As Alfred Oyekoya saw months of triumphant headlines about the success of the coronavirus vaccine rollout, with targets set and smashed, he knew the figures quoted didn’t tell the whole story.
While politicians and the media talked about how many people in the community had come forward for their jabs, he knew that hundreds of people were excluded from those statistics, with the NHS unaware they even existed.
Undocumented migrants seeking sanctuary in Wales, people unable to communicate in English or Welsh, others who were distrustful of the nation’s health system or didn’t understand how it worked – none of these people had ever registered with a GP, and when it came to the health service drawing up the lists for vaccine invitation letters, they were living outside the system. Undocumented migrants seeking sanctuary in Wales, people unable to communicate in English or Welsh, others who were distrustful of the nation’s health system or didn’t understand how it worked – none of these people had ever registered with a GP, and when it came to the health service drawing up the lists for vaccine invitation letters, they were living outside the system.
“When we talk about vaccinating the community, there are people among us we shouldn’t leave behind,” said Alfred, who after reading last year’s studies about the disproportionate impacts Covid-19 was having on people from black, Asian and minority-ethnic (BAME) backgrounds, knew he had to do something to help those people who were at risk of missing out on vaccination.
That’s why Alfred and his organisation, BAME Mental Health Services (BMHS), have spent the summer working with health boards across south Wales, setting up extra vaccination centres for people who have either fallen off the official NHS registers or were never on them, reaching hundreds of people who may otherwise have been left behind
The vaccination drive has been a huge success, with BMHS building a reputation of trust with the people it supports, offering multilingual advice to people who weren’t reached by official government messaging, encouraging them to get a jab, and helping them get familiarised with the way the NHS works.
“We got involved in vaccinations because, as you could tell from the statistics, ethnic minorities have had a lot of fatal consequences when they contracted Covid, and one of the reasons why is because a lot of these groups are not even registered with a GP in the first place,” he said. “Or, when they are registered, they don’t disclose their conditions – they don’t engage with the GP as they should. Then, when someone contracts Covid, they haven’t disclosed that they have underlying health conditions.”
The reasons for this are complex, diverse and cannot be summed up in a one-size-fits-all explanation that covers everyone from a BAME background, but from his organisation’s outreach work, several regular issues had been raised, Alfred said.
For undocumented migrants, they may feel reluctant to share their personal information with any authority – even a doctor’s surgery – in case it is passed onto immigration officers.
“The fear their details will be shared with the Home Office, and they’ll be deported,” Alfred said, adding that these concerns affect people on their asylum journeys, people who are appealing against their asylum decisions, and those who have been ordered to leave the UK.
“Because Wales is a nation of sanctuary, it has a pull factor – there are a lot of people like that in Wales,” he added.
For other people, such as international students, they may be new in the country and unfamiliar with the way the NHS works.
“Where they come from they may pay to register with GPs, and they feel that because they can’t afford it now, they’re going to wait until a time when they can afford it, or when they have serious health issues,” Alfred said. “In some countries you wait until you have a serious health issue before you go and pay to see a GP.”
There may be cultural and religious reasons why people do not register with a doctor, Alfred explained, adding: “What we try to say to those people is you have to do both: trust your pastor or your imam, but also register with the GP so your details are on file.”
Finally, another common theme is one not limited to people from BAME backgrounds.
“We also have some groups who are not engaging because of waiting times,” Alfred said. “The way we access GP services have changed dramatically during the pandemic and some people feel there’s no point anymore.
“If I need to speak to my GP, for example, I need to call between 8am and 10am. If I miss calling at that time, I can’t talk to my GP. Sometimes you have to be waiting for so long, and if I get any success, the best I get is a call back and five minutes to actually engage with the GP. Of course this is a nationwide problem, it is a big discouragement for a lot of people.”
Based in Swansea, BMHS normally specialises in mental health support for BAME people, signposting them to services as well as representing them on a national level, addressing any structural discrimination and petitioning government to reform the way ethnic-minority people are treated by mental health services.
Through this work, the organisation has built strong links with people across south Wales, and when Alfred and his colleagues starting receiving calls from people who wanted the vaccine but were hesitant about registering with a GP, they realised they could step in and be a trusted bridge between those people and the authorities.
“We wrote to the local authority [in Swansea] to say we need to do something different in terms of how they access the vaccine,” Alfred said. “It was at our request and it was a huge risk for the health board.”
Fortunately, Swansea Bay University Health Board had invested in a novel way of getting jabs to people unable to attend the normal vaccination centres – an old mobile library converted into a mobile vaccination centre, lovingly nicknamed the ‘Immbulance’.
As The National reported previously, the health board devised the immbulance as a way of reaching people who lacked access to transport, were homeless, or who lived in remote areas. And after reaching out to the council, Alfred was able to secure a date for the vaccine drive once the NHS priority lists for jabs had been completed.
That day in Swansea, at a “neutral venue” chosen to allay any fears about being picked up by the authorities, Alfred and his colleagues waited for the first people to arrive for their vaccine. It was raining, and with the event being held outside, there were some initial fears the gamble wasn’t going to pay off.
But that soon changed as the first people arrived, followed by a few more, until a total of 150 people got vaccinated.
“I felt so happy,” Alfred said. “The turnout was so impressive, 97 per cent of the vaccine was used on that day. I was so happy and shared [news of the success] with the Welsh Government as well.”
Since then, BMHS has held another vaccination drive in the Neath Port Talbot area, and the organisation will soon head to Newport for another event, looking to build on their early success. Alfred hopes that through this work, and his organisation’s ongoing mental health support, more BAME people can feel connected with their wider community – something he holds dear to his heart, and has championed over the summer with activity days including litter picks on Gower beaches.
“One of the ways we build trust with people is that we solve their problems,” he said. “They see us doing these things for them and they trust us.”
He added: “We try to give back to society as ethnic minorities as well, so we are not just seen as being on the receiving end [of support]. We’re givers, not just receivers – that’s something that’s deep in the racism issues we’re trying to correct. It’s difficult to be racist to someone who’s solving a problem. We’re trying to change the narrative.”
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