This post has been self-published on Youth Ki Awaaz by IMPRI Impact and Policy Research Institute. Just like them, anyone can publish on Youth Ki Awaaz.

Rural Realities: Practitioners’ Experience In Tackling The Second Wave In Indian Villages

More from IMPRI Impact and Policy Research Institute

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

Written by: Arjun Kumar, Indira Khurana, Ritika Gupta, Anshula Mehta, Sunidhi Agarwal, Sakshi Sharda, Chhavi Kapoor

The second wave of Covid-19 has now penetrated the rural pockets of India. It has gained traction in the country’s rural hinterland, where healthcare infrastructure is weaker than in urban areas, at a much faster rate than it did during the first wave of the outbreak.

To discuss the ways to tackle the spread of the second wave in rural areas, 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: Practitioners Experiences in Tackling the Second Wave in Indian Villages on May 5, 2021.

IMPRI

The esteemed panellists were Dr Yogesh Kumar, Executive Director of Samarthan: Centre for Development Support; Mr Sanjay Singh, Secretary of Parmarth Samaj Sevi Sansthan; Ms Maya Vishwakarma, Founder of Sukarma Foundation; Ms Smarinita Shetty, Co-Founder and CEO of Indian Development Review; Dr M R Seetharam, Consultant Orthopedic Surgeon, Vivekananda Memorial Hospital, Sargur and Swami Vivekananda Youth Movement Executive Director, VILD Foundation, Mysore Managing Trustee, DISHA Foundation, Mysore; and Ms Pratibha Shinde, General Secretary of Lok Sangharsh Morcha.

The Moderator of the talk, Dr Indira Khurana, Vice Chair of Tarun Bharat Sangh, Alwar, pointed that the second wave is spreading like an uncontrollable wildfire. We can clearly observe through the data and statistics that in the first wave, migrant workers were the most-affected and faced the social and economic crisis of the pandemic, yet, the spread of infection in rural areas and the hinterlands was relatively lesser than the second wave.

1 2

Today the media, policymakers, bureaucrats and politicians, both at the state and the Central level, are focused on formulating policies and finding out ways to combat Covid-19 in urban areas. Thus, it is evident that rural areas need a more focused attention this time.

The objective behind the discussion was to draw attention to the rural second wave crisis and its challenges, and to look for ways to address these challenges.

Panellist Dr M R Seetharam demonstrated the rural scenario through his real-life experiences and gave insight into the rural healthcare system, which continues to be neglected. In the past year, it did not see any major improvements pertinent in the time of crisis. Primary Healthcare Centres continue to be inefficient and have inadequate human resources. Though we do have Asha workers, and other healthcare and grassroots workers, their capacity to function is limited, making them less efficient.

Ground-Level Covid Situation

Dr Yogesh Kumar began by elaborating on the Covid situation on the ground in rural areas. There has been a large-scale spread of the virus in rural areas, where at least 10% of the population has symptoms. He cites various reasons for it, such as low awareness of Covid-positive case management, lack of medical resources (oximeters, thermometers etc.) at the village level, lack of doctors and paramedics for medical advice and support, and an environment of mistrust of the government at the community level.

Strong Resistance And Vaccine Hesitancy

Ms Maya Visvakarma stated that the lack of awareness, and reluctance and fear of testing and isolation make the rural population more vulnerable to Covid. The problem becomes complex when most of the medical infrastructure, particularly the tertiary centres, are concentrated in towns and cities, which becomes problematic for villagers to seek medical help. She also added to the fact that home isolation becomes a tough task in rural areas as people there live in small households. India’s Covid vaccination programme needs to accelerate, but uptake in rural areas has been low due to lack of awareness, strong resistance to vaccines and poor ground-level execution.

Mr Sanjay Singh discussed the positivity rate being about 25-30%, particularly in the Bundelkhand region. His organisation, Parmarth Sansthan, is conducting massive awareness campaigns, helping the health department in ramping the number of testings, providing nutritional and medical kits to people, and oximeters and thermal screening devices to the Jan Saheli cadre to help the rural population.

Ms Smaranita Shetty pointed at the rural perspective, which is not usually showcased in the mainstream media. This includes poor healthcare infrastructure in villages, a belief among the rural population of the virus being ineffective, hesitancy to vaccines and a transformation of the context of the awareness campaigns from the first wave to now, the second wave.

She added that in a survey conducted by the India Development Review (IDR), they observed that the local-level non-profit organisation (NGO) seek support in three major areas. The first is Awareness Building among people around the need to get tested and vaccinated, and regarding the difference in Covid symptoms in the second wave in comparison to the first one. The other two areas are: Support in the provision of rations and maintaining the livelihoods of people, and community support. Thus, there is a huge gap between what the people want to fund and what the real need is.

What is The Way Forward?

The rural population is in a pressing need of medical help and financial aid to seek medical consultation. Today, this is an integral part of life. People must be made aware of the need of double-masking, which is a lifesaver and lessens the risk of infection from spreading to a great extent. Amid the Covid outbreak, guidelines were issued to decongest healthcare facilities as doctors could only consult patients remotely to protect the patient as well as the doctor from virus transmission.

Telemedical consultation facility should be made available in rural areas as well where there is a lack of health workers and medical facilities, and there must be limited attention to the developed towns and cities, which are already well-equipped with health centres and hospitals. Ms Maya Vishwakarma gave an example of an overseas medical teleconsultation facility initiated by her friend in the rural areas of Madhya Pradesh.

Mr Sanjay Singh reiterated the need for livelihood support, ration support, nutritional security and maximising livelihood options. It is our responsibility to save people from the Covid outbreak and other societal problems such as lack of food availability, water scarcity (especially in the Bundelkhand region), unemployment and other consequences of the current crisis.

Dr Yogesh Kumar focused on the hierarchical structure of the three-tier decentralised management of Covid:

  1. District hospitals and higher-level hospitals for support of critical care patients.
  2. PHC/CHCs and other centres for patients with moderate symptoms.
  3. Village-level home isolation and community isolation facilities for mild symptoms by Gram Panchayats, i.e. proactive participation of local-level governments.

 

Sport Complex In Delhi Converted Into COVID-19 Care Centre
An oxygen cylinder for patients inside an isolation ward. (Photo by Mayank Makhija/NurPhoto via Getty Images)

He also adds the block level strategy to combat the crisis while systematically supporting the government:

  1. Value addition to the existing healthcare infrastructure, PHCs/ CHCs and other hospitalisation centres in terms of material support for procurement of medical resources, PPE kits, oxygen concentrators, ventilators etc.
  2. Sensitisation and training of volunteers to promote Gram Panchayats to support Covid positive cases or to curtail their paperwork.
  3. To build a network of private providers for online counselling.
  4. Professional management with experience in data management to support block administration to abate the criticality of issues.
  5. Support to Gram Panchayats in facilitating the utilisation of scheme benefits such as rations through PDS, health insurance facilities, compensation through Atal Pension Yojana etc.

Formation of a Covid Support Centre with the objective of management of Covid-positive cases, provision of non-scheduled drugs, building a communication network with government-established Covid management centres for secondary and tertiary care are imperative. Temporary pandemic care centres at the panchayat, block and district levels have to be identified and kept ready for operation at short notice. An adequate supply of oxygen, oxygen beds and augmentation of medical equipments like ventilators and ambulances with oxygen facilities have to be ensured; deployment plans for doctors, nurses and paramedics must be kept ready just as Odisha had done during the first wave of the pandemic. Other steps to mitigate this kind of disaster can be setting up district-level coordination groups, making flexible funding available to the local governments, and enabling NGOs to play an active role.

Fundamental needs like water, sanitation, nutrition, basic education, socio-economic requirements and livelihood support are paramount, and are a policy issue that people need to advocate. Governance, transparency and accountability, and holistic and contextually relevant approaches based on the needs of a particular community are key issues that need to be focused upon. The local media should also actively participate in highlighting the stark ground realities because it is crucial to change the narrative from being more urban-centric. The need of the hour is to amplify these local-level issues and establish a platform where people can help the organisations working in rural areas monetarily or in any other possible way.

Acknowledgement: Tarishi Chaturvedi is a research intern at IMPRI and pursuing Masters in Development Policy Planning and Practice from Tata Institute of Social Sciences, Tuljapur, Maharashtra.

YouTube Link for Rural Realities: Practitioners Experiences in Tackling the Second Wave in Indian Villages

You must be to comment.

More from IMPRI Impact and Policy Research Institute

Similar Posts

By Latest Laws

By Rana Ashish Singh

By Priyanka Shawarma

Wondering what to write about?

Here are some topics to get you started

Share your details to download the report.









We promise not to spam or send irrelevant information.

Share your details to download the report.









We promise not to spam or send irrelevant information.

An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

Share your details to download the report.









We promise not to spam or send irrelevant information.

A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

Sign up for the Youth Ki Awaaz Prime Ministerial Brief below