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INTERVIEW • #VACINA MARÉ: UNION OF SCIENCE, HEALTH, AND MOBILIZATION

By Julia Bruce

Edited by Andréa Blum and reviewed by Luiz Assumpção

 

The campaign vaccinated approximately 37,000 residents aged 18 and above in six days.

The second dose is scheduled for October 14th to 16th!

Learn more on the Vacina Maré website.

 

Raphael Vicente

Raphael Vicente, a digital influencer from Maré who contributed to the campaign's mobilization and was one of the first young people to be vaccinated on the first day of #VacinaMaré. Photo: Patrick Marinho.

 

"It's a dose of hope! Thanks to God, we haven't lost anyone in the family. We tried to stay indoors as much as possible, but we know many people who have lost mothers, children, and it's very sad. It's a daily fear!" says Luana Ricardo, 29 years old, born and raised in Vila dos Pinheiros. She is one of the 36,926 residents of Maré who were vaccinated in the six days of mass vaccination against Covid-19 during the Vaccina Maré campaign, the first in a Brazilian favela to immunize all residents between 18 and 33 years old. The action took place from 07/29 to 08/01 and was extended for an additional three days from 08/02 to 08/04, with a door-to- door active search by residents who had not yet received the first dose.

 

 

The campaign's goal was to vaccinate 31% of the adult population (31,000 people), and this target was reached on the third day, representing 99.14% of the target audience served, according to the Municipal Health Secretariat (SMS). The SMS decided to extend the schedule for an additional three days and expanded the vaccinated group to nearly 37,000 people. This unprecedented initiative was carried out by Redes da Maré in collaboration with Fiocruz and the Municipal Health Secretariat as part of a study led by Fiocruz. The study aims to evaluate the effects of vaccination, monitor the circulation of new variants, and provide health follow-up for 2,000 families over six months to study and map virus transmission within the family environment.

 

This study will also help evaluate the protection of children, as they are a group that has not yet been vaccinated."We want to understand how much the protection of adults preserves children or how susceptible children still are to Covid-19,"says the study's coordinator, Fernando Bozza. The Maré Complex, comprising 16 favelas, has about 140,000 residents, with the majority being young (51.9% are under 30 years old), according to theMaré Population Census.Over the past year, with the efforts of the Health Connection project,the fatality rate has decreased by 88%.

 

Coletiva Fiocruz

Press conference held on the first day of vaccination (07/29) at the Adib Jatene Family Clinic in Vila dos Pinheiros.

From left to right: Daniel Soranz, Secretary of Health, Renan Ferreirinha, Secretary of Education, Fernando Bozza, study coordinator at Fiocruz, and Eliana Sousa, director and founder of Redes da Maré.Photo: Gabriela Lino.

 

The study is an outcome of a series of actions carried out with the Maré population to address Covid-19 prevention. In early 2020, communication actions in the area were expanded to various fronts to contain the virus's spread. These efforts included telemedicine, with online consultations for Maré residents, free testing with the installation of a testing center and mobile units, and support for safe family isolation, which provides guidance and support to families with infected members. These actions are part of the Health Connection project,,which brings together Redes da Maré, Fiocruz, Dados do Bem (an app that monitors the evolution of Covid-19 in urban populations), SAS Brasil, SAS Brasil, União Rio, and the Municipal Council of Manguinhos."Throughout this past year, we have been working on notification and testing data in Maré. Today, we can say that more than 35,000 PCR tests have been conducted, and about 900 families have been monitored. But in terms of vaccination, Maré was still behind the rest of the city. That's why we became very aware of the need to accelerate vaccination and also reach many people who hadn't returned for their second dose,"Bozza emphasizes.

 

THE UNION OF FORCES FOR A COMMON GOAL

 

This action is the result of a great deal of effort and work by Redes da Maré, along with local organizations such as the 14 residents' associations, which conducted pre-registration of the population at Family Clinics (CFs). Additionally, NGOs such as Observatório de Favelas, Luta pela Paz, and Uerê contributed by assisting in both online and in-person mobilization processes, as well as providing volunteers. The Family Health Units, with their volunteers, and schools also played significant roles as vaccination centers. Communicators and digital influencers further strengthened the mobilization efforts among residents.Eliana Sousa, the director and founder of Redes,considers this moment "unique" "This mass vaccination takes place within the context of a process that we have been building to confront the pandemic. We started with various actions and sought partnerships."

 

Lidiane Malanquini, who has been with Redes da Maré for six years and led the entire territorial mobilization during the campaign,,shared her thoughts on the campaign:"When all these people come together, it's for a greater good, which is the mass immunization of Maré. I'm not surprised because I've learned that Maré is so powerful in terms of mobilization processes, but I am deeply moved. Vaccinating more than 36,000 people is like vaccinating more than a small town in Brazil!".

 

The mass vaccination campaign mobilized a total of 145 vaccination points,,including Family Clinics (CFs), Municipal Health Centers, residents' associations, municipal schools in the territory, and even the Maré Olympic Village. Among these locations, four were used as points for registering residents to participate in the study (Adib Jatene Family Clinic, Américo Veloso CF, Diniz Batista dos Santos CF, and IV Centenário Municipal School). Families filled out a questionnaire, a commitment form, and underwent serological or antibody tests for Covid-19. During the campaign days,1,640 people were interviewed and tested, according to Silvio Hamacher, an associate professor in the Department of Industrial Engineering at PUC-Rio, and one of the research coordinators:"Personal experience is essential, understanding each individual case. Mental health appears to be a central concern for many of the people we spoke with."The research team will continue to actively search for families to follow up with.

 

Over the next few months, the team will maintain constant contact with residents to conduct further examinations, consolidate data on family members,and build a database of 8,000 people.. The follow-up will also involve new tests at three and six months after vaccination. According to the Municipal Health Secretary, Daniel Soranz, within this process, blood tests will also be collected to determine whether individuals have been previously exposed to Covid-19 and how this protection and these antibodies will persist over time—crucial aspects of the research that will provide more data on the behavior of the AstraZeneca vaccine in the population.

 

On August 3rd, the Minister of Health, Marcelo Queiroga, and the Minister of Tourism, Gilson Machado, were also present at another press conference at CF Adib Jatene. Queiroga stated that during this vaccination period, the number of deaths and Covid-19 cases had decreased by 40%."This is the best strategy to contain the pandemic and potential variants. There is only one way for this to happen: the support of science and the unity of public officials. We are aware of our responsibility and will fulfill it to the letter.It is what the population expects from us," the minister announced. According to the 40th edition of the Health Connection Bulletin,the number of vaccinated residents after #VacinaMaré increased by 359% compared to the previous 14 days. The second dose will be administered in October.

 

THE MOBILIZATION JOURNEY OF #VACINAMARÉ

 

Valcler Rangel, the Interinstitutional Relations Advisor of Fiocruz, was one of the individuals who experienced the territorial mobilization work of Redes da Maré. He said,"I'm participating in the study to some extent, a bit in the organization of the campaign, and within the Conexão Saúde as one of the coordinators of this process. One of the things we realized was that paper couldn't be used; that was the first decision. We had to put everything into computers, tablets. So, even on the eve of the first day of vaccination, we were still working because we had to acquire more than 100 tablets to distribute everywhere."

 

He explained that the team decided to carry out the mass vaccination action with only one month of preparation: "We've been preparing for some time, but making a decision, knowing that we already had vaccine availability, with the Municipal Health Secretary getting involved... Initially, our concern was how many people we would have to work with."However, partnership was the key to #VacinaMaré.

 

Douglas Lopes

Mobilization meeting for pre-registration at the Maré Arts Center (CAM).Photo: Douglas Lopes

 

More than 1,620 volunteers from Redes da Maré, the Municipal Health Secretary (SMS),,which mobilized employees from various regions of Rio de Janeiro to assist in organizing, Bio Manguinhos team, with record-time vaccine deliveries, local communicators, 500 municipal professionals, and others played important roles. The Municipal Education Secretary, Renan Ferreirinha, informed during a press conference held on the first day of vaccination (July 29th) that 17 schools served as vaccination centers, and more than 300 sector volunteers worked during the campaign."For us, it has an element of responsibility, but also an element of gratitude for being part of a historic initiative,"said the secretary.

 

Even before the start of mass vaccination, between July 22nd and 27th, Redes da Maré team members conducted a pre-registration activity for families that did not yet have records in health units. In total, 3,735 residents were registered, including 465 young people aged 15 to 19 (12.4%), 1,143 young people aged 20 to 24 (30.6%), and 1,090 aged 25 to 29 (29.2%).

 

moradora

Pre-registration of residents
Photo: Gabriela Lino

Of these, 45% identified as mixed race (pardos), and 19% as Black (pretos). Since the previous week, most of the team had been holding meetings to develop mobilization and communication strategies for pre- registration and vaccination days, a core part of Redes da Maré's methodology.

 

Andreza Dionisio, 22, an organizer and mobilizer at the Women’s House of Maré,participated in three fronts: she was responsible for the Residents' Association of Vila do João, led a street mobilization team - distributing flyers, using megaphones for communication, and more - and managed a vaccination point at the Municipal School Ginásio Rio Olimpíadas 2016. She said, "I found it very important to go to people's homes, knock on their doors, talk to them, show that we're there and that it's important for them to be there. It was a good moment to explain the importance of having updated registration because it's mass vaccination, territorial vaccination to produce results for a study."

 

Diego Bezerra

"For me, working in Maré is what drives my life. As an individual, as a person, I understand that one of my missions is to empower the people in my community to occupy these spaces, so we can speak for ourselves and stop others from speaking for us," Andreza added.

 

Diego Bezerra, 32, born in João Pessoa (PB) and a resident of Vila dos Pinheiros for 24 years,, was one of the residents who took advantage of the opportunity and registered during the street calls in Vila do João. He brought his wife, Graziane Felipe, 29, to get vaccinated on the first day and, on the way to CF Adib Jatene, encouraged people to get vaccinated."The campaign is good; at least they are thinking of us, who are less fortunate. Our family didn't have any losses, thank God."His wife mentioned that her mother and aunt had Covid-19 but recovered quickly and have already been vaccinated. The family is also interested in participating in the study and is being monitored.

 

 


TERRITORY ASSISTANCE NETWORK OF MARÉ

 

 

This initial mobilization phase was also significant for residents to access healthcare facilities in the territory and other types of services, where community organizers discussed the healthcare services offered by the Unified Health System (SUS), the importance of Family Clinics, and the role of community health agents in promoting health and preventing diseases."This campaign has also been strengthening primary care and health services in the territory because we identified a significant number of people who were not yet registered in the Family Clinics,"notes Laís Araújo, a social worker from Redes da Maré, aged 34, who has been involved in the reception and monitoring of Covid-19 cases identified during the "Maré Says No to Coronavirus", campaign since March 2020.

Diego Bezerra

When asked about the perception of the importance of the vaccine among their families, friends, and neighbors, Diego says, "There are rumors going around, but most people believe. Now, people are more aware." Photo: Julia Bruce

She walked the streets, especially in Morro do Timbau, spreading the word and talking to the population about the importance of the vaccine.

 

Jorge Magnun, a 28-year-old community organizer in the Health Connection safe isolation project and a resident of Morro do Timbau,, shares the same opinion: "Understanding that the Family Clinic is a public service and, above all, a right of the residents, aligns with what Redes itself understands, which is to build relationships based on fighting for the rights of this population."Jorge was one of the leaders of the mobilization in the area, in the residents' associations of Morro do Timbau, and was part of the research team in health units conducting interviews and serological tests for the families that began to be monitored.

 

 

 

STREET COMMUNICATION

 

 #VacinaMaré included various mobilization and communication actions, such as: pasting posters on walls, posters in local businesses, mobile sound cars with information, online communication through social media, volunteers stationed at information points, and the production of podcasts.

 

Paulo Pereira

Paulo Pereira, a 36-year-old community health agent at CF Adib Jatene for 6 years, says, "There is still a lot of work to be done to show the importance of vaccination to the population. AstraZeneca is one of the vaccines that is most effective in preventing and combating the Delta variant, and many people are not aware of this. We have a lot of work to inform and promote health." Photo: Julia Bruce

Digital influencers and artists, such as Raphael Vicente, Clayton Guimarães, Paloma Callado, and Taís Araujo, shared content about vaccination on their social media platforms, urging residents to join this initiative and emphasizing the importance of getting vaccinated. ResidentRayane de Lima, aged 29,, who moved to Maré from Rio Grande do Norte with her family when she was 5 years old, said she learned about the campaign through the organization's social media but knows people who received information from television, from the promotion at healthcare facilities, and through the distribution of flyers by Redes da Maré community organizers.

 

The president of Fiocruz, Nísia Trindade, was pleasantly surprised by the strong presence of young mobilizers. "I was very happy to come here and see so many young people mobilized." She emphasized: "We produce the vaccine, but without a public policy strategy, the vaccine is wasted. So, the strength lies in SUS, in this integration, and this vision. I propose that we should create a group for permanent actions in this territory," she highlights.

 

POWER AND RECOGNITION OF THE MARÉ TERRITORY

 

Persistence, engagement, and movement were the main meanings of this mass vaccination action, which showed just how potent the collection of 16 favelas in the North Zone of Rio de Janeiro is. Eliana Sousa, director and founder of Redes da Maré, has been active in community movements since the 1980s and emphasizes that collective strength is essential for making everything happen.

Lidiane

Communication at the doorstep of each resident facilitated the registration process at local healthcare facilities. Lidiane Malanquini explains that the team went through all the streets and alleys of Maré, talking about the importance of vaccination: "This was one of the highlights, one of the successes we had in this mobilization process."Photo: Gabriela Lino


"I understand that everything we do today is the result of a process that was planted a long time ago, including in the 1970s when we had other community groups that fought for water, sewage, and basic sanitation. This continuous process is what most guarantees everything we experience here. So, I think that Redes itself is a product of this process, and I believe it can mobilize such significant projects for the collection of favelas precisely because it is something that has to do with a long- standing coordination," she reflects.

 

Two members of residents' associations share the same feeling: Jaqueline Lopes, aged 36, secretary of the Ramos and Roquette Pinto Residents' Association, and Deraldo Batista, president of the Parque União Residents' Association,,that joined forces to carry out pre- registration and vaccination in their units."We embraced the idea. After so many losses, this action brought me hope that we will soon be able to return to normal life and believe that better days are coming,"Jaqueline expresses. Deraldo, who has been a partner of Redes da Maré from the beginning, says that it's time for all 16 Maré communities."I told my organization to keep their doors open, both for registration and vaccination, whenever they want. I find this very beautiful, and it serves as an incentive for everyone, not just for newcomers but also for the elderly," he affirms.

 

UNION OF THE PRODUCTIVE SCIENTIFIC FORCE OF RIO DE JANEIRO

 

Fernando Bozza, the researcher responsible for the Fiocruz study, speaks emotionally about seeing two extremely relevant institutions for scientific production come together in this action."I always wanted, in a way, to bring together the Federal University of Rio de Janeiro (UFRJ) and Fiocruz. Thirty percent of biomedical science is produced in this axis, and today it became clear to me that these institutions are not separate but united by Maré," he said at the opening of the third day of vaccination, when teams of professionals from UFRJ, Fiocruz, and Bio Manguinhos were present in a meeting at one of the clinics, sharing their experiences in the collaborative network between science and education.

 

UFRJ's rector, Denise Pires, reports that research activities in the health field at the university originated at Fiocruz, and without it, UFRJ would not have developed this sector as it is today, providing the necessary assistance to Maré residents. "Starting this century, we increasingly see the importance of what is in the Guidelines and Bases Law: the inseparability of teaching, research, and extension. It's a joint action, and we will continue together," she comments.

 

Luna Arouca e Valcler Rangel

Luna Arouca and Valcler Rangel in one of the mobilization actions for registration.Photo: Gabriela Lino

It's worth noting that some of the actors who participated in the entire mobilization process during the campaign do not live, were not born, and were not raised in the territory, but their appreciation for the entire history of Maré that was part of their lives at a certain moment was decisive for the union of efforts. Luna Arouca, born and raised in Santa Teresa, became close to Maré in 2018 when she coordinated a Redes da Maré project for harm reduction for people living on the streets and using drugs, the "Normal Space." In 2020, she took over the leadership of Health Connection and naturally led the territorial and institutional articulations for this mass vaccination campaign.

 

She believes that Vacina Maré will be a sea of opportunities based on the diagnosis that will be made, allowing everyone to look at the population's health and create endless possibilities together with Fiocruz and the Rio de Janeiro City government."I would say there is something revolutionary happening, in many ways, in a Rio de Janeiro favela; to have this mass vaccination ahead of time due to the study, the unity of efforts, this joint work,"reflects the community organizer, who is the daughter of Sérgio Arouca, one of Brazil's leading public health theorists and a leader in building the Unified Health System (SUS).

 

Raphael Vicente

Thiago Wendel applying the second dose of the Covid-19 vaccine at Luna Arouca, during the vaccination campaign at CF Adib Jatene.Photo: Melissa França

Another important actor in this process is Thiago Wendel, aged 37, a master's degree holder in Public Health and the current General Coordinator of Primary Care at CAP 3.1. As a resident of Complexo do Alemão, he reflects on the vaccination action and what it represents for this territory. He highlights three fundamental points for the action."First, we managed to significantly reduce the number of deaths in the territory; studies show that vaccinated individuals already have a 90% chance of not developing severe symptoms of the disease. Second, the engagement of civil society, Fiocruz, Redes da Maré, and the Rio de Janeiro City Health Department was crucial for the realization; and third, as a young person, a nurse, coming from a community, and coordinating an action that will save lives within the community is a representation of the people for the people, and it motivates me every day, gives me the strength to move forward," he comments emotionally.

 

The relevance of citizenship in the current scenario is part of the entire path of recognition and potency of Maré and what this territory represents in the struggles of favelas and peripheries. On the first day of vaccination,Quitta Pinheiro, aged 25, a resident of Vila dos Pinheiros and a transgender woman, demonstrates that this action "is of tremendous importance for our citizenship, our access, and health promotion. For us, who are from the LGBT population and residents of Maré, it is very gratifying to have this mass vaccination so that we have the opportunity to get vaccinated, considering all the problems we had regarding vaccination,vaccination," she feels. Unfortunately, Quitta lost her great-grandmother, who lived in Morro do Alemão, to Covid-19 at the beginning of the pandemic. "Being here and being alive, witnessing this moment, is very emotional!" she says.

 

Quitta Pinheiro

Quitta Pinheiro (25), on the first day of #VacinaMaré.Photo: Julia Bruce

 

 

"What we have done in Maré is undoubtedly historic. When we think that Maré is a city within the city of Rio de Janeiro, and that there is also significant intelligence here that we should value and recognize, we give shape to concrete public policies that come from the ground, from the base of these territories. Often, public policy comes from the top down, and residents do not feel represented." - Renata Souza, State Deputy (PSOL/RJ)

 

"I feel honored as well, and it's very important that we come to get vaccinated. We can only eradicate the disease with the vaccine, so I am very happy to have been called to be one of the first to get vaccinated, especially in a community that always ends up being one of the last. When we see an action in which we are the first, it makes me very happy." - Brenda Ferreira, 20, Law student at UERJ, one of the first to be vaccinated in the action, member of the Maré Mobilization Front

 

"Thank God, we didn't have Covid. He studies at a federal school, works, and I advised him to take the vaccine. I am happy for that, to reach my age, 33, and his age of 18, and everyone being immunized." - Elisa da Silva, mother of Felipe Matheus

 

"On March 13, 2020, shortly after the World Health Organization (WHO) declared the pandemic situation, I received a call from Eliana to find out how we could work together, how Fiocruz could help Maré, and many partnerships were built for this vaccination work here. Also, at that time, we were already trying to ensure that the voices of Redes da Maré and other associations were heard regarding security, rights, and we had meetings with academics and lawmakers." - Nísia Trindade, President of Fiocruz

 

"I worked in Maré in the late 1980s and am reconnecting with people. I remember that in a vaccination campaign I participated in, we conducted a nutritional survey, and it reminded me a lot of this, and it's emotional because we also mobilized. I remember getting scales from Fiocruz and various places to put in vaccination centers... We did this in the middle of a vaccination campaign, at that time there was a lot of malnutrition! Back in 1988, I saw people mobilizing with much fewer resources and many more difficulties, and now they are also mobilizing. So, people are here, they have power!" - Valcler Rangel, Advisor for Interinstitutional Relations at Fiocruz

 

"When we are willing to seek solutions, ways to confront problems, things happen. We have to take action in the face of problems." - Eliana Sousa, founder and director of Redes da Maré

 

Rio de Janeiro, August 31, 2021

 

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