type of vaccination programs such as these. So it would be interesting and you know, with child immunization programs We've always had that going on for decades. So, in terms of the information that goes along with having those vaccines acceptable within our communities, it hasn't been really an issue or problem because I mean, I got vaccinated, my mom, of course, took me there, my children got vaccinated, so it's already within our way of life but having to have now these vaccinations coming and having adults to respond to them, is of course interesting.

Arieta Rika  13:20

Of course, there are some concerns about the vaccine due to the misinformation and conspiracy theories that are spreading in Papua New Guinea. How do we combat that misinformation?

Edith Kariko  13:31

I think sticking to the facts and as a public health specialist, scientific backing and ensuring that whatever is brought out scientifically must be interpreted for layman consumption. I think that's really crucial. When you have layman circulating scientific reports it's very scary for me because, of course with scientific reports, we have pros and cons and there's a scientific argument about acceptance of whatever scientific innovation is coming on board. But with from a layman's perspective, and particularly in Papua New Guinea, this can be very, very challenging in how information is shared and distributed. 

Arieta Rika

Our other guest on this episode, Will Genia, spoke about the huge cultural diversity in Papua New Guinea. And Edith, how do you communicate vaccine information to communities in remote or isolated parts of the country? 

Edith Kariko

It's going to be really challenging and to be quite honest. I've worked in the family planning space and worked with the family planning commodities in remote rural areas and just having to get that out to remote rural women and how it is supposed to help you. It's very challenging. Will is right in saying, you know, we all know that diversity in our language and communication, particularly health communication in these instances is challenging when that level of diversity exists. And not just the diversity but I would say that level of culturally how we receive information needs to be really strategized well. You know, in the highlands saying, they don't usually say things as cities, they call it in tok, tok pisin. It's like telling parables, but and then in the course, there's a different way of sending messages. So, I mean, whoever's responsible for communication strategies that targeted at rural remote areas need to hugely consider the cultural appropriateness of these messages.

Arieta Rika  15:38

That's really insightful. It is turning to the future. What are your hopes for Papa New Guinea, as vaccines begin to roll out?

Edith Kariko  15:46

I think first and foremost, you know, we're we're approaching it the right way having to try to prioritize who gets the vaccine first. And it's, of course, the people who are helping the rest of the population. And that's health workers and essential frontline workers. With the effectiveness of the vaccine for Papua New Guinea is not known yet. We know the efficacy as it's suggested within the literature, and scientific evidence that has come from the vaccine we're receiving but the effectiveness is yet to be yet to be known. And it's only after that we can see how it can affect us in the future, whether this becomes a routine program for Papua New Guineans. How long does the vaccine work in Papua New Guineans, and whether it's every six months or every five years? I mean, these are things that have to be established. And I think the rest of the world is also working individually in their countries trying to establish that for their population.

Arieta Rika  16:42

Are you looking forward to receiving the vaccine?

Edith Kariko  16:44

Of course, as a public health specialists, I find it my duty of care to join the rest of health professionals around the world in trying to ensure that whatever we find in to address this pandemic is supported not just as organizations, but as individuals. Of course, with every new thing comes that level of nervousness. You question what it really is, and particularly, to ensure that no harm is done to you. And I'm sure this vaccine has been looked at by specialists who also creates the medicine that we drink to cure illnesses. So I'm sure all that safety measures may have been put in. I would encourage everyone to think about protecting not just themselves, but their families as well when they make these decisions. We have no endset at the moment, the vaccine provides us that opportunity to at least live with this virus for the meantime. So I think you know, we should look at it with open-mindedness and not just think of ourselves, but think of our families and our communities as a whole when we make those decisions.

Arieta Rika  17:59

That was Edith Kariko, World Bank senior health specialist in Papua New Guinea. Now you'll hear from Francyne Wase-Jacklick, Deputy Secretary Office of Health Planning, Policy Preparedness and Epidemiology in the Ministry of Health and Human Services in the Republic of the Marshall Islands. Francine, it's so great to be speaking with you. How would you describe the Republic of the Marshall Islands experience of COVID-19 so far?

Francyne Wase-Jacklick  18:30

It's been peaceful. I guess that's the one word I can use. At this time. We've been able to live freely do things as normal. I'm still hugging my family. I'm still hugging my friends. So it's great to have that freedom and peace of mind. And the word we use in our language, we say Ainemon, which means we are at peace. So in peacetime, so it's good to have that.

Arieta Rika  19:04

Yeah, that's really nice. And I know RMI has had a very strict repatriation program and the only cases of COVID-19 have been in quarantine. So no community transmission, right? 

Francyne Wase-Jacklick  19:17

Since we started our repatriation program, this started in December. But since then, through our very strict repatriation protocol, we have been able to keep the COVID transmission from the community and into the country. So we haven't had any cases since then.

Arieta Rika   19:44

You know, managing that process of repatriation must have been really, really challenging. The success of it in avoiding any community transmission, I mean, it's really amazing.

Francyne Wase-Jacklick  19:54

It's a lot of work but the work is very porton to ensure that COVID does not go into our country. We do have, I'm not sure if I've shared with you, but we do have a two phase quarantine process which a lot of work is put into it, We have the first phase is the repat folks have to go through a 14 day quarantine process stages in Honolulu and after that once everything is clear, then the next phase is going into the Kwajalein US garrison military base here in RMI. They also going to another additional 14 day quarantine.

Arieta Rika   20:41

Wow, so a month long quarantine process. Moving on to the vaccine now, RMI has had the COVID-19 vaccine for a few months. Francine, can you tell us what has that been like?

Francyne Wase-Jacklick  20:54

Well, the vaccine is here since december so we're very happy that it's here. We've been one of the few fortunate countries here in the Pacific islands to be able to get it firsthand and be able to get it at any given time. Because we're doing house to house.  The strategy for the rollout is a house-to-house mobilization of the vaccine so vaccine straight at your door so that's how we've been able to achieve a great completion rate with our COVID vaccine rollout here in the community.

Arieta Rika  21:42

It's really incredible to hear people are getting the vaccine in their homes. Has there been any resistance to it so far?

Francyne Wase-Jacklick  21:50

We have not had any resistance to getting it. At first you know there was uncertainties of what it is and what it may be do. But through continuous risk communications and information going out to the public, continuous press releases and text messages. Using every outlet that we can do and have to share information of the vaccine through our public health officials I think we've been able to achieve a great acceptance acceptance rate of of the vaccine here in RMI. So I think a lot has to do with leadership, not just from the government but also community leaders and as well as the frontline workers. A lot of work has been done tremendously by our public health nurses. They're the ones going house-to-house explaining the vaccine explaining this - what the side effects are what to expect. A lot of work has gone into it.

Arieta Rika   22:58

Okay, so did you always intend to vaccinate people in their homes?

Francyne Wase-Jacklick  23:01

Initially what we had done was we had initially established points of dispensaries in the communities meaning that we've set up a vaccine site and anybody above 18 years of age are welcome to receive the vaccine at these points of dispensaries. While we were you know assessing the rollout plan we noticed that we weren't getting enough people so we had to switch the game plan and given previous public health programs and projects we've had, we thought of using the same model as we've done previously of house-to-house campaigns with immunizations, even with TB mass screening. Using those best practices we've had, we thought maybe, hey, let's try and change this strategy from past experiences and lo and behold we got the same grade success rate as we've had previously in other projects.

Arieta Rika  24:12

So did you find that people were very grateful that the RMI had access to the vaccine so much earlier than nearly every other country?

Francyne Wase-Jacklick  24:21

They're very blessed I can say this. But there were some that did not know that other countries that not received it or there were conditions given to the vaccine and like for the US you had to be there was certain age group requirements provided in order for someone to get vaccinated. Here in RMI as long as you're 18 and above you're qualified whether you're Marshallese or non-Marshallese, you're eligible to get the vaccine. So I think everything has been pretty coming to RMI and such a blessing to many of us, including myself.

Arieta Rika   25:06

And so speaking of yourself, what was it like to get the vaccine and were there any side effects?

Francyne Wase-Jacklick 25:13

It was just my arm, it was kind of heavy but other than that, it was good. I didn't really have any side effects, just mild fever, but just like getting a normal flu shot. That's the way I preach to my team because there's as you mentioned earlier, there's a lot of hesitancy or vaccine hesitancy to towards the COVID vaccine, because it's new. It's foreign to many, but you know, as many as those that are very known to COVID, they know that this is very similar to the flu. So I use that to my own, to my own mentality when getting it because at first, I was not one of the first few that got it. And then I keep telling myself, it's just flu shots. So that's the way I conceptualize it.

Arieta Rika  26:14

How incredible for you to be one of the first people in your country to get it. Looking to the future now, what does a COVID free future mean for you?

Francyne Wase-Jacklick  26:24

Well, my hope is that RMI can be an example of sharing what works in our country, we can be a model of our public health interventions, and we can share with others what works in our country, and maybe they can adapt to what we do here. And my hope is that others can see what we're doing and we can we can be of help in any way, shape or form. My hope is that us along with the other Pacific Island brothers and sisters if we set the precedence of having COVID, free and 100% COVID vaccine Pacific Islands, we can become COVID, free Pacific. Snd therefore others can see what the big ocean blue countries can become a great prime example of what we can do to protect the entire... everyone from this very, very unfortunate disease that has brought to and has changed many of our lives. And my hope is that by doing so, we may have the ability to not only have a herd immunity RMI, but a herd immunity Pacific and so on and so forth, then perhaps maybe we can go back to our normal social lives, borders can open up, I can see my in-laws, my families overseas, my son can go to any colleges he wishes to without having any fear of what's happening in the US. And I do also hope that while we're doing all of this work together, there's an opportunity for the Pacific Island countries to look at the health security plans that we haven't planned and maybe update during this time of peace. During this time that you know, it's not so chaotic. At least for here in the RMI that we can look into these policies and make improvements accordingly. For RMI it's an opportunity for us to go out to the Rural Health and outer islands to visit those vulnerable populations and provide services where we can during this time that we don't have any external obligations such as sometimes we have to go to meetings externally. But more it's much an opportunity for us to really go out in the outer islands and provide the services that sometimes we don't really have the time but now it's we have the time now.

Arieta Rika  29:28

Francyne, that's a beautiful vision for the Republic of the Marshall Islands. We really appreciate your time today. This episode was brought to you by Contain This and Vasa. Further details on the podcast can be found in the show notes.