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in his office in Padampuri—the only significant
medical facility for 25 miles. The building, cov-
ered in faded yellow paint, stands atop a mountain
slope, approachable only by a long flight of steep
stairs carved out of the mountainside. At about
5,200 ft. of elevation, it is thousands of feet below
many of the mountain villages it serves. “People
have to commit to a full day to get vaccinated. That
didn’t help,” Kandpal said.
Hema Devi knows just how difficult that can
be. In July, the 45-year-old farmer made the steep
mile-long uphill trek from her home in the remote
hamlet of Thiroli to a vaccination camp in the big-
ger village of Dhanachuli. She waited for hours for
her turn, before learning that the camp had just run
out of vaccines. “I hear about people not taking
the vaccines in the cities, and I am puzzled,” she
says. “They don’t even have to climb a mountain
or negotiate broken roads. They also don’t have
to think of who’s going to cook dinner or lunch if
they are stuck at the camp—they can just order
food on the phone.”
On Aug. 2, she tried again, waking before dawn
to cook, clean, and take her buffalos and goats out
to graze before setting off with her husband and
two neighbors. When they arrived in Dhanachuli,
Devi and her husband joined different lines to reg-
ister for their shots. The line for men was much
shorter, with most of them—including Devi’s
husband—there to receive second doses, while
most of the women had yet to receive their first.
That disparity has persisted across India, in part
because of the difficulty in getting time away from
housework and childcare. According to India’s of-
ficial vaccination website, CoWIN, as of Feb. 14,
a total of 1.67 billion vaccine doses have been ad-
ministered in India: 49.5% to women and 50.5% to
men—a gap of some 38 million doses.
Indeed, when Devi’s husband received his
first dose in July at the primary health care cen-
ter in Padampuri around an hour’s drive away, she
couldn’t go with him because of home responsi-
bilities. “It would have taken the whole day, and
who would have taken care of the children and the
housework?” Even on the day Devi finally received
her vaccine, she rushed home after registering at
the camp to cook lunch and tend to the livestock
while her husband saved her spot. She sprinted
back just in time for her shot. “I didn’t want to miss
out this time, too,” she says. “If we run out of vac-
cines, you never know when we will get it next.”Devi wasn’t always so eager to get the vaccine.
Like many Dhari residents interviewed by TIME,
she was initially scared. “We heard stories of in-
fertility and deaths,” she says. “But then we saw
people taking it and they were OK. Also the health
workers came to the village and explained and en-
couraged us. They are one of us, so we trust them.”
Crucially, these workers have history on their
side. The health care workers in Dhari are mostly
local women who have been trained to act as edu-
cators in their communities through work as ac-
credited social health activists (ASHAs) or hired
by the government as nurse- midwives (ANMs) to
act as the first point of contact between the com-
munity and the public health care system. Across