This panel discussion was related to the working experiences of various professionals, especially in the wake of the second wave of COVID in Indian villages. It was organised by the Center for Habitat, Urban and Regional Studies (CHURS) and Impact and Policy Research Institute, New Delhi, on 19 May, 2021 by the joint efforts of Parmarth Sevi Sanstha (Uttar Pradesh).
This discussion was another episode of the “Panel Discussion” being organised by the institute for all the states of the country, whose central point should be the rural reality of the state of Uttar Pradesh and its related issues.
This program was initiated by Ritika Gupta (Assistant Director) of the Institute of Impact and Policy Research. Also, while preparing the background of this panel discussion while welcoming all the visitors, Dr Simi Mehta said that the goal was to present a proper discussion and find out what the object of the second wave of COVID was in the state of Uttar Pradesh at present.
What is the situation and what are the efforts being made at the ground level by various stakeholders?
Prof Amita Singh (Chairman, NAPSIPAG Center for Disaster Research, Delhi, Retd, JNU) took over the conduct of this forum, acting as a moderator. Other eminent panellists included Khalid Choudhary (Regional Manager, Uttar Pradesh, Action Aid India), Neelam Verma (State Coordinator Uttar Pradesh, Indo-Global Social Service Society), Vivek Awasthi (Executive Director, UP Volunteer Health Association).
Dr Sanjay Singh (Secretary, Parmarth Samaj Sevi Sansthan, Jhansi), Lenin Raghuvanshi (Founder and CEO, People’s Vigilance Committee on Human Rights, Varanasi), Saurabh Lal (CEO, Model Village), Saurabh Singh (Chief Functionary, Inner Voice Foundation Community Arsenic Mitigation and Research Organization), Dev Pratap Singh (Vice-Founder and CEO, Voice of Slum), Sandeep Abasaheb Chavan (Project Lead, Tata Trusts, Gorakhpur, Homoeopathic Doctor, Public Health Professional), Dr Hira Lal (Indian Administrative Servant and Consultant, Model Village) and in the role of the talker was Ms Pragya Akhilesh.
Specific Administrative Set-Up
Initiating this panel discussion in Hindi itself, Prof Singh invited all the interlocutors to discuss two aspects. Those are the two approaches:
- What work has been done by the state government of Uttar Pradesh in view of the second wave of COVID and could they have done better. It was seen that in some areas, the government capacity was good, but then its satisfactory results were not visible, so this analysis should be done. What should be the reason that these capabilities of the state governments proved to be ineffective?
- Why the participation of various civil and community organisations and other non-governmental organisations of the society was not decided by the state government in this critical time and what were their important obstacles in this sequence—it should have been observed.
In this context, Prof Singh ended her expression by advocating for strengthening it, terming the democratic government as a special administrative system based on mutual cooperation of the government and local organisations.
In the next course of the discussion, Ms Verma gave a presentation on the second wave of COVID-19 and the infection rate, availability of health facilities, challenges of vaccination and other related issues.
Regarding the state of Uttar Pradesh, under brief presentation, sharing a comparative study with the help of demographic, socio-economic, etc. indicators including updated data, she made us aware of the ground reality of this state and invited all the visitors to share their views for a meaningful discussion, wishing the state prosperity.
Political Will Power
At the outset, Mr Raghuvanshi, in a nutshell, sharing his personal experiences, said that this global pandemic badly affected the marginalised section of the society in particular. He questioned the political willpower of all the ruling parties of the country during the COVID period.
Every section of the society, Dalit, women, Muslim etc., should be helped by rising above the caste and caste prejudices. The health facilities of these sections (what measures were adopted to remove the infection?) and food security (in this direction, it should also be decided by the government whether all their food-related problems have been completely solved by just providing food grains? Like grinding of dry ration etc.). He talked about ensuring their rights.
At the same time, he stressed on awareness related to testing and prevention and vaccination to remove the misconceptions related to this pandemic at the village level, appealing to the social and civic organisations to come forward in this direction and wished good health to all.
Subsidies and Financial Assistance
Dr Lal emphasised the priorities of the rural areas of the state, not talking much about the horrors and various aspects of COVID. He said that the concern of the government at this time was to get rid of the problem of hunger by giving financial assistance (₹1000 and farmer money, etc.) to the poor sections of the society (urgent to pay attention to food more than medicine).
At the same time, emphasising two points, he said that in this second wave of COVID, saving the poor class from the economic crisis and public participation of all the stakeholders of the society was needed in this direction.
Further, Dr Lal, referring to reducing the second wave based on data and information, said that now preparations should be made in view of the third wave of COVID so that the loss remains zero. Apart from this, citing the concept of a model village, he concluded his talk by stating the need for public participation and supportive dialogue of various community organisations, keeping the talk of empowering the Indian rural population.
Health Condition
Mr Chavan spoke about the plight of health in rural areas of the state and ways to strengthen primary health centres with the help of community-based development.
Sharing the COVID related problems of rural areas of the Gorakhpur area of the state very earnestly, he talked about the sudden increase in the spread of cases among the people in the second wave of this global pandemic. The main reasons for this were people in these areas refused to accept the symptoms of COVID, nor did they get proper investigation and initiative towards prevention, while about 10–20% of the families in this area remain badly affected.
Further, he said that there were not enough general testing kits for COVID and its diagnosis even at the block level under low health facilities in the state. Also, antigen testing and RT-PCR were not available within a radius of 20–25 kms. And also terming the management of isolation related to COVID at the village level as challenging, he said that there was a situation of denial among the people about the acceptance of proper practical approach of home isolation.
Therefore, in this direction, at least L1 (L1 patients at the village level are those patients who are less infected, who have a mild fever, the oxygen level is fine, blood reports are fine and they are treated at home) do not need to be admitted to the hospital.
There is a need to ensure patient care. Also, keeping this wave in mind, appropriate therapeutic initiatives under L1 and L2 need to be properly grounded. In the end, Mr Chavan also attributed the population density of the state of Uttar Pradesh to an extent for the rising figures of COVID. He acknowledged that in this sequence, especially for the awareness of rural people, local public representatives, health department and district officials, etc.
It is very important to fix the responsibility of primary health centres by establishing mutual coordination with them.
Role of Civic Organisations
At the same time, Mr Saurabh Lal gave details of the institutional efforts, mentioning the fact that his team was working voluntarily round the clock, despite the low potential of his organisation. Expressing concern about the second wave of COVID in the rural areas of the state, people had many misconceptions about this epidemic earlier, so there was a lack of credibility among them about testing, prevention, vaccination, etc.
In this context, the role of various civic organisations along with Corona Warriors and front line workers becomes important, especially by sensitising and educating the rural masses (rural stiffness due to stereotypes is also a deterrent aspect) as the only way to avoid this epidemic. To ensure the imperative of effective measures, i.e. “vaccination”.
At the same time, he identified the reasons for the unacceptability of all medical efforts related to COVID by the rural people. He acknowledged that there was a complete lack of basic infrastructure at the village level in the state and administrative implementation and weaknesses and their access and distribution have happened. These problems are widespread in the state’s remote areas, so there is a need in this direction by making available adequate resources.
Building a collaborative bridge and providing better health facilities while making a social commitment to getting the situation under control was the way forward.
Social Support
Ms Verma shared her views citing government policies and inaction as the main reason for the rise of the second wave of COVID. In the same sequence, during the recently held panchayat elections in Uttar Pradesh, there was an increase in the death figures (increased death rate due to the obligation of teachers in the epidemic) in both rural and urban areas.
At the same time, as a result, there was an atmosphere of fear and a decrease in the spirit of social cooperation, distance from funeral rites etc.
The only reason in the village was found to be a lack of awareness among the people. So in the course of preparation for the third phase, it became inevitable that dialogue is established while doing community development in rural areas. In addition, villagers should be encouraged to vaccinate through community mobilisation with the help of youth in villages.
In order to give real shape to these objectives, the state governments will have to work at the grassroots level in this disaster in coordination with various non-governmental organisations of the society, adopting community-based ideas by moving from their individual point of view.
Vaccination
Dr Singh has given his opinion widely and said that it was a big state of Uttar Pradesh which mainly consists of 5 agro-climatic regions: Oudh, Bundelkhand, Purvanchal, Vindhyachal. At the same time, the government’s preparations under this second wave of COVID were challenging in terms of the state’s population.
In addition, the main focus of state governments over the past few decades has been to improve urban facilities. This was due to the inadequate availability of primary community health centres at the village level and an acute shortage of health workers.
In this context, it is a matter of fact that, after all, why did rural areas of the state have to bear the brunt of this global calamity? There are mainly three reasons for this:
- The people of the villages, showing dogma, did not take this wave seriously and were worry-free considering the situation of last year’s COVID.
- The problem of migrant labour once again struck the rural economic structure and showed a pathetic condition.
- The dependence of the people of the villages on the parasitic doctors and doubts regarding the testing, prevention, vaccination, etc., related to COVID also created an environment of challenge.
At the same time, in view of the Panchayat elections, resentment towards the system among the people of the state and religious and social orthodoxy in the rural population also created an atmosphere of fear and the death rate increased tremendously.
Ultimately, Dr Singh said that the wave of COVID had been appalling at the grassroots level. There is a need to encourage all social and economic organisations to take responsibility for vaccination in this direction. At the same time, the state government will have to take all appropriate efforts on the issues mentioned above, like availability and implementation of medical facilities, rehabilitation, etc.
Public Health and Education
Mr Choudhary, while adjusting his views, especially in the context of the marginalised community and migrant workers, said that the second wave of COVID had shown issues like health crisis and invisible emergency towards them. This wave proved to be heart-wrenching for the rural areas of the state in many ways—increase in cases during Panchayat elections, non-appropriate behaviour of COVID and underestimation of its consequences by rural people not taking the problem of COVID seriously.
In this sequence, 60–70% of cases have been seen in the Purvanchal and Bundelkhand regions of the state. Lack of a proper testing system and non-availability of oxygen has increased the death toll, which from the state government’s figures and records doesn’t match.
Further, he said that the state government, social, medical and other institutions would have to make joint efforts to solve this problem.
At the same time, he talked about making public investment in certain items by the state government. He said that there was a need to spend more on health infrastructure, rural infrastructure, and allocation of resources in this context. Here he expressed the commitment of the state government of Uttarakhand has also been exposed.
Apart from this, there is an urgent need for the state government to coordinate with socio-religious organisations for awareness of developmental issues like public health and education. The economic condition of the underprivileged sections of Uttar Pradesh, especially the mushahras, weavers, migrant workers, etc., is worrying.
At the same time, it is not entirely appropriate to do away with your duty by announcing only 5 kg of food grains by the state government. In this critical time, the government needs to make a realistic assessment of the condition of the migrant labourers. In order to ensure food security, they should be provided with the “benefits of MGNREGA” as an alternative means of employment, gas fuel, etc., under the government scheme.
At the same time, he pointed out the problems of children and suggested that their mental health needs attention and said that in this environment of uncertainty, the education of rural children had been badly affected. Only 12–15% of the population was online and could access education; the rest, 85%, fall in the category of the deprived class.
Therefore, to solve all these problems, the State Governments must work in collaboration with the various stakeholders of the society: civil society, journalists, academic sections, etc., without any discrimination for the benefit of all the communities. Also, take a lesson from past mistakes and move forward, playing a responsible role.
The Issue of Hunger
Saurabh Singh explained the operational work (free distribution of food and medicines) being done through his organisation, mainly in Bihar and Uttar Pradesh, providing food security to the slum dwellers and deprived sections like beggars, etc., of these two states.
The point to be noted here is that the “hunger issue” has emerged as a basic problem (Varanasi and Chandauli areas of the state being particularly affected) in this second phase of COVID after the health issue.
At the same time, the caste-based political decisions of the state government have also restricted the reach of government schemes to certain sections. Thankfully, the coordinated efforts of some people, social media and civil society rather than the government, have brought these problems into the mainstream of society. A healthy debate has started.
Both the urban and rural areas of the state are badly troubled by the second wave of COVID. Only some influential people of the society are getting the benefits of government departments. At the same time, he condemned the government mentality for not giving proper recognition and support to the NGOs by the state governments and said that organisations like his have always struggled to serve the poor due to their limited resources.
Also, he shared some examples of government inaction, how the public faced problems with infrastructure facilities, and the lack of health workers in both the states of Bihar and Uttar Pradesh and non-functional government hospitals in some villages Uttar Pradesh, the benefits are denied. Therefore, in this direction, basic medical facilities should be started by coordinating various committees at the village level.
Fear is rife in the state’s rural areas, misleading government statistics of death of teachers across the state during Panchayat elections (only three teachers died of Corona during election duty), COVID patients and their relatives in government hospitals, etc., are some such real concerns, which presents an ugly image of the state government.
Therefore, while discharging the fundamental duties of the governance system, the State Government should proceed in harmony with the village public committees and heads while playing the role of a responsible, accountable and transparent body.
Also, even in cities, the state government should adopt a collaborative approach with NGOs. The state government should take a positive initiative in the direction of good governance by making the public well aware of the purpose of revenue models like Namami-Ganga, etc.
Ultimately, he suggested the revival and activation of rural panchayat sub-committees and also advocated working together for various laws to show administrative commitment to the public, such as food security, right to education and right to information. There is a need to work at the village level under the coordinating strategy.
Democratic System
Finally, Mr Awasthi shared his personal experiences related to COVID, agreeing with the views of all the other panellists. He also accepted that the first objective of the government was the welfare of the people. So the foundation of the success of the democratic system rests on this that the governments should move in this direction with the help of civil society services, etc.
The horrors of COVID that prevailed in the villages of the state have completely affected normal life, exposing the helplessness of the government. Also, this second phase of COVID has taken a dig at the weaknesses of the “top-down approach” of administrative policies.
Therefore, there is a need for all civil institutions to work together towards further strengthening the government commitment. In this context, there is a need to recognise and respect such institutions by providing government financial assistance.
Future Plans
Prof Singh concluded the last phase of this panel in a very meaningful way, appreciating the expressions of all the panellists. The main points of this discussion are outlined three important issues:
- The government has sufficient resources, but there is a lack of political willpower and vitality towards their proper implementation. Condemning the repeated gimmicks (population of the country is a hindrance in solving any new problem) given by politicians, she said that it is only a useless tactic to divert the public’s attention from all the basic issues. The allocation of government funds does not appear to be used at the grassroots level.
- The unresponsive character of the governance system. The government cannot explain how it implements government schemes (e.g., how to convert government ration and food grains into food, Ujjwala gas scheme, abolish MNREGA).
- Are the marginalised sections of the society getting the benefits of medical facilities in the health sector or not? In this direction, the state governments will have to introspect and focus on social transformation by rising above caste and party politics. At the same time, there is a need to strengthen the ethics and integrity of public servants in the governance system as they play the role of the real service provider at the local level. Further, all the panellists expressed their views by sharing the strategy ahead in the context of this disaster.
In conclusion, Prof Singh ended the panel discussion by giving five-point valuable suggestions (short term and long term) to deal with this global disaster:
- The state government needs to take a policy decision as soon as possible by meeting with all the opposition parties and playing a cooperative and coordinating role in the state’s interest.
- In all rural areas, arrangements should be made for persons with symptoms of COVID at a designated place for quarantine/isolation (by putting up tents and equipped with all basic medical facilities) by government efforts.
- In this direction, in order to prevent COVID, the government should decide on basic medical facilities (free availability of soaps for hand hygiene) and free distribution of food (on the lines of Amma Canteen in Tamil Nadu state).
- The state governments need to establish a liaison between the Panchayat and the “State Disaster Management Authority” so that the accountability of the government can be fixed in real terms. If the State Disaster Management Authority is dormant, it needs to be revived so that plan wise transparency can be ensured (details of plans/schemes are given under the timeline prescribed under the National Disaster Act, 2005).
- Last resort: by forming brigades of NGOs and Yuva Shakti (using their energy positively), the challenges of COVID can be eliminated by establishing direct coordination with the districts of the states with their administrative authorities.
Also, given the third wave of COVID, the government can issue a “white paper” to decide the commitment of its plans.
In the end, Advocate Sushant Singh shared his view that in rural areas, the Panchayat and DM need to be made aware to strictly follow the COVID protocol in the order of cremation of a person suffering from COVID on the death of a person suffering from COVID.