Now that most pandemic restrictions on houses of worship have been lifted, the Sikh Institute of Fresno looks much like it did pre-COVID. On a recent Sunday at this 3-story, salmon-colored temple known as a gurdwara, people stream in and out of the main worship hall, some wearing traditional saris and kurtas, others in t-shirts and jeans. While they circle the altar, a trio of men playing harmoniums and tabla drums sing hymns known as kirtan in the Northern Indian language of Punjabi.
Outside, families wait in long lines for bubbling trays of vegetable curry, lentils and roti on the way to the langar hall, a cafeteria where they can eat and catch up with friends.
But on this day, classrooms decked out with chalkboards and bright posters that are typically used for Punjabi school have been repurposed. Sitting in one of them is 13-year-old Navleen Kaur. “A lot of people are getting sick, and for them we are getting the vaccine,” she said.
This room is the observation area of a pop-up COVID-19 vaccine clinic, and Kaur just received her first dose of the Pfizer vaccine. “It was just like someone pinched you, it doesn't hurt,” she said.
Her cousin Anmol Kaur, also 13, sits at the desk behind her. “I don't want to be sick, and I want the coronavirus to end,” she said.
Many attendees have already been vaccinated, and they cite a variety of reasons: Some were informed by Punjabi Radio USA, and others by social media, like group chats on Whatsapp or Instagram posts by the non-profit advocacy group Jakara Movement. For high school senior Baldeep Singh, it was important to be the first in his family to volunteer for the vaccine in order to ensure it was safe for his older relatives, while 22-year-old Kiranpreet Rathour said it was her mother in COVID-stricken India who ultimately convinced her to get the shot.
But Navleen and Anmol Kaur are among more than 1,500 San Joaquin Valley residents who’ve benefited from another form of engagement: Mobile vaccination events set up directly at gurdwaras. Since late March, at least nine pop-up clinics like this one have visited Sikh temples from Fresno to Bakersfield, run in part by county health departments and partner healthcare providers. Another is scheduled for August 8 at Gurdwara Nanak Sahib just north of Fowler.
Behind the scenes of almost all of these events has been the Jakara Movement, run by Executive Director Naindeep Singh. Mild-mannered and jovial, Singh spent his childhood studying Punjabi in the same classrooms where the Kaur cousins received their shots, and on the day we visit he bows to many passersby and fist-bumps countless others. One woman asks him to call her husband because she misplaced her phone.
After English and Spanish, Punjabi is one of the most common languages spoken in the Valley. And depending on their age and length of time in this country, many Punjabi speakers know very little English. That, combined with the isolation of some elderly, rural residents, had Singh concerned about COVID’s trajectory within his community. “Very early on in the pandemic, we had raised quite a bit of alarm bells,” he said.
That’s why Singh and the Jakara Movement joined the Fresno County COVID-19 Equity Project, a broad coalition of groups that came together to protect immigrant, refugee, Black, disabled, and other under-represented groups from the virus. For the last year, these groups have done the grassroots, community-level canvassing and education that city and county governments have largely not had the bandwidth to provide. “Within the communities themselves, we know the neighborhoods where we reside, we know the apartment buildings that are overwhelmingly Punjabi, we know which areas the farm workers live in,” said Singh.
Still, progress is slow. A year and a half into the pandemic, very little public health information has been made available in Punjabi, despite its prevalence and the fact that so many of its speakers are essential workers. The North American Punjabi Trucking Association estimates that around 40 percent of the industry in California is controlled by Punjabis, who felt hung out to dry when the state never followed through on its commitment to offer transportation workers priority access to the vaccine. Punjabis are also over-represented in agricultural fields and meat processors, and at least four died in 2020 as a result of COVID outbreaks at poultry plants in Fresno and Merced Counties.
Pop-up clinics like this one at the Sikh Institute of Fresno are one way Singh and his organization are bringing culturally competent virus outreach, as well as testing and vaccines, to the Punjabi community. “We've had billboards, we've commissioned Punjabi music songs, we've really tried an all hands on deck approach,” he said.
The most common questions Singh and his colleagues have encountered will sound familiar: Concerns about how quickly the vaccine was developed, as well as its potential side effects. But many Punjabi speakers feel their worries aren’t being addressed by health authorities offering information mostly in English, Spanish and sometimes Hmong. “If you’re only telling people to vaccinate, vaccinate, vaccinate, without answering their questions, people start digging in their heels after a while because they feel like they're being shamed into a particular action,” Singh said.
As a result, many Punjabis haven’t been vaccinated yet, though Singh mostly characterizes them as “vaccine curious” rather than “vaccine hesitant.”
Dr. Kenny Banh agrees. “I find the Punjabi community wholly fairly accepting of it,” said Banh, an emergency physician and Assistant Dean of the UCSF Fresno medical school. “They have less resistance to vaccines.”
Banh runs the medical school’s vaccine clinics, including a stationary site with the capacity to administer thousands of doses a day at Fresno City College. But the team’s traveling medical clinic, a van known as Mobile HeaL, has hosted hundreds of pop-up vaccine events around the county, including this one today.
Banh says bringing vaccines directly to the Valley’s diverse communities, staffed by people who speak their language, can help fill the voids left by conventional outreach. The response was so enthusiastic at a March vaccination event at a Selma gurdwara that nearly a thousand people were vaccinated in one day, and overflow events for hundreds of others ended up being scheduled for later in the week.
Banh hopes that mobile clinics like these can be used beyond the pandemic. “COVID has really forced us to do things that we should have been doing for decades from a public health standpoint,” he said, “and we’re hoping COVID has allowed us to create some infrastructure with these groups.”
Fresno County Interim Health Officer Dr. Rais Vohra, who’s also a faculty member at UCSF Fresno, agrees. “We're glad to be able to reach populations that would otherwise not be able to get that vaccine, and to reach them in a way where they feel comfortable, they feel like it's part of their community, and that it's done in a very culturally sensitive way,” he said during a recent media call. “That's really wonderful, that's exactly how medicine should be delivered. It shouldn't be a scary, exotic, foreign concept to people.”
So are these clinics bringing up the Punjabi community’s vaccination rates? It’s a difficult question to answer. Vaccination data obtained via public records requests by the Documenting COVID-19 project at Columbia University’s Brown Institute for Media Innovation reveal that some of the state’s starkest vaccine deserts lie in rural Valley census tracts that are home to many elderly Punjabi Sikhs.
But government agencies don’t collect or share virus-related demographic data at a granular enough level to identify patterns within specific ethnic groups or by occupation due to state medical privacy requirements. For instance, Punjabis might identify most closely with the “Asian” race, an extremely diverse group of people with highly variable infection and vaccine uptake rates. The Jakara Movement spoke with the Census Bureau about breaking down the “Asian” race category to be more representative, but changes have been slow. Plus, unlike in many other states, vaccinated Californians can opt out entirely of self-identifying their race, making it difficult to track equity efforts.
Naindeep Singh does think these clinics and other equity project efforts are moving the needle within the Punjabi community, though he’s cautious about celebrating prematurely. “There really is successes on the personal level, on the anecdotal level,” he said. “Those kind of lead me to believe we’re moving in the right direction.”
Guddi Ranu, an educator at the Sikh Institute of Fresno, agrees. She’s also the co-founder of the Sikh Women’s Organization of Central California, which collaborated with the Jakara Movement to bring vaccine clinics to this gurdwara.
Ranu says bringing vaccines directly to people where they are can be the deciding factor for those who are curious or on the fence. “Sometimes you don't even think about it,” she says,
“like, ‘my friend is having it, I'm going to have it.’” That’s especially true if your friend speaks the same language and visits the same temple that you do.
Caitlin Antonios is a California-based freelancer working with the Documenting COVID-19 project at Columbia University’s Brown Institute for Media Innovation and is supported, in part, by the L.A. Press Club and the Charles M. Rappleye Investigative Journalism Award.