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Rural Realities | Northeastern States Practitioners’ Experiences In The Second Wave

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This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

In continuation with the ongoing discussion on rural realities around the country, 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 | North East Practitioners’ Experiences in Tackling the Second Wave in Indian Villages’ on May 16, 2021.

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The IMPRI team informed the discussion by locating for the participants the situation of Covid-19 in the country, particularly in Kerala. The team also provided an insight into the geographical and socio-economic conditions of the state. The rationale was to provide the participants with an overview of Kerala.

In the introductory remarks, Dr Simi Mehta, CEO and Editorial Director of IMPRI, spoke on the necessity of discussing the way rural practitioners and population were coping with the pandemic. Moreover, there was a need to focus on the way forward in tackling the pandemic.

Government’s Response

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Moderator Utpal De, Professor and Former Head, Department of Economics, North-Eastern Hill University (NEHU), Shillong, Meghalaya, began the session by tracing the journey of India in the first wave and the trajectory it assumed in the second one. He remarked that the approach of the government in the second wave differed from the previous one. He highlighted certain issues with the government’s response such as the uneven imposition of lockdowns across states and their impact in hampering market channels of agriculture and the industrial sector.

Following Prof De’s opening remarks, a brief presentation was made on the Northeast states reflecting their socio-economic characteristics. The presentation reflected that Tripura is the second-most affected state in the Northeast after Assam. Administrative efforts specific to the Northeast region were highlighted in the presentation, including a mention of Corona Protibondhi Dol– community participation at the grassroots level to increase awareness, Antiflip– an app that easily connected grocers with consumers in Assam’s Lakhimpur.

Medical Necessities

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Mr Sadam Minjabam, Founder of Ya All, Manipur, spoke about the situation prevailing in the state for the past 10 days. According to Mr Sadam, Manipur had 7,000 active cases and only 1,800 beds for Covid care.

Home isolation was proving to be a challenge as many people were unable to access medicines, oximeters and oxygen cylinders. The oxygen (PSA) plants commissioned in Manipur weren’t functional yet. Further, there were only 4-5 oxygen refill centres across the state.

He stated that costs of basic services and products such as ambulances and pulse oximeters had drastically risen, people were getting fleeced and black marketing was widely prevalent. For instance, an ambulance ride for five kilometres costs Rs 5,000, while the pulse oximeters cost Rs 2,500. He stated that the state government had been unable to increase the capacity of Covid-specific hospitals.

Awareness Building Mechanisms

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Dr Sunil Kaul, Founder, and Managing Trustee, The Action Northeast Trust, Assam, shared his observations on Assam. He stated that the number of positive cases diagnosed increased by almost 60 times in the past few weeks in Assam. The positivity rate, too, increased from 0.3% to 7-8% within a month. Further, Dr Kaul stated that unlike the Kamrup metropolitan area, where cases increased 42 times, the rest of Assam saw a higher increase in cases. This reflected that the rural areas bore the brunt of the pandemic in excess of urban areas.

Dr Kaul stated that in the rural areas many people did not even believe in the existence of Covid. Many had forgotten about the pandemic by July-August last year itself.

He observed that home isolation was a good method of tackling Covid. However, isolation in homes and community centres had to be based around strengthening the ASHA workers and creating awareness among them. Further, informal practitioners had to be utilised to spread awareness among the people. Material translations in local languages were another imperative to increase awareness at the ground level. Speaking on the mental health programme, Dr Kaul referred to the state government program called ‘Monon’ and remarked on its salience.

Lack Of Infrastructure And Coordination

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The next speaker was Mrinal Gohain, National Lead Person and Regional Manager (North East), Action Aid India, who spoke about the lack of infrastructure in the Northeast region and how the governments had approached NGOs and small care-centres to accommodate Covid-positive persons.

Mr Gohain brought focus on the different geographical regions that beset Northeast, and the requirement of handling their needs in a context-specific manner.

The next topic of his focus was the vulnerable communities. The poverty-zones/ slum-dwelling areas of cities, the disabled, refugees, street vendors, domestic workers, and the tea workers were the hardest hit by the pandemic. This scenario required the government to approach these communities, catering to their varied needs.

He remarked that state governments in the region had approached the pandemic in an isolated matter. This resulted in a lack of coordination between government agencies, hampering efforts. Further, he observed that the governments focused more on urban areas than rural areas. In the latter regions, the absence of governance forced the communities to deal with the pandemic themselves.

Information Dissemination

The next speaker, Netaji Basumatry, Regional Head (North East) at Indo-Global Social Service Society (IGSSS), spoke about the situation prevalent in rural areas. He stated that rural dwellers approached quacks rather than medical practitioners to treat the virus. This resulted in preventive medication being highly practiced in rural areas.

Secondly, Mr Netaji spoke on the economic repercussions that arose due to contrasting policy decisions.

Lack of clear communication over the curfew timings and lockdowns created confusion and panic in the public, said Netaji Basumatry.

Thirdly, like other panellists, Mr Netaji spoke about the lack of information and communication dissemination; and how these gaps resulted in the negligence of Covid appropriate protocols.

Digital Divide

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Prof Manjit Das, Professor and Dean, School of Social Sciences, Bodoland University, Assam, was the next speaker. He attributed the rise of Covid-19 cases in Assam to two factors: state elections and Bihu celebrations. In Assam, the Kamrup metropolitan area had the highest number of cases, followed by the Dibrugarh district. Further, he explained that the wide distribution of cases across the state could be linked to factors such as connectivity with outside areas, higher migrant population and different testing capacities between the urban and rural areas.

The second topic he chose to highlight was the infrastructure in hill areas. Between the first and the second wave, infrastructure had considerably improved in the hills’ region. This included public as well as private sector infrastructure.

Third, Professor Das spoke on the vaccination rate in Assam. According to data, only 30 lakh people had been vaccinated as against the total population of 3.33 crores. He said that the rural areas lagged behind in vaccination. He attributed this to vaccine hesitancy. Also, he stated that the digital divide was preventing rural dwellers from registering on the Co-Win portal.

Like other speakers, Professor Manjit Das stated that financial aid from the government was restricted this time, unlike in the previous wave. Also, private donors and businesses were reluctant to help the poor as compared to last year.

Needs-Based Assessment

The next speaker was Tirtha Prasad Saikia, Joint Director of North-East Affected Area Development Society (NEADS), Assam. Mr Tirtha spoke on the importance of undertaking a needs-based assessment of different communities. He stated that the pandemic was creating secondary disasters such as psycho-social care, malnutrition, food insecurity, and domestic violence.

Tirtha Prasad Saikia said “Enforcement of right Covid-19 protocol such as mask-wearing and appropriate behaviour were lacking in rural areas.”

Further, he highlighted the risk of floods that Assam was prone to and the immediate need to effectively manage and plan for these floods that reel the state from June-September.

As far as the vaccination programme was concerned, Mr Saikia spoke about the relevance of the pulse-polio programme, and how the government could devise similar strategies to ensure that vaccinations reach each and every community.

Discussants: Grassroots Governance

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Christopher Lun, Secretary, Goodwill Foundation, Aizawl, discussed the situation prevalent in Mizoram. He discussed the efforts made by civil society organisations such as Young Mizos Association and the church in aiding the government. He brought to notice the local-level task forces that had been created to tackle the pandemic in both rural and urban areas. These task forces comprised of local civil society organisations rooting the approach of the state in grassroots governance.

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Dr Bibeka Nanda Gogoi spoke on the need to prepare, plan and manage the pandemic. Also, he said that the pandemic would not abate quickly. Hence, there would be a need to continuously undertake mitigation-related activities to prevent the spread of the virus.

Concluding Remarks, Q & A

Dr Kaul spoke on the need to ensure sentinel surveillance prevalent to catch the spread of any infections. Though the Northeast had relatively lesser infection rates compared to the rest of India, there was a need to remain vigilant about future looming threats.

Highlighting the communitarian and disciplinary attitude of the Northeast, Dr Kaul stated that these two measures could possibly help avoid a devastating impact in the region.

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On a question relating to a rise in cases of black fungus in India, Dr Sunil Kaul provided two reasons that could explain this situation. One was the irresponsible use of steroids. The second could be the usage of industrial oxygen instead of medical oxygen. The latter are produced in highly sterile conditions as compared to industrial oxygen.

Regarding a question on how NGOs could alleviate their performance, especially during times of a disaster, Mr Mrinal Gohain highlighted the information gaps that many NGOs help plug. Leakages and bottlenecks in bureaucratic outreach can be bridged by roping in NGOs. They can help spread awareness and engage with the community in a much better way than the government agencies.

On an open-ended question regarding the need to create a framework for ensuring mental well-being, Professor Utpal De spoke on the fear-psychosis out of his own personal experience. Further, the uncertainty regarding lockdowns, work-from-home were taking a toll across the entire society.

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Dr Arjun Kumar asked a question related to the positivity rate in the Northeast region and whether this parameter varied differently from the rest of the country. To this, Dr Kaul replied that as long as testing is confined only to specific urban centres and district headquarters, the chances of missing patients were higher. Dr Kaul stated the need to increase testing in rural areas using the help from ASHA workers.

Posing a question to Mr Christopher Lun, Mr Indrajit Pathak wanted to inquire whether high literacy rates were the primary reason behind low Covid case fatalities in Mizoram. Elaborating on the local-level task force, Mr Lun replied that the grassroots membership of these task forces that came to the aid of the local people. Each locality had a specific local level task force chaired by the local councillor and vice-chaired by the leader of the Young Mizos Association. These task forces directly coordinated with the District Disaster Management Authorities and other state agencies.

These local task forces were responsible for contact tracing and setting up Covid-care community centres. Such a de-centralised approach to pandemic management proved to be effective across all eco-geographic localities of Mizoram.

Concluding the session, Dr Utpal De remarked that pre-emptive measures were the necessary tools to control the pandemic from reaching the rural areas. Ensuring the survival and livelihoods of the rural folks has to be the primary aim of the government. This should be done to prevent the pandemic fallout from dragging for years to come.

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