By Mariama Jallow

After I finished my spring semester at Wake Forest University, I left the United States for The Gambia in May.

I went home to see my family. I hadn’t seen them in person for a year and a half.

While I was in Gambia I was writing for The Standard Newspaper, a publication written in English and often picked up by people on their way to work. Seeing my family and being surrounded by love was the highlight of my trip.

My favorite thing to do back home is to grab a mango fresh off a mango tree in my backyard. I was no longer wayt, a Gambian term for being alone, not surrounded by loved ones. 

When I left North Carolina for The Gambia, a small country on the coast of West Africa, where I have many aunts, uncles, cousins, friends, people were still wearing masks and enforcing social distancing rules. A persistent glooming cloud of the unknown hung over us all.

For some, the start of vaccine rollout around the world brought a slight glimmer of hope. For others, COVID-19 vaccines brought another spark of concern.

Even before I knew I was going back to The Gambia, I got the Pfizer vaccine. When I found out I could go home, I encountered a challenge that many international travelers may also face.

To get on the plane, where passengers were required to wear masks except when eating, I had to show a negative PCR COVID test which had to have been taken within the previous 72 hours. Neither CVS nor Walmart would guarantee that I would receive my test results in time. So I got a test at both places and wished for the best. I heard my result was negative just in time.

When I landed in Gambia, I had the option of getting a rapid COVID test before leaving the airport or being taken to a hotel to quarantine for two weeks. 

I chose to take the rapid test. Waiting a year and a half was already painful enough. I didn’t want another minute to pass before I could see my family. After getting my results, little did I know I was about to walk into a completely different world outside those airport doors.

North Carolina was still largely a masked-up state. Gambia was not.

People were using public transport as if all were normal. Social distancing measures were non-existent in places such as the Serekunda market, where you can find anything from fresh produce to clothes, jewelry, hair braiders, beautiful African fabric and tailors who can make anything you can imagine.

4,000 miles apart

Comparing North Carolina’s response to COVID with how Gambia is responding to the pandemic, in many ways, can be difficult.

There are some similarities between my home country and where I live now, in Winston-Salem. 

One thing: Gambia has an Atlantic Ocean coastline, which is a feature of my country’s West Coast, not the eastern coastline as it is here in North Carolina.

There are differences, too.

Gambia’s population is estimated to be slightly more than 2.6 million compared to the more than 10.5 million estimated to be living here in North Carolina. 

The number of COVID-19 lab-confirmed cases in The Gambia since the beginning of the pandemic is over 7,000  compared with 1.04 million in North Carolina.

Unlike The Gambia, vaccines are readily available in North Carolina, still only 47 percent of the population is fully vaccinated.

In Gambia 0.5 percent of the population is fully vaccinated and vaccines are not as easy to get in The Gambia, which was evident to me while I was there. 

Waiting until I was fully vaccinated to go back home was very important to me because I knew vaccination rates were low and the country didn’t have a mask mandate anymore. Some members of my immediate family received their second dose while I was there, but the majority of people had not, so there was always a slight element of worry. 

I had spent only a month and a half far across the Atlantic with my family before I landed in Dulles International Airport on the last day of June. 

For a year and a half, masks, social distancing, a new online normal, and uncertainty changed the lives of so many across the country and in the state where I go to college. Vaccine uptake in North Carolina and in all 50 states was on the rise when I left, but there was still a statewide mask mandate.

Here I was in the U.S capital, only a month and a half later, and it was like walking into a different America.

A glimpse of Gambia

Gambia’s first 36,000 doses of the AstraZeneca vaccine arrived at the Banjul International Airport on March 2, according to the World Health Organization. 

President Adama Barrow “launched the national COVID-19 vaccination campaign” when he took the first dose of the two-dose AstraZeneca vaccine on March 10, according to a UNICEF report.

Similar to North Carolina, Gambia prioritized health care workers, people with pre-existing health conditions, people 65 and older, teachers, and immigration and security workers whose jobs put them at higher risk for exposure.

Ten days after the Gambian president received his first dose, some 200 frontline workers at the Medical Research Council Unit The Gambia, a hub for researchers and clinicians in sub-Saharan Africa, received their shots

Then, as happened in North Carolina, enthusiasm for vaccines slowed and misinformation about them quickly spread.

While I was in The Gambia working at The Standard Newspaper, I interviewed Mustapha Bittaye, director of health services in the Ministry of Health in Gambia. He talked about vaccine hesitancy and how the country, similar to North Carolina, had shifted its messaging efforts to combat the misinformation and hesitancy

“I think that we should be more engaged with the Gambian community, people not knowing about the virus means we are not doing our jobs properly,” Bittaye told me. “Specifically at a community level, talking to them, answering questions more directly and making programs to clear their doubts.”

In North Carolina, vaccines are available at pharmacies, doctors’ offices or through providers who will come directly to your home. Gambia is nowhere near that level of access.

“We’re working on getting a lot more vaccines, the ambassador of the United States has been very helpful in getting us some vaccines,” Bittaye added. 

New waves of infection

Meanwhile, continued COVID testing remains important to catch outbreaks quickly and trace potential spread.

Malick Sogur, a public health officer in The Gambia with whom I spoke with after I returned to the U.S., spoke about the third wave of infections Gambia is experiencing. 

“The saddest part is our testing rates are very low, most of the people getting tested are people who are traveling and we are seeing high positive rates in those groups,” Sogur told me during the phone interview. “That tells you that there are a lot of positive cases in communities which are not being traced and as we speak those cases are spreading.”

“There are people that believe the virus isn’t real even after testing positive for COVID-19. They believe that testing machines have problems. The situation can get out of control very easily, considering how our health sector is,” Sogur added.

North Carolina is seeing another wave of infection related to the Delta variant, a much more contagious version of the virus. The United Nations system in the Gambia reported the presence of the Delta variant there, too.

Gambia has more than 900 active cases and a countrywide mask mandate was put into effect on July 17.

Questions for the unvaccinated

Despite the new waves and the more contagious variant, there still are vaccine skeptics there and here in North Carolina.

Why, I wonder.

It seems as if the answers are universal, but just as troubling in both countries.

Sohna T. Jammeh, a midwife in Gambia, has taken in all the misinformation about vaccines and decided that she won’t get a shot.

Public health officials acknowledge that people can have a sore arm, headaches, feelings of being tired or feverish, but they typically subside within a day or two. Not getting a shot, public health officials caution, can lead to life-threatening illness.

Jammeh offered a glimmer of hope, though, saying she might be persuaded if Gambia’s government officials got out in the communities and answered questions to sufficiently address her concerns.

“I am practicing social distancing measures, washing my hands, wearing a mask and with the patients I see, I try to keep one meter distance between us when possible,” Jammeh told me during a phone interview from North Carolina.

Instead of taking the vaccine, though, Jammeh said she “would stay at home. I wouldn’t go to work anymore or to any social events and I think that will be enough.”

Amelia Pohlman, a homemaker from Tennessee who frequently comes to North Carolina to visit family in Sylva, has decided she will not be taking the vaccine and neither will her children.

Pohlman has four lung diseases and contracted COVD-19. She was very sick but is adamant that she won’t get a vaccine.

“I have the right to make decisions for myself, what’s so surprising is the backlash I’ve gotten for this decision,” Pohlman said during a recent phone interview. “I am willing to take the risk, and I’m willing for my children to take that risk.”

Pohlman mentioned that she has had severe reactions to pharmaceutical medications in the past, so severe, she said, that she was in a wheelchair, then using a walker and cane for nearly a year.

“A lot of Americans suffer from obesity, and it’s a problem that people are being offered doughnuts and burgers for this shot but that’s not healthy,” Pohlman said. “It’s like giving alcohol to a sober alcoholic. There are unhealthy people that stay in their basement, maybe they’re obese but they don’t ever get outside and exercise, etc. Those are people that are at risk.”

Let’s work together

Mollyhe Razi-Sharif, a Winston-Salem resident and student at Wake Forest University with me, was one of those people early on who was moved to get the vaccine, in part, for a doughnut reward.

The real reward, she said, was helping the wider community.

“I lived in a very liberal household my junior year when the vaccine was being distributed at Wake Forest,  and there was a lot of pressure from my housemates to get the vaccine,” Razi-Sharif said. “I remember looking at the group chat and someone was saying, ‘Who still hasn’t gotten the vaccine, come on, let’s get your vaccine and you’ll get a free Dunkin’ Donuts.’ ” 

Razi-Sharif always intended on taking the COVID-19 vaccine, she said, but had planned to wait until frontline workers, people with underlying conditions, and others who needed it more than she did to get it first.

“The vaccine rolled out in our school for people who worked on campus, but you could kind of sneak your way into the system and get a vaccine during that time,” Razi-Sharif added. “I didn’t really agree with that because I can wait. I wasn’t going out and hanging out with the same few people. I remember in early April when Wake Forest said to students that ‘We have these extra vaccines come today if you want one, even if it isn’t your scheduled time.’ So I kind of weighed that and was like, alright, let me go get it now.”

The contrast between North Carolina and my home country is stark.

The vaccine is readily available, and if people do contract COVID-19 here, some of the best hospitals in the country offer significantly greater chances of survival than many Gambian health care centers.

North Carolina and Gambia are 4,000 miles apart but the message of health officials in both places is the same: Taking a vaccine is important to save lives.

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