KVEMO ENTELI, Georgia -- It was 4:30 in the afternoon and Manuchar Kobakhidze got the call, the call that everyone dreads.
It was a co-worker from the hospital where his wife worked as a nurse. "Your wife is a little unwell," they told him on the phone, "can you come to Akhaltsikhe," referring to the Imedi (Hope) clinic in the small city in southern Georgia. When he arrived at the hospital, Kobakhidze was met by crying staff.
"I said, 'Where is Megi?' Then a guard took me up to the second floor. She was just lying there [unresponsive] on the bed. I wouldn't wish such a thing on my worst enemy," he says.
Just hours earlier on March 18, his wife, Megi Bakradze, a 28-year-old nurse, had been filmed by an assortment of Georgian media. "I call on everyone to take this vaccine," she said in front of the cameras. As a health worker, Bakradze was in the first wave of people in the country to get vaccinated, an initiative that had started just three days earlier.
Twenty minutes after receiving her shot of the AstraZeneca vaccine, Bakradze became seriously ill -- an extremely rare allergic reaction that occurs in only a few people out of a million and is usually easily treatable. Unable to treat the severity of her condition, the provincial clinic had Bakradze transferred by ambulance to the better-equipped First University Clinic at the Tbilisi State Medical University. She arrived at 7:45 p.m. By midnight, she was dead.
Seeing her so ill in the hospital bed in Akhaltsikhe was too much for her husband. He went to an adjacent room in the clinic and smashed the place up. He was arrested and taken to the local police precinct. After he was released, he rushed to Tbilisi and arrived shortly before his wife died.
Megi Bakradze's death and the investigation that followed has been headline news in Georgia for months, widely discussed in public and on social media. With the country recently facing a surge in COVID-19 cases, reverberations from Bakradze's death are still being felt, with talk of "that girl that died" fueling the fears of a population already hesitant about vaccination. And nowhere are those fears more pronounced than back in Bakradze's home village, where her family is still waiting for answers as to how their beloved daughter, wife, and mother died.
Megi Bakradze had lived in Kvemo Enteli her whole life. It was here in this small village of around 300 people, nestled on a plain in the lush mountainous region of Samtskhe-Javakheti, where she had met Kobakhidze. They married and had children, Saba and Salome, and Bakradze stayed at home, cooking and cleaning and taking care of the children. It was only when Saba and Salome were older that Bakradze decided she wanted a change.
It was a pediatrician close to the family, Ketevan Jinchveladze, who works at the Imedi clinic in Akhaltsikhe, who helped Bakradze get a job. "She was capable and I offered her a job. I said to her, 'You will have a monthly salary, you will get to leave the house,'" Jinchveladze says.
Starting in 2017, Bakradze first worked at the clinic as a cleaner, but she was ambitious and wanted to help people. So, at some point, Jinchveladze told her she should study to become a nurse.
"'How long are you going to go around with this dustpan and broom?' I said to her," Jinchveladze recalls. "She was so beautiful, I felt sorry she had to do this job. But you know, rural families, they have so much work. She said, 'Who's going to let me go, how will I manage this?' But sometime later, she came to me and hugged me and said, 'They [her family] said I could go.'"
On Jinchveladze's advice, Bakradze began to hit the books, sharing her time between school, family, and work. When she was working as a student nurse, she was known locally for being kind, always willing to help her neighbors with medical matters, from injecting shots to measuring blood pressure.
"She got obsessed with medical practice," Jinchveladze says. "When she was taking medicine with a syringe from the vial...she was pleased with herself. Every one of her workdays were happy days. When I touched her hand, I could feel it was rough from all the work."
When the pandemic reached Georgia at the start of 2020, the small but busy hospital in Akhaltsikhe was treating a growing number of COVID-19 patients. By late February, the clinic was overwhelmed. The workload became so intense that doctors and nurses started to think about quitting.
"There was panic, a lot of fear. But Megi was very brave and did not think for a moment about leaving.... She was a fearless girl, a leader by nature," Jinchveladze says.
According to family and friends, Bakradze loved being a nurse. She saw it as her calling and it was precisely because of that passion that she wanted to appear in front of the cameras, to set an example in the fight against the coronavirus. "I urge everyone to get vaccinated," she told the media on March 18. "There is nothing dangerous."
Bakradze's mother-in-law, Manana Kobakhidze, still can't bear to touch the couple's former bedroom in the house they all lived in together. The room remains exactly as it was, the only difference a small shrine featuring photos of Bakradze alongside religious icons and a candle her mother-in-law lights every day.
"Shouldn't someone have to take the blame for her death? She died for the vaccine, for the needle. Someone wasn't paying attention and because of that she died," Kobakhidze says.
Bakradze's children, Salome, 7, and Saba, 10, don't really remember what happened that day. Or they don't want to talk about it. They speak in general terms about their mother, the ways in which they still remember her.
"My mother used to take us with her [in the bed], but now we sleep with my grandmother," Salome says. They say that she did not like coffee but preferred tea. They point to a photo that they say their mother took.
Sitting next to a flickering stove, the emotion audible in his voice, Manuchar Kobakhidze remembers Bakradze's final day. "When she saw how sick people were [in the hospital], she said we should all get the jab. That's probably why she called on people [on TV] to get vaccinated," he says.
When he arrived at the hospital in Tbilisi, he was at first told his wife would live. "[They] told us that...if she survived, she would be unable to take care of herself," Kobakhidze says. "I wouldn't have minded feeding her with a spoon for the rest of her life. If only she had survived."
Bakradze's case is being investigated under Article 116 of the Georgian Criminal Code on the grounds of negligent homicide. There is no dispute that she had anaphylaxis, a severe allergic reaction that can cause people to stop breathing and lose consciousness, but it is not clear what killed her. The case hinges on whether Bakradze was given the correct treatment, and whether the medical staff attending to her were at fault.
The anaphylaxis that Bakradze experienced is extremely rare with coronavirus vaccinations. The U.S.-based Centers for Disease Control and Prevention (CDC) estimates that they occur in 2 to 5 people per million vaccinated in the United States. An independent expert review in Australia from March found that AstraZeneca, the vaccine Bakradze received, was not associated with any more cases of anaphylaxis than other vaccines.
For six months now, the official government inquiry into Bakradze's death has been stalled, mainly, the family says, because a specialist allergist-immunologist cannot be found. The specialist is to be selected by the Health Ministry, although that individual has the right to refuse to cooperate with the investigation. Under the law, no time limit is given, so the investigation can be suspended until an expert is found.
Bakradze's family lawyer, Vakho Baramishvili, says that two specialists have already refused to cooperate with the investigation. "There is an ethical issue here: the [experts] must understand their responsibilities and they are ignoring them. They do not receive additional remuneration for this and have no motivation to participate," Baramishvili says. Although Bakradze's husband, Manuchar, has repeatedly said that he would pay for the expert himself, under the law the family isn't allowed to do so.
As the investigation has stalled, more details have emerged from the testimonies of witnesses talking to government investigators and security-camera footage from the hospital wards.
Baramishvili alleges that Giorgi Aptsiauri, an ER doctor at the Imedi clinic who had completed an allergy-management training course, left the clinic a little before Bakradze became sick. Then, he says, Beka Liparteliani, an assistant ER doctor, called Aptsiauri 15 minutes after he had left and asked him to return to the clinic immediately. Before Bakradze was taken to the intensive-care unit, Liparteliani has said he gave her dexamethasone and diphenhydramine, a steroid and an antihistamine, respectively, that can be used to treat allergic reactions.
There has been disagreement about whether Bakradze received epinephrine, commonly known as adrenaline. The CDC recommends that medical staff immediately treat "suspected cases of anaphylaxis with intramuscular injection of epinephrine." While it differs in various countries, people receiving coronavirus vaccines are usually asked to sit and wait at the vaccination center for between 15 and 45 minutes, so they can be observed and treated in the event of both minor and major allergic reactions.
Violeta Inasaridze, the head doctor at the Imedi clinic who had also passed an allergy-management training course, said that she knew that Bakradze had become incapacitated after the vaccination and that the nurse "gave her adrenaline in seconds." That claim has been disputed and on April 7, the Prosecutor-General's Office announced that two doctors, Giorgi Aptsiauri and Violeta Inasaridze, and a nurse had been charged with perjury.
Other unanswered questions remain and continue to trouble Bakradze's family. According to the family's lawyer, there is no video footage from inside the ambulance transferring to the hospital in Tbilisi. Investigators requested the footage a week after her death, but it had already allegedly been deleted.
After being given a warning at the police precinct for vandalizing the hospital room, a few days after Bakradze's death, Manuchar Kobakhidze got drunk. He went to the clinic and threatened a security guard with a knife. Criminal charges have been filed and he now faces up to one year in prison.
"I did wrong," he says, "but I do not feel guilty. And now I've read that they say [the investigation] may be extended for two years. What is this? No matter where you go, in the end you will be deceived."
With rugged mountains peaks rising in the distance, Natia Rogava's house looks directly over the small village cemetery where Bakradze, her good friend, is buried. The black headstone in the grave plot is adorned with a picture of Bakadrze, her hair coiffured and wearing a glamourous necklace. "When Megi died, I was restless with fear for a long time. She was always laughing when she rushed into my backyard. I would never think that anything bad would happen to her," Rogava said.
The village of Kvemo Enteli has yet to recover from the loss of a nurse who was always so willing to help her neighbors. But there is another consequence of her death that would have almost certainly saddened and disappointed Bakradze. Because of what happened, many people have chosen not to get vaccinated against the coronavirus.
The region of Samtskhe-Javakheti has one of the lowest COVID-19 vaccination rates in Georgia. According to Geostat, the population of the region is 151,100 people and only 17,706, or 11.7 percent, are fully vaccinated. The rate of vaccination for the whole country is about 30 percent.
The Caucasus Datablog reported in August that several studies showed that vaccine hesitancy went up following Bakradze's death but then recovered in the following weeks.
In Kvemo Enteli, though, that hesitancy has lingered. Bakradze's friend, Rogava, says that she doesn't want to get a vaccine. "I am afraid. I won't do it and I can't think of anyone in the village who would be vaccinated," Rogava says.
Manuchar Kobakhidze doesn't want to get vaccinated either, even though he knows from his wife just how serious the pandemic is. "If this hadn't happened, I would have got vaccinated, too, no problem," Kobakhidze says.
"Nobody came here," says Natia Chitaia, another friend of Bakradze, referring to the government officials who the locals say never came to the village to convince people that the vaccine was safe.
"In general, if something happens to anyone here, no one will expect anything from [the hospital in] Akhaltsikhe, everyone runs to Tbilisi," Chitaia says. "They do not trust local health care. If they hear that someone in a neighboring village has been vaccinated, they look at it with suspicion. They say, 'That vaccine is just water.'"
Vaccinations with AstraZeneca were halted in Georgia on November 1 because the unused stockpiled doses had expired. According to the National Center for Disease Control and Public Health in Tbilisi, only 58,723 people in Georgia were fully vaccinated with AstraZeneca, almost nine times fewer than with Pfizer.
The office in Georgia of the Anglo-Swedish drug giant AstraZeneca told RFE/RL that a report on Bakradze's case was sent to a centralized database for monitoring adverse reactions to vaccines. As for a potential investigation, "this is not the prerogative of the company," a spokesperson said.
AstraZeneca, which has now shipped 2 billion doses of its vaccine worldwide, came under international scrutiny after its vaccine's reported links to rare blood clots, leading some governments to restrict its use to certain age groups. The World Health Organization, however, has said that the benefits of the vaccine still outweigh any potential risks.
"This case brought the vaccination process to the brink of collapse," says Jinchveladze, the Bakradze family friend and doctor who still works at the Imedi clinic. With the recent rise in coronavirus cases, she says the hospital is now constantly full. In conversations with patients, they avoid mentioning Bakradze's name, she says, but often ask what she thinks about the vaccine. Jinchveladze herself is vaccinated and has called on other people to do the same.
Local health officials fear that with the arrival of winter and a decline in immunity, the numbers of infections will rapidly increase. Despite neighboring Azerbaijan having over double Georgia's population, its coronavirus death rate is around 30 percent lower. And while case numbers and deaths have stabilized in Georgia after August and September peaks, for figures reported on November 22, Georgia has the third-highest number of coronavirus deaths per million people in the world for the last seven days. Around the world, the majority of COVID-19 cases in intensive-care units are people who have not been vaccinated.
"This girl [Bakradze] felt with all her being that the pandemic should be stopped. And even though this great calamity has befallen us, it does not mean that we should not take care of each other," Jinchveladze says. "How many unvaccinated people have died? Hospitals are overcrowded and all resources are exhausted. I can only repeat Megi's words, that vaccination is absolutely necessary.