This panel discussion was related to the working experience 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 (IMPRI), New Delhi on May 20, 2021, by the joint efforts of Parmarth Sevi Sanstha (Uttar Pradesh). This discussion was another episode of the Panel Discussion series being organised by the institute for all the states of the country, whose central point was the rural reality of Madhya Pradesh (MP) and Chhattisgarh, and the issues related.
This programme was initiated by Ritika Gupta (Assistant Director) of IMPRI. Dr Simi Mehta (Chief Executive Officer and Editorial Director, IMPRI), while preparing the background for this panel discussion, welcomed all visitors and said that the goal of the webinar was to present a proper discussion and discuss the present status of the second wave of Covid in the states of MP and Chhattisgarh, and the efforts being made at the ground level by various stakeholders in this regard.
The list of eminent panellists who mainly participated in this panel discussion is as follows: Dr/Smt KF Kazmi (Executive Director, NGO Parvarish Child Development and Health Care Institute), Dr Sanjay Singh (Waterman of Bundelkhand, Secretary, Parmarth Samaj Seva Sansthan), Dr Yogesh Kumar (Founder Member and Executive Director, Support – Development Assistance Centre), Shri Devi Das (Farmer MG, Support), Ms Abha Sharma (Director, Judav Foundation, Bhopal), Shri Bhupesh Tiwari (President, Fellow Social Service Organisation, Chhattisgarh), Mr Rakesh Paliwal (Retd. Principal Chief Commissioner of Income Tax, Madhya Pradesh and Chhattisgarh), Mrs Anjali Noronha (Fellow, Eklavya) and Dr Anshuman Karoli (Lead – Local Government, Priya, (PRIA, New Delhi).
Initiating the panel discussion, Dr Sanjay Singh of Parmarth Samaj Sevi Sansthan first thanked all the visitors for taking out their time for this discussion. Further, to introduce the important role of the states of MP and Chhattisgarh on the national stage, and accepting MP as the heart of the country, described its geographical structure and ethnicity etc.
It is to be known that a large border of MP is connected with Maharashtra. The state is rich in biodiversity because of the forest density of the Satpura and Narmada river valley. Apart from this, the state is primarily a tribal-dominated area, which is also a residence to the population of the poorest sections of society. There has been an old tradition of migrant workers in this area’ the tales of Bilaspuri labourers of Chhattisgarh state are especially well-known.
Further, Dr Sanjay Singh expected practical recommendations from today’s discussion on the lines of the success and recommendations of the discussion held on the same subject in the context of Uttar Pradesh the previous day (May 19, 2021).
At the same time, while sharing his personal work experiences of the Gwalior and Chambal region of the state, he envisaged improvement in the situation of the second wave of Covid in the next 15 days by these recommendations, saying that these would especially benefit the farming classes as the rainy season is also nearing in the state.
With this hope and confidence, Dr Singh, after his opening remarks, took a pause and again invited other panellists and debaters for a discussion by thanking them.
In the next sequence of discussion, Ms Mahima Kapoor (IMPRI) and Ms Ramya Kathal discussed health facilities and infection rate respectively in the two states during the second wave of Covid-19.
During a brief presentation on the issues, the two brought up availability, challenges of the vaccination and other related issues in the context of these two states, sharing a comparative study with the help of demographic and socio-economic indicators. This made them the rest of the participants aware of the ground reality of both the states and the health status and progress of these states. Wishing prosperity, all the visitors were invited to share their views for a fruitful discussion.
Ms Abha Sharma of Judav Foundation, while congratulating the entire team of IMPRI, said that we have corrected the time between Phase I and Phase II of Covid. The country made a huge mistake in its assessment of the wave, as a result of which there was a sudden increase in the number of cases of infection and death.
Another reason for this was also the evident delay and inaction in taking management and policy decisions while showing laxity towards this epidemic. In this context, the two states have lost their state human resources on a large scale in the grip of this menace by not properly calculating the reality and magnitude of health crises.
Also, health management remained at the lowest due to a lack of medical facilities such as medical buildings, non-availability of staff, etc. A large number of Covid-infected cases were seen in every household in the state, but the situation became challenging due to a lack of accurate government data.
In the same sequence, due to the non-availability of proper address and numerical proof of migrant workers and the unemployed, the state’s largest youth population of 30-35 age group is falling victim to this health malformation. So, collective efforts are urgently needed in this direction.
Drawing attention to another challenge related to vaccination, he shared that the current vaccination process is being misused. Giving examples of this, he said that the difficulty and ignorance regarding registration of people in the villages has violated the health rights of the villagers by providing access to the people of the city to the vaccination centres set up for the villagers.
Also, when questioned in this matter at those health centres, the medical staff made another revelation, saying that there is still a trend of reluctance among the villagers regarding getting the vaccination. So, how to address this problem is a serious question.
In the end, Ms Sharma, in collaboration with her organisation Judav Foundation and other voluntary organisations, talked about the Covid relief work being done in the state — 20,000 N5 masks have been distributed in the last three months and protective gear to the state’s frontline workers.
The collaboration also created awareness among the masses, and provided ration kits and medical facilities at community health centres to ensure the availability of oxygen. A lot of on-ground work was done by the team to build confidence of the villagers in the vaccination, in the areas of Bastar (MP) and the remotest block of Udaipur, Rajasthan. Ms Sharma also shared her personal experience of how she got Dr Sridhar’s medical help in the Chhatarpur district of Madhya Pradesh):
Simultaneously, keeping in mind the risk of the coming third wave of Covid, doctors in the state were also concerned and have cited the need to be vigilant towards the children of the state.
Afterwards, Dr Yogesh Kumar of Development Assistance Centre shared the basic problems and aspects related to the second wave of the Covid pandemic in the state. He said that it is to be known that a large number of Scheduled Castes and Scheduled Tribes in both the states of MP and Chhattisgarh (tribal majority areas).
The population is inhabited and has always lagged behind most of the country in the order of general development. From this point of view, this global calamity seems to be an attack at the local level.
In addition, there is a complete lack of trust infrastructure in rural areas in the wake of Covid, due to which voluntary organisations are facing many challenges at the grassroots level in order to provide basic and useful support to the people. Also, in the rural areas of the states, home-isolation facilities and the protocol related to it are not being followed seriously due to lack of adequate and proper means. This is why this disaster took a formidable form, so it is also problematic for health workers. The topic is now coming up in policy discussions.
Apart from this, Dr Kumar informed the participants that many such cases have also come to light in the state where the sole earning member has died. This has led the family to a problem of food and hunger, along with a financial crunch, resulting in poverty. In the time of this calamity, the role of voluntary organisations has also been particularly visible – at the community level, and with medical facilities in rural primary health centres and government hospitals etc.
By providing other personal help, a pleasant picture has been presented in the direction of the diligence of civil organisations etc. At the same time, he said that in this critical time, such organisations need to work with state governments, health departments etc. and show commitment at the Panchayat and local level.
Along with this, there exist many prominent issues related to Covid before the villagers – such as non-availability of medical facilities (non-availability of ambulance etc.) even at the district level, problems of farmers (related to Kharif crops, seeds etc.), those suffering from Covid (especially those who are sole earners which has led to economic problems in families, the concerns about MGNREGA and cash income of workers at the village level, etc.
Continuing the discussion, Shri Devi Das, while referring to the spread of Covid in the rural areas of Chhattisgarh, said that people kept on treating this global pandemic as a “seasonal disease” and kept falling prey to it. Another reason for the rapid spread in these areas is that villages are a community-based society and share their resources, whether it is a public place (pond) or drinking water.
In addition, there is a need for micro-level implementation in order to control the infection. Also, sharing a personal experience, he mentioned the challenges of migrant workers returning to their states and quarantining them. With the workers returning to their states after the second wave of Covid. The quarantine protocol was not adhered to as they were busy planting crops for the upcoming rainy season. This further made these cases uncontrollable in rural areas.
The biggest hit of this wave was also seen on women domestic workers of the state (women working in 50 cities around Raipur). They lost their work, which had a direct impact on the lives of their children. They also roamed around in search of work. Therefore, ensuring the social and economic security of such classes will prove to be an effective step in preventing Covid.
Retd. Pankaj Pandey shared his experience giving details of the horrors of this second wave of Covid by sharing statistics with context to MP. He said that he and his organisation, Samarthan, work in about 13 districts of the tribal areas of the state.
During the organization’s survey, they selected households from 21 blocks in 12 districts and reported that they fully covered nine out of 13 districts in their survey. Apart from this, he attributed low literacy and awareness level as the reason for the second wave taking a fierce form in these areas.
Further, he mentioned the positive rate of Covid cases in this region, especially the case study of the Barwani district of MP, which threw light on the difference between government and actual figures (in the survey that concluded on May 8, 2021, in the case study of about 39,785 families in 12 districts of Barwani, it was found that out of a total of 2,868 cases in 96 villages of a single block, 287 had died. On the other hand, the government had recorded 35 deaths and issued death certificates in favour of only 11 people. Such a situation is not only confusing, but also challenging in the direction of mishandling this disaster.
In the end, Mr Pandey, while discussing the suggestive aspects, also informed about that around 20,000-22,000 youth volunteers who have been associated with his organisation for the last four years are supporting with their efforts in this calamity.
Further, with reference to the government, he said that as found through a survey, there are various socio-economic security schemes running in the state — including seven types of skill development schemes, Sambal Yojana, National Family Benefit Scheme). A free assistance of Rs 10,000 is being provided to the heir-head of the family in case of natural/accidental death of persons 65 years of age or above).
The priority should be to address their problems in the right sense.
At the same time, Dr Gajendra Singh from UNICEF shared a different view about this phase of Covid, saying that although this virus has been there since last year, we did not see so many cases earlier. The reason is also believed to be that at this time, the accelerating government efforts in Covid-testing is registering a proportionate increase in the figures of infection, as a result of which the cases of death of Covid have also increased.
At the same time, the state governments were also mistaken in understanding the nature of this pandemic. Without anticipating its dire consequences, they gave free rein to the general public by giving a free hand to the general public and vaccination (the youth of the country right now). Compared to the rest of the population, people who are 45 years or above are more vulnerable to this wave and most of them have been successfully vaccinated already.
Apart from this, he also challenged the presumptuous behaviour of villagers towards Covid. According to the current information available with the Government of India, Covid cases have decreased in places including Chhattisgarh and Indore (MP) etc. There is also a challenge in this direction —on what basis are rural and urban areas selected and classified in the direction of policy-making and data collection?
Therefore, to get rid of assessment-related weaknesses, the trick is to provide correct data to the civil society while bearing the responsibilities along with the state government. At the same time, he stressed that in this phase, attention will have to be paid to aspects such as surveillance of infection trail, testing, isolation and counselling at the village level.
Also, keeping this wave in mind, appropriate therapeutic initiatives under L1 and L2 need to be properly grounded. Testing is an essential step as symptoms shouldn’t be ignored in any way. There is also a need to identify and trace corona carriers who are not performing their duty well by not showing awareness of the symptoms and testing.
In addition, Dr Singh shared the highlights of the Government of India’s press briefing on the upcoming plans for Covid that had come out on the same day.
Apart from this, by making available sufficient quantities of oximeters, thermometers, etc. at the village level, there should be no delay in the symptoms of Covid among villagers. For this, the role of public movement and volunteers becomes indispensable.
The concept of testing can be worked out in only two ways at the village level – one is mobile testing for every 10 villages and availability of vans, and the second is rapid antigen testing in order to speed up testing.
It is also necessary to work towards providing proper arrangements Covid testing as well as adequate medicines at all primary, community health and sub-centres in Jan Aushadhi centres along with other medical facilities. For this, communities are organised. There is a great need for future action plans on socio-economic issues at the grassroots level. In the end, he also cited the efforts of UNICEF in the same.
In this discussion, Mr Bal Paritosh Das from UNICEF shared his views on institutional initiatives to address the problems arising out of the second wave, giving a comprehensive overview of the working of the United Nations Children’s Fund. He explained how this phase, while affecting the health system in a harmful way, has also posed a challenge to aspects of assessment and response.
In the context of multi-dimensional poverty, both MP and Chhattisgarh have seen results of 44% and 12% respectively, in comparison to urban areas. Also, during this time all the indicators such as health, nutrition, water supply, sanitation, child protection and child marriage etc. have been badly damaged. In the Bastar district (an operational district) of Chhattisgarh, the vulnerability rate was high due to Covid and its widespread lockdown.
Further, Mr Das described two main types of Covid impact:
Therefore, in the context of the above-mentioned effects, Shri Das stressed on the role of all civil society and non-governmental organisations for a speedy resolution and expressed the expectation of their cooperation. He also expressed concern over children’s education being badly affected during the pandemic, saying that it is seriously pushing their development towards oblivion. Apart from this, prenatal health services for pregnant women in rural areas remained stable during this period.
Moreover, the provisional level report on MGNREGA and PDS in the state has not been published yet, which has hindered the assessment of social security schemes. More serious problem remain in the tribal areas in the state.
At the same time, the reach of Divyangjan, old-age pension schemes is only 2-3% at the village level and the reach of the Maternity Security Benefit Scheme is slightly less, which is less than 50%.
In this sequence, it was told that they are discussing the information and issues related to the important role of the Panchayati Raj institution in the Bastar region. At the same time, appealing for public cooperation to improve awareness of security schemes, he said that all of us various stakeholder groups are just like a pearl in this “ocean of society” whose sole purpose is to prosper and enrich the society.
Another speaker, Shri Shyamsunder Yadav of Lok Shakti Samiti started his ideas by referring to the economic background of Chhattisgarh. He said that undoubtedly, the state has an abundance of resources (industrial and mineral, energy and steel industries etc.), but with many challenges.
During the second wave of Covid, it was seen that in both the urban and rural areas of the state, whole families were in case of infection of even one family member. So, in this direction, there is a need to analyse such cases in two forms for the correct assessment of data. What is needed is an overview of the situation before and after Covid etc.
He commented on controlling the rate to some extent to avoid human damage and talked about the insensitivity of the efforts of the district administration in the second wave of the pandemic.
In the end, while also discussing the efforts of his organisation, he said that arrangements for home isolation, counselling for vaccination, hospitalisation in case of deterioration of a person’s health etc. are being made. Apart from this, through our organisation, a continuous dialogue is being held with Panchayats across the state. Appeals to heads of various tribal ad non-tribal communities are also being made to encourage vaccination among the rural population at the local level.
Shri Shyamsunder Yadav, while concluding his statement, described the situation of MGNREGA in Chhattisgarh as well as the condition of orphan children suffering from this global calamity. He said that a comprehensive and clear strategy on behalf of the state is required to make them as the ‘legal guardian’ or make a succinct proposal, terming the system of guardianship and rehabilitation.
Further, Shri Rishi Mishra of Indo-Global Social Service Society shared his views through a presentation on issues related to the current wave of Covid and suggestions for their solution. He said that the increasing cases of Covid have once again affected the industries, and with the problem of reverse migration, problems of food, shelter, medical services and livelihood have arisen in front of villagers as a result of the halt of transport. Also, in this phase of Covid, the same form of destitution of the rural system was visible, whose brunt was suffered by the urban system last year.
Also, this wave saw several challenges at the village level of the states – inconclusive information, increased unscientific practices, inadequate testing and lack of medicine, poor health infrastructure, lack of disaster management plan at Panchayati Raj level etc. He said:
Apart from this, in both MP and Chhattisgarh, it is inevitable to have a scheme or a committee at the Panchayati level so that the above-mentioned problems can be addressed at the local level.
Further, sharing information about his organisation, he discussed the reach of his action plan to about 210 villages in Jhabua, Alirajpur, Dhar, Panna and Chhatarpur districts of MP.
Along with this, he mentioned how his organisation has identified an action plan in order to deal with the Covid crisis. This included the Government Response Scheme to Youth Volunteers (Cash Support for Economic Empowerment) and NREGA Scheme to support households in availing benefits, the realisation of preparedness for Covid-Appropriate Practices and dissemination of correct information of vaccination and testing centre information, scheme benefit information etc.
Expressing his views on other issues, he said that we need to decide how to address the aspects of family concerns and psychology counselling by adopting the approach of positive divergence at the village level while facing this wave of Covid.
In this context, he concluded his talk by calling attention to the facts like pre-natal care of pregnant and lactating women, and supplementary nutrition of young children in addition to Covid vaccination.
Shri Bhupesh Tiwari of Saathi Samaj Seva Sanstha shared his personal experiences through his organisation among the rural communities of Bastar district of the state in view of the current situation of Covid. He specifically mentioned three-tier problems:
1. Real challenges at the ground level,
2. Issues of education and awareness at the community level, and
3. Settlement of critical situations at the state administrative level.
Under the rural system, administrative inadequacy or attitude, citing many other issues, lack of basic facilities of home-isolation in villages (absolute lack of extra rooms, toilets, bathrooms and water system in most of the houses) and proper implementation of protocols. Concern was expressed over non-compliance etc.
Apart from this, the lack of proper assessment of rural households by the government and displaying names of medicines only through posters in health centres were some of the issues due to which the problem of Covid became acute. Also, due to the lack of food-collection instinct in tribal areas (people of this community believe in getting things according to the need from nature), even after suffering from an infection, they themselves made all the arrangements for their family.
Giving information about the failure of home isolation in the state, Shri Tiwari condemned how cases of infection have increased exponentially due to non-compliance of protocols in this direction.
In the same context, he said that while giving medicines to the people, the villagers do not have the knowledge of proper instructions. Medical prescriptions and prescribed instructions are written in the English language. Due to a lack of proper information about the use of other medical equipment (oximeter, oxygen cylinders etc.), this problem is becoming serious. He said:
At the same time, there exist misconceptions within communities, due to which more and more testing and vaccination should be encouraged at the village level. A few causative persons need not be blamed and the trend of people getting tested or vaccinated on someone’s advice instead of seeking medical advice can prove to be fatal and needs to be removed.
Since our state governments are already burdened with duties, ASHA workers took over. One of them was even subjected to violence during vaccination duty because of misconceptions (impotence and death) that the villagers had against the vaccine and started protesting. Local awareness has to be worked on seriously, so that only the right information on the vaccine reaches the public
In the end, Mr Tiwari, while advocating for provision of all basic facilities at quarantine centres in the village, held the view that due to the lack of uniformity in circumstances and resources of each region, a generalised solution is not possible during Covid. The same type of action plan cannot be implemented everywhere. Therefore, considering the available conditions of the areas facing a problem, a decision should be taken and a solution must be found.
Concluding his discussion, Mr Tiwari requested the district administration to stop home isolation in Bastar as soon as possible because it has proved to be a complete failure. At the same time, referring to the contradictory schemes in case of the nutrition-tracker at the village level, it, too, has been described as a failed strategy in fighting the calamity of Covid.
Dr KF Kazmi of Parvarish Child Development and Health Care Institute also made her presence felt in this discussion, keeping in mind the second wave of Covid. First of all, she defined children’s and women’s health issues based on their experience. A paediatrician herself, Dr Kazmi shared the issue of government directives on the controversial issue of immunisation of unborn babies and pregnant women, especially in the context of this second wave of Covid. As soon as symptoms appear, she asked them to take the issue seriously.
In addition, Dr Kazmi mentioned an example of community intervention in urban slums by women in the remotest village of Betul at the village border to make their village Covid-free. Presenting an excellent example of awareness among mothers/women towards their children and communities, she said:
There is an urgent need to make villagers aware of their health issues by adopting friendly and simple behavioural instructions on their health issues.
In this sequence, while taking appropriate intervention by the government and understanding the seriousness of this pandemic, she said that the general public is aware of the seriousness of the pandemic and understands the need for proper prevention measures and practices (applying masks, frequent hand washing, the importance of vaccination, strict adherence to government protocols etc.). She appealed to make a practical and convenient plan in order to discharge responsibilities.
At the same time, she advised fellow activists to work seriously on the real aspects related to rural society. She said that there is a need to not only coordinate with villagers, but they also provide leadership at the local-level, because they are the only ones who are responsible for their problems. By understanding it well, you can find a better solution for it.
Our final speaker, Mr Rakesh Paliwal made a realistic assessment of the second wave by looking at the structures of these two states, mainly on the basis of two frameworks or perspectives – pathology and Gandhi philosophy.
While appealing to save the villages first in order to avoid the horrors of Covid, he suggested adopting the ideas of the Father of the Nation, late Mahatma Gandhi. He said that steps should be taken keeping in mind the present rural scenario and not some ancient society.
In the same context, he based the data on the growth of the first and second wave of Covid (where in the first wave, it took three months to go from 1,000 to one lakh cases, while in the second wave, the cases increased from 10,000 to four lakh within a span of days). But stating that it is difficult to fight this disaster, he expressed concern over the failure of government schemes and not being effective on the ground (the central and state governments took policy decisions in their closed AC rooms, ignoring rural realities and diversity of India).
Apart from this, considering the present scenario of Indian villages, administrative officers were suggested to implement the schemes, especially in relation to the District Magistrate (under the administrative system, an administrative officer has to travel from DM to Secretary for about 30 years, As a result, they get acquainted with the rural society for the first and last time only during the training period of their service).
Also, the sequence of Covid preparedness has to be considered in advance so that large scale failures are not seen.
In the same sequence, while sharing the information about his administrative initiatives related to the preparedness of Covid in the state last month, he said that in this, he provided detailed information about the schemes prepared by 36 NGOs of 12 states of the country.
It is in this context that he described how there are about seven model villages in five parts of the country (mainly in Telangana, Gujarat, Uttar Pradesh and Madhya Pradesh), with a few Gandhian institutions that are entirely (100%) tribal areas. And out of these, the initiative has been taken in four villages that come under the category of tribal villages.
Also, during his speech, Mr Paliwal shared many instances from his administrative experience. On the aspect of planning, he explained the role of all public representatives (Sarpanch, Panchayat Secretary and members of Panchayat) and various stakeholders of the rural self-government unit (Patwari, Forest Guard, Police Constable, Anganwadi and Asha workers and NGOs etc.) at the Panchayat level. There is a need for strict adherence to development.
In sequence, it is also suggested that anyone working in an NGO must work in the direction of realising the concept of an ideal village by adopting the Gandhian approach. Also, he criticised some NGOs in the country that indulge in financial irregularities and corrupt practices.
In the end, he shared Gandhiji’s views as described in Hind Swaraj, and said that there is only one bad thing in relation to the village, and that is the terrible laziness and filth among villagers – which always obstructs their path to development. At the same time, it also claimed that the cleanliness mission has contributed to a great extent.
Challenges in rural sanitation have been reduced to the present. Also, giving information about the organisation of the two-hour webinars every week and the 36 NGOs and their representatives so far from different states of the country, he described the webinars as necessary in the direction of micro-level action plan of rural society. By registering an objection to not appreciating or promoting the good work of such NGOs, he took a break from his words.
Anjali Noronha of Eklavya, before her talk, remembered eminent personality of the Indian medical world, Dr Shekhar Agarwal, while paying a heartfelt tribute to him, calling it an irreparable loss to the medical system. While analysing the realities of rural society, some of the major points she discussed were:
1. Till the second wave of Covid had not come, there was an illusion in the rural society that the disease is limited only to the affluent and urban areas of the society, so they did not take precautions and the cases kept increasing.
2. Leaders of the country registered an increase in the pandemic by gathering crowds during the election campaign, while that should have been for its prevention and awareness.
3. In this phase, without doubting the aspect of disease carriers on the poor and domestic helpers, it is to be considered why the effect of Covid in the rural system was very less even when a large number of migrant workers returned to their villages last year. So how did the coronavirus mutants take on such a lethal form in this stage, leading to a deterioration in the circumstances?
4. The new mutants of this coronavirus also hurt the urban system because proper Covid prevention practices – such as not wearing a mask properly, not following instructions of social distance, using air conditioners that led to vitamin-D deficiency – were not adopted. Due to all these, the flu-virus took a formidable form.
5. Apart from this, Covid-infected persons increased infection cases due to their irresponsible behaviour. Along with this, there is also a need to cross-examine the actual figures of infection and mortality, taking care of aspects like proper testing, vaccination etc.
6. She talked about the confusion regarding vaccination for pregnant women due to the lack of vaccine-trial so far. Also, the sooner Covid infected cases are identified on the basis of testing or symptoms, the more it effective it’ll prove to be.
7. Along with this, proper prevention of Covid has to be included in our daily life habitually. For this, the help of NGOs can be taken.
8. Further, he said that there is an urgent need to set up Covid quarantine centres instead of home-isolation. In this context, Mrs Anjali expressed hope for more good work from government department regarding the supply of basic facilities such as bedsheets and other daily items in these centres. At the same time, describing the plight of several primary health centres in the Sagar district of MP, she demanded from the government to revive them.
9. Lastly, there is a need for the various health workers of the state – ASHA and ANMs (Auxiliary Nurse Midwives) etc. to work together to tackle Covid by formulating collaborative plans with the youth of the community.
The issues on which Dr Anshuman Karoli of PRIA spoke in his statement are as follows:
1. The impact of the second wave of Covid was felt first in Maharashtra and Punjab in March this year, as a result of which the Central government banned all flights to the UK. Also, the impact was less in villages as compared to the cities. In this wave, the reverse migration crisis of daily wagers could be seen once again. Apart from this, in view of the fierce form of the second phase, the states have issued guidelines for partial and complete lockdown at their level.
2. Further talking about the rural health system, Dr Karoli said that the Ministry of Panchayati Raj needs to empower and enable Panchayats by working strongly towards ensuring better availability of health infrastructure in all the villages of every state. There is also a need to give an advance role to various civil societies for community preparedness under State-Centre sponsored schemes and advisories.
3. At the same time, there is a need for strategic linkages at the local level, so that the rights of the last person in the society can be addressed while reaching out to the local people.
4. Referring to the 15th Finance Commission, he said that there is a provision of clear financial assistance for the primary and community health centres at the block level to get rid of the disease. In the same sequence, it is suggested that the state government, along with civil society, will have to be strengthened at the panchayat level for the preparations for the third wave of Covid.
5. In order to prepare village, block and district health plans under the strategy of the third wave of Covid, there is an urgent need to work on maintaining harmony and trust with the government, civil society and other donor agencies.
On its last leg of the discussion, some recommendations and strategies were shared by the panellists point-by-point, keeping in view the second phase of Covid. Dr Sanjay Singh, while terming this discussion as succinct and diverse, mainly pointed out two ideas: communication and liaison strategies; and collaboration and alliances of various stakeholders.
In the same sequence, Dr Arjun Kumar, advocating to work on one-time disaster management, also asked the question: How can quack and quack doctors be avoided in the state of Madhya Pradesh during the pandemic?
Under this, the role of civil society, the process of clear identification between rural and urban areas regarding vaccination, rural health and nutrition, development and financial allocation under the annual plan, etc. should be addressed in a holistic manner.
Shri Rishi Mishra briefly spoke about the role of Panchayat and the following points of financial decentralisation.
1. Response: Resource allocation to Panchayati Raj Institutions for disaster response (increased joint fund),
2. Risk Reduction: Deprivation of Panchayati Raj Institutions, adequate powers, financial decentralisation of Panchayati Raj Institutions, and
3. Resilience: Promoting comprehensive and integrated village-level health policy (local policy) and PPC (public-private and community) partnership initiatives.
In hr closing remarks, Kazmi first shared the government’s latest guideline, clarifying the confusion surrounding vaccination of pregnant and lactating women by another speaker. Also, analysing the various health protection schemes and services of the Government of India (Ayushman Bharat, Pradhan Mantri Bhartiya Janaushadhi Kendra, Pradhan Mantri Jeevan Jyoti Bima Yojana etc.) and health management system (Arogya-Setu) under their rural system, “From below Adopting the Upward Approach” advised state governments to work towards the development and upliftment of a healthy India and its new generation.
At the same time, citing the seriousness of the governments of other countries (Germany, China, Australia and New Zealand) towards their new generation, he wished to envision a prosperous and healthy society at the national aas well as nd state level.
Apart from this, under the rural system, various government socio-economic and monetary aids (PDS and Pradhan Mantri Matru Vandana Yojana etc.) suggested making it more strong and focus on public welfare.
Further, he said that various health workers engaged in Covid testing work (such as Anganwadi workers involved in Integrated Child Development Services) also face difficulties due to the non-availability of Android phones during the survey. At the same time, there is a need to work towards the preparation of the ongoing second wave through community awareness, vigilance and public cooperation at the local level for rural health and sanitation.
Shri Rakesh Paliwal shares some thoughts, suggestions and points through his personal experiences while advocating for adoption of neo-liberal approach in the revival of rural society, justifying the relevance of Gandhi in the 21st century. These are as follows :
1. Establishment of Model Village: By doing any construction work in the village on the strength of rural labour, villagers inculcate a sense of moral importance and they are ready to protect those services throughout their life.
2. In the present scenario, there is a need for scientific up-gradation of Indian villages, while discussing the responsibility of social audit of NGOs and 14 points described in the direction of the constructive program of rural development of Gandhi’s theory written in “Hind Swaraj”.
3. Inevitability of solving the problems of the villagers in their local dialect or language.
4. Example of corruption-free village and village of Medha Lekha in Gadchiroli [Prevailing slogan: Our government in Delhi and Bombay, and ‘We are the government in our village’].
5. Rural development in totality and the concept of the corona-free village – i.e. better health and sanitation, proper food security, organic farming, drinking water supply, an awareness campaign for Covid appropriate behaviour, etc.
6. Idea Exchange Approach – For the overall development and sustainability of villages, we have to exchange ideas with villagers (on nature and diagnostics).
7. Preparedness for Contingency — We have to prepare or strengthen our Panchayati Raj institutions with a strong will so that they can coordinate properly with other stakeholders.
The main recommendations made by Mrs Anjali Noronha were as follows:
1. An urgent need to set up isolation centres at the village level and the challenges home isolation with the government
2. To have diversity in community strategies keeping in mind the second and third wave of Covid.
3. In view of the spread of the second wave, all government guidelines and protocols of the ICMR should be made available to the rural population in their local dialect and language.
4. Showing gratitude to the medical group or fraternity for their contribution and services, taking and giving help etc.
5. Also, as part of policy decisions, foreseeing this global disaster in the third wave, there needs to be an increasing emphasis on the process of vaccination. Apart from this, it would be preferable to allocate about 5% (recommended expenditure on GDP) in the national budget for health and medical infrastructure and for the appointment of medical staff. In the same sequence, a stepwise strategy is suggested to make a strategy every three months for the next one year, etc.
At the end of the discussion, Dr Sanjay Singh, co-organiser of this panel discussion, described this forum as a comprehensive discussion and asked all to think over the issues on which consensus was reached. In order to deal with this global disaster, he assured all to take it before the higher administrative officers of the state. Finally, he wished for a strong, prosperous and healthy society and thanked everyone and described this event as meaningful.
YouTube Video for Rural Realities | Madhya Pradesh and Chhattisgarh Practitioner’s Experiences in Tackling the Second Wave of COVID-19 in the Indian Villages