UPDATE ON THE CORONAVIRUS SITUATION IN ODISHA
It is wonderful sometimes when ones assumptions are proved wrong. I feared for the worst when I heard that coronavirus had struck India, and then Odisha where most of our work takes place. How long ago that seems now, another time, another world.
I felt that India was not well placed to deal with the pandemic, with its concentrations of huge populations in urban slums, and ill-served remote rural areas. There have been serious problems, obviously particularly in Mumbai and Delhi, and it may get very much worse in some of those areas..
However, Odisha is coming through this relatively mildly. The population of the state is about 40,000,000, and yet it has had only about 1,700 cases and seven deaths so far. For one of the poorest states in India, this is a almost a miracle, and yet it owes itself to several important factors, and I think it is worth learning some lessons from what they have achieved.
1. Disaster preparedness
Being a state which is regularly struck by natural disasters, the government has, over the years, developed increasingly effective strategies to deal with a wide range of eventualities such as flood, drought, and cyclone damage. A key to dealing with these events is a strong network of local organisations which know their communities and liaise with Block, District and state level departments. This has stood them in good stead through several serious cyclones in recent years, where the death rate and damage has ben drastically reduced from the time of the super-cyclone of 1999 and the terrible droughts of the preceding decades. In addition, cholera, another once-pandemic disease which emerged in the early nineteenth century, reappears from time to time. The India health services and social institutions are familiar with having to deal with devastating illnesses such as this. The possible reality of it is ever-present, with over half a million cases a year in India and more than 20,000 deaths; we in the West seem to have forgotten how vulnerable we are to such things.
2. Social support system with ASHAs and AWWs
Every village over a certain size has a Health Worker (the ASHA) who is responsible for pregnant and new mothers, and an Anganwadi Worker (the AWW) who cares for the children up to five, and for the elderly and disabled. At their best, they know their villages like the back of their hand. They are responsible for a wide range of government schemes and provisions, so are particularly aware of the needs of the poorest and most vulnerable in their communities. This system lends itself to the propagation of information about any situation which might threaten the community, so they are ideally positioned to carry out campaigns about hand-washing, social distancing, and quarantining, etc. A significant part of our work has been to ensure that this system works well because it is so valuable, and it has really proved its worth through the current crisis as the ASHAs and AWWs have done their utmost to protect their communities from the virus, tracking down contacts of any cases which occur and ensuring proper quarantine measures are instated.
3. Isolation with relatively few people coming in and out of the state
Generally speaking there is not a great deal of traffic in and out of the state. The exceptions to this are the migrant workers, who go elsewhere in the country to work for money which will help keep them and their families through the year. Sometimes it is whole families which travel, maybe thousands of miles for work, but mostly it is young adult males, aged between fifteen and forty. They go to brickworks in Andhra Pradesh, the building sites of Mumbai, the factories of Gujarat or Kolkata.
When the lockdown was announced, at four hours’ notice, it was catastrophic for the migrant workers who were left without money, work, food or accommodation, and sometimes on the other side of the country from their homes. There are some appalling stories of the experience of these workers as they found ways of making their way back to their villages. Many died on the way, of heart attacks, of exhaustion, as they walked and cycled across the country, and we will all have seen the images of bedraggled workers trying to make their way homewards..
4. Strict quarantining and contact tracking
Some of these migrant workers were put into quarantine camps where they had been working, or at state borders. Here at least they were fed. As they arrived at their villages, they found that they were not allowed back to their homes for fear that they were bringing back the virus. At the beginning it was chaotic and many had to stay on the edge of their village until gradually materials, services and facilities were provided. A strict quarantine system was enforced, and it is in these camps that most of the cases of coronavirus has occurred. The migrant workers had brought the infection back with them, but the quarantine system, combined with the tracking carried out by ASHAs and AWWs means that it has not spread, that those affected are treated without it being passed to their families and other villagers.
It could have been catastrophic, but the controls have meant that it has not been anywhere near as severe as we all feared. Looking at the statistics it is possible to see which are the affected groups: 90% of the cases are male, and the majority between the ages of fifteen and forty, matching the profile of migrant workers. No system is perfect, and despite their best efforts, the authorities in Odisha have made mistakes and rogue cases have appeared, but they appear to have managed to keep this relatively under control. Certainly, in our project areas, particularly in Western Odisha, there have been few cases. Who knows what the future holds, but so far, so good and we keep our fingers crossed.
WHAT HAS OUR PARTNER, CHALE CHALO, BEEN DOING?
CHALE CHALO has been very busy in its project areas, working to prepare villagers for coronavirus, raising awareness about the disease, and ensuring that all protective measures are taken. The two main concerns have been to ensure that everyone in the villages has their food entitlements, and that proper care is taken of returning migrant workers. A report on this will shortly be posted.
If you wish to know more, please contact Helena Nightingale at: helenanightingale@hotmail.com
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