KK Shailaja: ‘COVID became a litmus test for governance worldwide… Wherever there was a strong public health system, we could fight the virus, reduce mortality rate’

I also didn’t intend to write an autobiography but I wanted to write something about my grandmother because she was a brave woman and an inspiration to me. She was a good storyteller and she spoke about the struggle against feudalism waged by the socialists and Communists of her time, against untouchability, etc. I always thought of writing about her. Then Chiki Sarkar of Juggernaut Books called me and said she wanted to write a book on me. She added the word ‘extraordinary’ (in the book title). I’m not an extraordinary woman. I’m an ordinary woman and political worker.

But I happened to be the Kerala health minister from 2016 to 2020, when several natural calamities and pandemics occurred — floods, hurricanes and the outbreak of the Nipah and COVID-19 viruses. Not only that, my government, under the leadership of comrade Pinarayi Vijayan, started new missions to develop Kerala — the Haritha Keralam Mission, Life Mission, Aardram Mission and the Comprehensive Educational Rejuvenation Programme. I also wanted to write something about that. But I had no time.

Manju Sara Rajan (her co-writer) recorded everything I said and wrote this book — how a girl from a poor, traditional family and a remote village came to politics and became the central committee member of the CPI (M), and then a minister. Many political activists have a similar story to tell. It is not my story alone. It is (a collection of) memories of an ordinary political worker, not an autobiography.

LIZ MATHEW: You played the most significant role in helping the Left Democratic Front (LDF) government through the COVID crisis. You set up a new model to fight the pandemic that played a key role in the government’s return to power in 2021. But you weren’t part of the government when it returned. Why haven’t you mentioned that (in the book)?

There is no need to mention that because it is not the only important thing. Under the leadership of the LDF, we were all doing new things in our departments. I worked hard in my department. That doesn’t mean only I can do these things. Our party and the LDF decided to change all the ministers, not because the ministers’ performances were bad — everyone worked hard and performed well in the last ministry — but we decided that everyone should be fresh in the new ministry, except the leading person. No one is continuing, not just me. I’m a member of the Communist Party Central Committee. Both these activities, parliamentary and extra-parliamentary, are the same to us. The party taught us from the beginning that a person should work either in the field or in the parliamentary area. There are so many leaders who do not even contest an election, but they are working for society as party workers and leaders. There is no way to become disappointed with this decision. It is a collective decision. I am working as an MLA and a party Central Committee member. That’s enough.

The (Communist) party taught us from the beginning that a person should work either in the field or in the parliamentary area. There are so many leaders who do not even contest an election

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LIZ MATHEW: Why have you declined the Ramon Magsaysay Award? The party does not seem to be ideologically against it. 

The party had not imposed anything on me. When they (the Award committee) selected me, I was grateful that the committee selected a politician. I think the Magsaysay Award is not given to political leaders but only to those engaged in public service. But I’m a Left politician. I was thinking if I could accept (the award) because I am a central committee member of a political party. No one ordered me to reject it. It was my decision. I discussed it with some of my colleagues and, at last, decided to reject the award with politeness.

LIZ MATHEW: The Left always advocated for equal rights for women. Why do you think that women are not part of the top leadership of the Left, like other parties in the country?

In Kerala, when we (Communists) came to power in 1957, we started land reforms. At first, we passed the ordinance to stay eviction from the land and the poor got a piece of land — their individual lives became dignified. Then we started to get rid of the feudal thinking that a woman’s place is in the home. Poor families were not sending girl children to school in the 1950s. But our party and many social reformers intervened for women’s education. In Kerala, nowadays, every child, irrespective of their gender, is joining school. Even in higher studies, the number of women has increased. But the mindset has not totally changed. The society is not only feudal but also capitalist. Capitalism treats women as a commodity. But the Communist Party is trying hard to fight against this. We have asked our party workers to add more women to branch, local and area committees. This time, after the party congress, more than 2,500 branches have women secretaries. Previously, women would just get a membership and work in the party branch. But now more women are coming to the forefront and shouldering the responsibilities of a party branch secretary, a panchayat secretary and of ward members.

Wherever there is a public health system that is strong, they can tackle this kind of pandemic and infectious diseases… Wherever there is complete privatisation, only a few can afford the treatment

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LIZ MATHEW: The Left parties, at least when it comes to ideology, give a lot of importance to the women’s rights movement. There is a view that the weakening of the Left could be a setback for this movement in the country because other mainstream political parties, as well as regional parties, do not espouse women’s rights like the Left does. What could be the future of women’s rights movement in this country in the backdrop of the weakening of the Left?

In the Left’s ideology, democracy means equal opportunity to all citizens, without discrimination. If the Left’s ideology becomes weak, the emancipation of women will also have some setbacks. No other ideology gives equal status to women. Capitalism does not want to equalise everything. In their mind, the progress of a part of society is more important than others.

KAUNAIN SHERIFF: The entire country looks up to the Kerala health model. At the same time, Kerala is seeing a silent pandemic of non-communicable diseases, whether it’s diabetes or hypertension. During the pandemic, there were several deaths in Kerala because of co-morbidities. In the future, how do we tackle this issue?

Kerala is at the forefront of some health indices. The child mortality rate in 2016 was 12 out of 1,000 live births. In 2020, it reduced to 5.4. The maternal mortality rate was reduced from 67 out of one lakh births to 20. We are at the forefront in life expectancy — it is 74. In Kerala, the human development index is high. We have been able to reduce poverty — 0.7 is the percentage of severe poverty in Kerala, but in other states, it is 28 to 30 per cent. But our lifestyle has changed. Physical or manual labour has reduced, eating habits have also changed. Therefore, people in Kerala have become more diabetic than people in other states.

(But) other states are also facing this problem. When I participated in a meeting of the health ministers in Delhi, I said to the then Union Minister of Health, Dr Harsh Vardhan, that we are the diabetic capital of India. He replied, don’t worry, India is the diabetic capital of the world.

During this pandemic, we had challenges in front of us. One is our population density. Kerala is a small place and more than 860 people live in one square kilometre, while the national average is 430. For infectious diseases, population density is dangerous. The second thing is our life expectancy — Kerala has a good population of the elderly above the age of 68. They make up about 50 per cent of the total population. After 60 years, most of them have co-morbidities such as diabetes or hypertension. We had to fight harder than other states. But what made Kerala different? In January 2020, the pandemic came to Kerala. But due to our preparation and planning, we caught them from the airport itself. We have some strategies — trace, quarantine, test, isolate and treat. We traced all the people coming from outside because time was crucial then. Vaccines were yet to be invented. We isolated properly and cut the infection chain. In December 2020, the mortality rate was only 0.4 per cent in Kerala and the vaccine came at that time. Due to vaccination, we reduced the mortality rate further. In 2021, we had the Assembly election. We could not lock down everything forever. The virus spread. But it was comparatively lower in Kerala (compared to other states). We had 100 per cent death registration in Kerala. In some states, it was only 30 or 31 per cent. Now, there are mutated viruses affecting the population. We are aware of that and are trying to contain it. The situation in Kerala is not too bad.

RINKU GHOSH: Through its COVID management, Kerala has created a new template for public health management. What lessons do you think other states can adopt from it?

COVID became a litmus test for governance systems throughout the world, not only in India. Wherever there was a strong public health system, they could tackle the problem, oppose the virus and reduce the mortality rate. Privatisation will not help tackle these kinds of calamities or pandemics. For example, in the USA, you have wealth and technology, but no proper public health system. That is why they couldn’t contain the virus initially. Thousands of people died in America. But in a place like Cuba, where there is a very good public health system, they could somehow manage this deadly virus.

In Kerala, the public health system has been strong from 1957 onwards. We have been building public health institutions. With each and every panchayat, we have functioning primary health centres. But with the pandemic, we understood that it is not enough. So, we tried to strengthen the infrastructure and capacities of our health system. Our aim was to put the virus under the health system’s threshold. We never allowed the virus to come up. Because of that, we increased the beds in the isolation unit, we increased the open oxygen supply, its production before demand increased. We anticipated that sometimes cases may go to 25,000 or 50,000 in a day and we planned for that. No one died in Kerala without getting oxygen. That is the difference of pre-planning.

We can have collective action with even the private sector. Some state health ministers called me and asked me how to manage private institutions — they said they are not obeying us, they are charging the poor according to their wish and are not giving space for COVID isolation wards. I said it’s not so in Kerala. Even a day before the spread of the virus, our chief minister called a meeting of private hospital managements and I participated in it. We asked them to leave aside some space for isolation wards as cases may increase in the future. Some promised 200 beds, some only 50, some small hospitals promised to give 15 beds. Private and public systems worked together. That is because we have control over them. They cannot dominate. That is the difference — who is controlling the health system. We cannot allow the private sector to control it, otherwise we cannot give assistance to the poor. That is the difference between Kerala and other places.

ANONNA DUTT: Right now, we are seeing an increase in COVID cases, and there are likely to be other pandemics in the future. You spoke about the privatisation of healthcare and we see a lot of that happening. How does a state government ensure that you have control over this, especially because we want the innovations to come in. Now, the government is also promoting medical tourism. So we want these, but it has to be balanced with the public health aspect as well.

Wherever there is a public health system that is strong, they can tackle this kind of pandemic and infectious diseases. They can handle non-communicable lifestyle diseases also. Wherever there is complete privatisation, only a few people can afford the treatment. What about the fate of the poor people? We can allow private hospitals or very huge corporate hospitals because they can apply and buy some new technologies. But for the poor, we should arrange all these facilities in the public sector. Privatisation is dangerous for society, and the COVID pandemic proved that.

LIZ MATHEW: In Kerala, we are seeing a massive outreach from the BJP, including from Prime Minister Narendra Modi. Do you think it is enough to shake the bipolar polity that we have seen in the state for so long?

Those who assembled in the Prime Minister’s meeting, not all are BJP followers. Most people in Kerala are secular-minded. Not only Left party followers, but also Congressmen and those from other parties. Most believe in our Constitution, in secularism and democracy. But the BJP doesn’t think like that. They are propagating the Hindutva ideology. India cannot become a Hindu rashtra. Lakhs of Muslims and Christians are here; thousands of Buddhists and Jains are here. We are one nation. What makes us one nation is that secular attitude. A religious belief is a private thing. Other than that, we are all Indian citizens.

A number of people gathered in front of the Prime Minister, not in front of a BJP leader. They wanted to ask some questions. No questions were raised there. What is the fate of the country? Unemployment is at 8 per cent and increasing. The Prime Minister should allow the poor youth to ask these questions: why is unemployment increasing? What is your policy to reduce unemployment and give jobs to youths? Is there any agricultural reform? Is there reform in the industry? Only a speech will not give answers. I think Keralites should think about that.