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Rural India is being devastated by Covid. Urgent action is needed

Bhupinder Singh Hooda writes: The Centre must decentralise, states must arm themselves with data, build capacity, and put panchayats at the heart of their Covid response.

Written by Bhupinder Singh Hooda |
Updated: May 14, 2021 9:30:56 am
In a village, families with Covid-positive members should be given kits consisting of medicine, thermometers and oximeters. (Illustration by C R Sasikumar)

The Covid-19 crisis is forcing us to evaluate our priorities. It is important that the government executes and implements the delivery of vaccines and healthcare services on a war footing. This needs active coordination not just between the Union and state governments but right down to the last level of governance, the panchayats.

The panchayat is now pivotal for tackling the Covid-19 epidemic as the virus has reached the villages and is rapidly ravaging the countryside. Of our healthcare services, 75 per cent of hospitals are in urban areas. It is important that the government builds a system to reach into the rural areas.

In the villages, there is a huge hesitation to test for the coronavirus. Even after testing, villagers are not willing to admit that they have contracted the disease. Most of my friends in the villages are still in denial — they still believe that they have the common cold and will get cured. In mild cases, Covid-19 does get cured on its own but the moderate form of Covid-19 requires medication and care. The severe form of the disease requires hospitalisation and can lead to death, if not treated properly. Because a large number of villagers are unwilling to accept that they have Covid, most of them do not get tested or check their levels of infection; nor are they properly geared towards curing themselves. By the time realisation dawns, it’s generally too late. The frantic last-moment search for the hospital beds, which are in acute shortage, leads to an avoidable loss of life.

State officials and district commissioners should actively report both positive numbers and deaths as it is important to have the right data. The Union government is allocating oxygen on the basis of the severity of the second wave in the state. If the state government underreports the numbers or fudges the data, it will harm, rather than help, the state as it will get a lower allocation of oxygen and more deaths will follow.

In rural areas, where the state government is not able to do testing or tracing of those who have died, it is now very important to get exact data of people who have contracted the virus, those who have recovered and also the vaccination count.

In a village, families with Covid-positive members should be given kits consisting of medicine, thermometers and oximeters. It is important for the caregivers to know the oxygen level if they need to understand the severity of the infection. Village homes do not have oximeters or even thermometers; providing these should be an immediate task. The delivery of the kits should be made through the panchayat sachiv as most panchayats are headless, especially in Haryana, after their terms expired. For this provision, there has to be correct testing data, and mobile testing vans need to be introduced in service immediately.

Till such time the district administration does not collate and collect the data, they will not be able to identify and direct their energies to that geographical location. Hence, hiding or obfuscating data at any level will do a disservice to handling this pandemic.

Oxygen availability and allocation is a big issue. Along with it, is the planning needed to deliver oxygen. Hence it is important that a task force, consisting of all ward officers, district and municipal commissioners, maps out the demand that is required in the district, which will be based on the data of the spread of deaths in the districts. Epidemiologists, experts and doctors will then be able to predict better the requirement of oxygen in the coming months.

Mumbai used the food and drug administration department for planning the demand and ensuring the supply in the city. Every ward in the city of Mumbai also created an emergency stock of oxygen; this reduced the time to send supplies to hospitals running out of oxygen.

The second wave will shift towards the rural areas; there might even be a third wave. Hence, it is imperative that India builds additional capacity. We should no longer be caught unawares after this. One of the things to learn from Mumbai is that hospitals should only increase beds if they can provide for oxygen. Any large increase of beds anywhere should always be followed by building oxygen generating plants in the hospital premises. It is also time for states to create jumbo facilities that have oxygen plants with adequate ICU beds to prepare for the shift of the second wave to rural areas and the expected third wave.

The Union government should decentralise crucial decisions to the state governments. The state governments must trust its officers to deliver. Our people are capable of handling any crisis — we have to believe that they can do what is right for the common man.

Covid is taking a mental toll on all the people working in the system — from the drivers who have been supplying oxygen to the doctors on duty and the district commissioner. The whole system is overworked and struggling to meet the demand. In a crisis, it is important that the system should not get overwhelmed. It should work calmly and quietly. Like a compassionate system, it should absorb the criticism and keep improving itself.

It is taking a superhuman effort to handle this crisis with limited resources; they need all our support if the nation has to come out of it quickly. Therefore, for the country, each of us should make some effort to help or support the system. The pandemic should not break down the spirit of humanity that binds all of us together. If you are feeling helpless in this pandemic, help a stranger.

This article first appeared in the print edition on May 14, 2021 under the title ‘How to bend the rural wave’. The writer is former chief minister of Haryana.

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