SAINT-DENIS, France (AP) – Born, raised and working as a nurse in Saint-Denis, Samia Dridi fears her impoverished city and recalls how the coronavirus is making a particularly deadly path through the diverse area north of Paris , a burial site for French kings buried in a majestic basilica.
Dridi and her sister accompanied their petite 92-year-old Algerian-born mother to a vaccination center for the first of two injections of protection against COVID-19 days after it opened last week for people over 75.
While red tape, consent requirements and delivery issues have slowed down the rollout of vaccinations across the country in FranceThe Seine-Saint-Denis region faces special challenges in warding off the virus and vaccinating people when it is their turn.
It is the poorest region in mainland France and had the highest mortality rate in the country last spring, largely thanks to COVID-19. Up to 75 percent of the population is immigrant or has immigrant roots, and the inhabitants speak some 130 different languages. Health care is substandard, with two to three times fewer hospital beds than in other regions and a higher rate of chronic disease. Many are essential workers in supermarkets, public sanitation and healthcare.
The coronavirus was initially generally seen as the great equalizer, infecting the rich and the poor. But studies have since shown that some people are more vulnerable than others, especially the elderly, those with other long-term illnesses, and the poor, who often live on the margins of mainstream society, such as immigrants who don’t speak French.
Dridi, 56, a nurse for over three decades, is relieved that there is currently “no significant evolution” of the virus in her town. But she doesn’t forget what happened when the pandemic first struck.
“We had entire families with COVID,” she said. Many have multiple generations living together in small apartments, which experts say is an aggravating factor common in the region.
Despite those grim reminders, local officials are grappling with special challenges in communicating vaccines to a population where many do not speak French, have no access to mainstream medical care and, as in much of France, distrust the safety of the vaccine.
Next month, a bus will travel around the region, particularly to street markets, to provide vaccination information. In addition, about 40 “vaccination ambassadors” who speak different languages will be trained to contact vaccinations and “fake news” around them starting in March.
An example of this is Youssef Zaoui, 32, an Algerian living in Saint-Denis.
“I’ve heard that vaccination is very dangerous, more so than the virus,” said Zaoui, sitting in the shade of the basilica. His proof that he doesn’t have to worry about the virus: the butcher down the road and the man who sells cigarettes nearby. They were there at the beginning of March ‘and they are still there. … I’m still here, ”he said.
Is there any chance that the vaccine could turn the tide of inequality reflected in the mortality rates for the region?
“Before the vaccine becomes a big equalizer, everyone needs to be vaccinated,” said Patrick Simon, who last June co-authored a study on the vulnerability of minorities in Seine-Saint-Denis to COVID-19. But he said the challenges for marginalized communities to access health care continues, “so these disparities will also be reproduced for the vaccine.”
While France’s health care system is designed to provide accessible medical treatment, bureaucratic demands and out-of-pocket payments often deter new immigrants or the poorest. Government health education does not always reach those outside the system.
As a nurse at a municipal health center, Dridi sees in advance the poverty that translates into vulnerability to the corona virus.
“I give an injection, an injection, put on a bandage … and some say, ‘I live in a car, I’m on the street,” she said.
That misery was not evident at the vaccination center where Dridi’s mother received her injection – one of 17 opened in the region last week and where the more fortunate of Saint-Denis, living in private homes, were seen on a recent visit. Some made their way to the center on walking sticks or held by an arm. A couple appeared on a scooter. They all wanted to be vaccinated.
They were among the lucky ones. Appointments were scaled back after dose allocations of the Pfizer-BioNTech vaccine were reduced, as elsewhere in France and Europe.
“I am lucky to have been vaccinated today,” said one woman, who then burst into tears. She became infected with COVID-19 while undergoing treatment at a private clinic in April and lost her mother to the virus in October after contracting it in a hospital where she was treated after a fall.
The woman, who refused to give her name, told Dridi and her sister to take care of their mother because “she is your sweetheart.”
For Dridi, watching people die from COVID-19 can be a game changer.
“Some people say no (to vaccination) because they have no contact with death,” said Dridi. But death, “that’s what makes you respond.”