Nairobi, Kenya CNN  — 

Inside a hospital in a leafy campus in the shadow of Mount Kenya, workers dressed head-to-toe in pale green Hazmat suits load a shrouded body into an ambulance.

For the past few weeks, this somber scene has become a daily routine at the 31-bed Mount Kenya hospital, in Nyeri county, a few hours north of Nairobi. The hospital, which is now exclusively treating Covid-19 patients, is struggling to cope under the strain of Kenya’s Delta variant-fueled fourth wave.

The official nationwide data, which shows an average of just 20 deaths per day over the past week, tells only a small fraction of the full story – everyone here, it seems, knows someone who has died from the virus.

The Mount Kenya Hospital, like many others across the country, is turning away new patients because it simply doesn’t have enough room. It is also lacking resources.

Despite a newly installed oxygen compressor, extra cylinders, trucked in every day, are still needed to meet demand.

Four patients arrive, desperately in need of a bed in an intensive care unit, but there are none.

Without an ICU bed, their chances of survival are not good.

Fear of the vaccine

Most of the patients at Mount Kenya are unvaccinated – not because they didn’t have access to a vaccine, but because, in most cases, they chose not to take it.

“When you ask why they didn’t get the jab, some of them, they’re told it’s not available. Others – the majority – they fear to have it, because they’ve heard of the issues,” explains Eudiah Wang’ombe, the hospital clinician who runs the facility.

She is referring to the extremely rare blood clots associated with the AstraZeneca vaccine, which before a new shipment of Moderna vaccines arrived from the US this week, was the only brand available in Kenya, according to the Kenya Health Ministry

People have also heard stories of vaccinated people falling ill or even dying after receiving the vaccine.

“That’s not true, I am on the ground. Those people who have died so far, have not received anything… There’s a lot of misinformation,” says Wang’ombe.

Kenya has struggled with vaccine supply since day one, so far only 3.6 million doses of vaccine have arrived in Kenya, the latest shipment coming from the UK just this week.

Even with every available dose, it would only be enough to inoculate roughly 3.5% of the population. But even as supply issues slowly ease, vaccine hesitancy is quickly emerging as a very serious problem.

Along a busy street in Nyeri town, everyone is masked – it’s the law in Kenya – and street vendors sell masks and hand sanitizer along with their usual assortment of clothes and household knickknacks.

Selling the vaccine, though, is a more difficult task and misinformation is rife.

The early stigma surrounding the virus, denial, general misinformation, and some traditional beliefs are all contributing to an unhealthy skepticism of the health system and vaccines. Misinformation, spread mostly by word of mouth has been a challenge for the government to overcome, as health officials plead with citizens to take the vaccine in regular Covid-19 TV briefings.

Jane Wangari Kahemu, a mask vendor in Nyeri

“We heard that Kenya was making Covid-19 vaccines, that’s why we are scared. They don’t even know how to make matchboxes or even toothpicks,” says Jane Wangari Kahemu, a mask-vendor.

The Kenyan government does have a long-term plan to produce its own vaccines, but it’s still a long way off.

Kahemu would take the vaccine, if she knew for sure it was American, she says.

“Why should I take something that I don’t know what it will do to my body?” another vendor asks, holding his baby son in his arms.

His colleague agrees. “If, and I say ‘IF’ with capital letters, if we understand about it, maybe we can do it, but for now it’s a no!”

A boon for coffin-makers

Along a dusty road, a stone’s throw from the local morgue, a small black hearse is parked opposite a strip of coffin vendors. Lately, it has been a hive of activity.

Outside, a group of young men cut, sand, plaster and paint an array of caskets in different shapes and sizes as quickly as they can.

Before the pandemic, they were making fewer than one coffin a day.

Coffin builders in Nyeri

Now each man is expected to make three a day and they can’t keep up with demand, forcing the owner to recruit more coffin makers.

Before the pandemic, they were making less than one coffin a day — sometimes only one per week. Now each man is expected to make three coffins a day — and the owner has hired twice his normal staff to keep up with the demand.

“The workload is too hard for us now,” said 34-year-old coffin builder Joseph Mureithi. “We are working on very tight schedule and we can even say we are suffering fatigue right now.”

He says that many people who are hesitant simply don’t know enough about it, but he thinks more and more people are starting to seek out the vaccine because so many people are dying from the virus.

“Unless you see the impact of something, you won’t take it seriously,” he says standing over an unfinished casket he had just began to plaster.

Yet many of the Mureithi’s colleagues still say they wouldn’t take the vaccine if it was offered to them.

Dennis Maina, a slight 24-year-old in jeans and camouflage trucker hat, is one of them.

“Many people, they are not dying because of the virus, they are dying because of another disease,” he says. He adds that some of the families who bought coffins told him their loved one were vaccinated.

He adds that some of the families who bought coffins told him their loved ones were vaccinated.

‘Dire situation’

Vaccine skepticism is such a problem that the government has now legally mandated civil servants to get vaccinated. The local county governor agrees that more has to be done to get shots into arms.

“Yes, I will admit, the situation is dire. We have not been here before,” Nyeri County Governor Mutahi Kahiga tells CNN from the driveway of his well-manicured, gated property on the edge of town.

Not only are hospitals turning patients away, but many people only seek out medical attention when it’s too late.

“That tells you clearly that our people are doing self-medication at home. And that is dangerous. Because by the time you get to the hospital, you are gasping for oxygen, your oxygen levels are too low. We don’t have enough oxygen and we may end up losing you,” said Kahiga.

Nyeri, a largely rural area with a population of less than one million, has one of the highest vaccination rates in the country, at 6.2% of adults, second only to Nairobi.

Even so, the governor says that more than a third of the police officers, teachers and senior citizens who were given the first dose of the vaccine failed to come back for the second.

Many others don’t want the vaccine at all. In some Kenyan counties, the vaccination rate is less than 0.5%. Nationally, it’s less than 2%.

“We have more than 40 tribes, with different traditions, beliefs, and taboos,” Kahiga says. “I think with Covid-19, some of us are still in denial, they are still holding on to traditional beliefs that cut across Africa… that’s why we may be where we are.”

At the moment, the county has only 1,000 doses of the vaccine on hand – to distribute to 28 vaccination sites. The central government will only send more once they’ve all been used.

But as the virus continues its deadly surge, some attitudes are changing. At a vaccination site in the capital, Nairobi, earlier this month, 24-year-old Olendo Obondo told CNN she “wasn’t concerned for a long time” about the virus, until the Delta variant started filling up hospitals and morgues. That was enough to convince her to get vaccinated.

“Death can convince me. If this can prevent me from dying, hopefully, then I’d rather take it.”

Bethlehem Feleke, Larry Madowo, Clement Masombo and Evode Muhire contributed to this story.