To discuss the ways to tackle the spread of the second wave in rural areas, the Centre for Habitat, Urban and Regional Studies (CHURS) and Impact and Policy Research Institute (IMPRI), New Delhi organised a panel discussion on “Rural Realities: Gujarat Practitioners’ Experiences in Tackling the Second Wave in Indian villages“ on May 14, 2021.
The panelists for the session included Mr Umashankar Yadav, Founder-Director at Ahmedabad International Literature Festival; Ms Hiral Dave, Program Head at Cohesion Foundation Trust; Ms Poonam Kathuria, Director, Society for Women’s Action and Training Initiative – SWATI; Mr Rafi Malek, Director at Centre for Development in Ahmedabad; Dr Deepak Acharya, Consultant at Development Support Agency, Gujarat and State Medicinal Plant Board; and Ms. Shushila Prajapati, Program Manager, ActionAid Association.
The discussion was introduced by the moderator of the panel, Dr Mansee Bal Bhargava, an entrepreneur, researcher and educator from the Eco-Development and Research cell in Ahmedabad.
The discussion primarily focused on the impact of the second wave in rural India, which comprises nearly 60% of the population, and the need to acknowledge the privilege of living in urban areas, especially during the pandemic.
During the presentation, it was established that Gujarat had the highest case-fatality rate and the lowest doubling time during the first wave of the pandemic. Gujarat’s test positivity rate was the third-highest in the nation, after Maharashtra and Delhi. As of now, during the second wave, cases in Gujarat are doubling every eight days and as of March 23, 2021, a total of 1,641 people have died in the state. However, Gujarat is leading in vaccination, with 69,23,008 people fully vaccinated.
There are some emerging issues, though, in Gujarat, that need to be addressed.
Firstly, there is a shortage of vaccines, because of which vaccination for those 45 years and above was halted for three days. Secondly, there is a shortage of oxygen, because of which more than 50 patients reportedly died in Navsari, Surat, Banaskantha and Rajkot in 10 days. Thirdly, there is a need for improvement in health infrastructure. The government must increase Covid-19 bed capacity by 15,000 new beds. And lastly, rising rural unemployment needs to be addressed immediately.
After the presentation, the panelists of the discussion gave their views on the second wave of the pandemic, its impact on the rural areas and what policy decisions need to be taken to address the second wave efficiently.
Livelihood Security
The discussion was initiated with Ms Hiral Dave, who spoke about how livelihoods were tremendously disturbed in rural areas as a result of the second wave. There is a vast difference between the first and second waves, since the first wave did not exactly reach the rural areas. The primary issue is that migrants who were working in cities had no choice but to return to their villages. Additionally, there was no agricultural income as well since it’s summer and MGNREGA isn’t efficiently functioning either.
In addition to livelihood, food security poses a major challenge as well. As for the pandemic, villagers do not have access to basic amenities that the privileged do in urban areas, such as basic medicines, RT-PCR tests and oximeters. Since this strain is affecting the lungs even more so, oximeters are a necessity to monitor oxygen levels and thus take necessary treatment.
Thus, organisations such as Cohesion Foundation Trust are working to help people with some of these issues. NGOs are stepping up to help with these amenities, ration kits and other facilities. It is important to point out that single women, including widows and unmarried women, are one of the worst-affected groups since many of them don’t earn their own livelihood. Thus, it is imperative to link government schemes, and develop and adopt specific models as well as create new models for livelihood.
There is also a need to eradicate and debunk myths and false ideas regarding the safety of vaccinations, which is also something NGOs in rural areas have been striving to do. Since NGOs are close to the community, their representatives provide them with relevant information through voice messages, pamphlets, and other reading materials. It is also important to work closely with panchayats and district administration since they are influential stakeholders of the community.
Information Dissemination
The discussion was further taken ahead by Mr Rafi Malek, who highlighted three critical points:
- First, lack of awareness,
- Second, overconfidence,
- And third, lack of awareness.
During the first wave, urban areas were affected more than rural ones. It’s likely that because rural India was not affected much in the first wave, the state and the people became complacent during the second wave and thus, were not prepared for the second wave to hit them.
Further, the patriarchal structure in society ensures that women are mostly busy with their agricultural duties and don’t venture out much, whereas the men do. Since men are exposed to more people and gather more information, it’s questionable whether the information gathered by men is shared with the rest of their family or not.
Further, Mr Malek pointed out that the caste structure is still very prevalent, especially in rural areas and especially in Gujarat. Even if Covid-related facilities are set up in rural parts of the country, it’s doubtful that the marginalised sections of our society, Dalits and Adivasis, would get access to the said facilities.
Gujarat has not seen a pandemic of this scale ever, it has only ever faced natural disasters. Thus, it is critical that the state is asked whether they have prepared a roadmap or a plan to address this situation at all. It is also important to question the mandate of the National Disaster Management Authority (NDMA) and what role they play in such a crisis.
Given that rural areas in Gujarat do not adhere to social distancing norms, the state should give them a clear picture of the second wave and the deadly impact of the virus in terms of the number of cases, death rate and the recovery rate for them to understand the gravity of the situation.
Role Of The Panchayat
Dr Deepak Acharya followed Mr Malek with his enlightening thoughts. He pointed out that the treatment given during the initial phase of the first wave of the pandemic was given keeping in mind that the virus had not yet reached its deadliest peak, or even close. However, the longer a particular variant remains in a particular community, the faster it modifies and mutilates into more variants. Panic and chaos amidst the second wave led to a lot of misinformation, which further made matters worse.
Rural India was fully complacent even as the second wave of the pandemic took urban cities by storm, thinking it would not reach them. This was the result of a lack of communication between the Government and relevant stakeholders within rural areas. The need to bridge the information gap is stronger today than it has ever been. Dr Acharya emphasises the need to take Panchayat members and the youth in rural areas into confidence since they’d be in a position to help rally forces to combat the virus in these places.
He also spoke about the need to get at least 60-70% of the population in India vaccinated as soon as possible. However, this is not an easy goal to achieve because of the apprehensions about the vaccine as well as vaccine shortage. This has resulted in a lot of mismanagement.
Moreover, the lack of accurate knowledge and incorrect information led to the wrong or negligible treatment, which further led to many deaths in Indian villages. In order to avoid mismanagement and ignorance, it is imperative for the government to give people a clear picture and help them understand the urgency of the calamity at hand.
Health Infrastructure
During the discussion, Ms Sushila Prajapati gave a clear understanding of what the reality in rural areas are and how the second wave of Covid-19 in India has spread in rural India like wildfire. At present, the governments are not giving an accurate picture of the number of cases by excluded many Covid deaths.
She also cited an example of the Baroda district where her organisation works. It was found that RT-PCR tests were being done only within a one-hour slot in the entire day because of a lack of resources. According to a regional newspaper in Gujarat, 1.23 lakh death certificates were issued by the government of Gujarat in 71 days.
Ms Prajapati suggested the following steps:
- Firstly, the government needs to make the improvement of health infrastructure in rural areas a key priority.
- Secondly, the government needs to increase its budget allocation for health.
- Thirdly, it is important to make vaccination free of cost. The government should work with NGOs to reach the grassroots levels and tackle the impact of Covid in these areas.
Rural And Urban Differences
Ms Prajpathi’s insights were followed by Mr Umashankar Yadav. He focused on the negligence of medical colleges and how it is made near impossible to get admitted to medical colleges. The pandemic has given a serious reality check on the urgent requirement to improve the health infrastructure of the country.
He also emphasised on the discrimination faced by the youth that migrates from rural to urban areas in terms of employability and other factors, and how this has also been the case in terms of providing healthcare during the pandemic.
It is important to move away from the thought process that working in urban cities is the only key to success and even more so to treat rural India as a part of the country. Mr Yadav also highlighted the necessity of budget allocation, especially in the healthcare sector, and in that, the healthcare staff. This, in itself, will help solve numerous problems.
The key is to accept that there is a problem that the country is indeed vulnerable and address this accordingly.
The Caregiver’s Burden
Dr Poonam Kathuria talked about how things have gotten completely out of hand during the second wave. During the first wave of the pandemic, as a result of the lockdown, gender-based violence and domestic abuse had come to the forefront. Dr Kathuria brought up key important points on how women getting infected with Covid are being dealt with, or how those suffering from malnutrition are addressing these health conditions while taking treatment for Covid.
Her organisation, Society for Women’s Action and Training Initiative (SWATI), is doing a study on this, of which she shared a few findings. She spoke about how existing policies are either gender-blind or gender-neutral, not addressing the differences between men and women.
During a study, Dr Kathuria’s team spoke to a woman who told them that while her husband had Covid, she took care of him. But when she contracted the virus, her father-in-law telephoned her father and asked him what to do with her. Eventually, the husband and wife moved out of the house for that time, wherein the wife had to take care of everything and run the house, without any support.
Another story they narrated was also focused on Covid-introduced stigma. If a woman, while taking care of the family members in her house, gets infected with Covid, then it is not a problem. However, if the woman is the one to bring the virus into the house, she has to face the wrath and anger of her family members. The findings, so far, show that Covid or no Covid, women continue to be caregivers in the family.
Dr Kathuria also pointed out that Covid centres in rural areas are considered “shelter homes” for people, mostly, women, who have got Covid and have no means of their own to get treated. Had the treatment been compulsory for all, the centres would not have been stigmatised. It is important to bring in relief, cash transfer and tiffin service to help provide some relief to Covid-infected families and particularly, women.
A Healthy Society
Prof Ghanshyam Shah asserted that we are living in extraordinary times. Governments are approaching NGOs to effectively reach out to people. There has to be a ray of hope. Human development is lacking, therefore, we need to work together as all stakeholders need to be involved. There is a lot of confusion. Health policies need more attention. The issue of livelihood is a major concern. We have to see society in the context that is broader than our own experiences. Governments have to come out of their denial mode. We have to build faith among the masses and think about the long-term crisis.
Building Trust Mechanism
In conclusion, the panelists talked about the way ahead, which primarily focuses on the need to empower and trust communities and NGOs that can help the government address the pandemic in the best way possible, and not only in urban India, but rural India as well.
To watch the full discussion, click below.
