Covid-19 Lockdown in India, the Exodus of Migrant Workers: What the Government can do

We are witnessing a very unfortunate situation that the lock down had brought upon a certain migrant population across the country. The sudden stoppage of transport system along with loss of jobs (and shelter too in many cases) set the stage for the exodus of millions of these workers from big cities to their villages. The tragedy has been unfolding over the last four or five days now.

Painful stories of these migrants trudging along the highways, often with no money or food, with luggage over their heads and children clinging to their shoulders (some barely a few months old), hoping to reach their villages that are hundreds of kilometers away, have filled the media and the internet. It was only on the 26^th of March that three Chief Ministers, Mamta Banrjee, Nitish Kumar and Navin Patnaik requested Chief Ministers of other states to provide shelter and food to the people of their respective States, in lieu of payment. Besides that, Mr. Arvind Kejriwal, the Delhi Chief Minister, started some shelter and food facilities in Delhi almost as soon as the lock down began. However, the first three were a few days late and Delhi facilities are not enough to cater to each and every one, although they have been trying. Add to that the reports of the Police beating up, tormenting people on the streets to ensure the curfew.

The central government’s lack of response to this tragedy is incomprehensible. The silence is even more befuddling because this is an absolutely solvable problem. It would have been even easier to sort it earlier. However, it is not too late to step in even now.

Why is it important for the Government to stop this exodus?

This exodus not only renders the lockdown a needless exercise, it may even lead to a much faster and far bigger peak of infections than expected. The logic is simple. A mere look at the visuals of the exodus tells us that if a single person in that crowd is Corona virus positive, the spread is almost guaranteed among those who are alongside him / her simply because of the proximity. As we already know, the Corona Virus is one of the most contagious viruses in the recent times. The long and stressful journey will ensure a far quicker and greater spread within the group, as not many may be able to focus on the precautions or even have the means to adhere to them during this time.

Since many of these journeys may take weeks or even longer and traverse across States, the infection, besides multiplying amongst the group, is also very likely to spread all along the route. That is simply because people will need to find water and food on the way. That implies coming in contact with people in the habitations along the route. Alternatively, if they are unable to access any food and water on this hazardous journey, that in itself may lead to morbidity and perhaps deaths too. And even then it does not ensure that a lateral spread in the habitations on the way will not happen.

In short, not only does this exodus lead to a spread of the infection, it may also result in a large number of preventable deaths and morbidity. So, whichever way we look at it, it defeats the entire purpose of the lock down.

What can the government do?

Much time has been lost. Nevertheless there a lot can still be done. I suggest below a simple plan that the government is welcome to adapt or modify as per operational possibilities. This is both doable and goes hand in hand with the lockdown.

A.    Stop the exodus. Bring people to shelters.

1.     Police

Instruct the ENTIRE police force across the country not to use force, abuse, insult or beat up people on these journeys and instead be helpful and supportive.

2.     Transport Department

State Buses from each city / town / district, which is witnessing people walking towards, through or from it, to be sent asap to collect people and bring them to shelters.

Caution:

Protect the Driver / Staff (e.g. secure the drivers area).

Fill the bus to half capacity. Families can sit together but maintain distance with others (as much as is possible).

The buses may need to do a few rounds, depending on the circumstances.

B.    Create Temporary Shelters. Engage Civil Society / NGOs

3.     Municipal Department

If existing shelters lack space, convert Stadia / Exhibition grounds / Parks / any other open ground on outskirts of the city into temporary shelters. Engage local tent houses to create temporary shelters.

Establish temporary toilets and other sanitation facilities. Ensure cleaning / waste management with the same system that already exists in the city.

Establish Kitchen with Utensils (from Tent houses), Chulhas (basic temporary ones can be built with brick, stones etc.) and wood or Gas burners and cylinders.

Create raw food material supply.

Engage cooks for the first few days. If needed, seek help from NGOs or citizen’s initiatives in the city.

4.     Medical facility

Provide basic medical checkup facility in the shelter or connect with the city’s existing plan for Covid-19.

5.     Clearly communicate the government’s assurance for basic necessities during the entire lock down period and the need to stay put at the shelter. This may need to be repeated during the course of time.

6.     Civil Society / NGOs

If the govt. lacks people to run such a camp, seek help from NGOs or civil society. There will surely be enough helpful people in every city.

7.     Once the people have settled down (in a day or two) they can be assigned responsibilities to run the structure themselves. That will reduce the burden of cooking, cleaning, maintaining the place. The government would then only need to maintain the raw material supplies and sanitation and perhaps a couple of person to oversee / lead it.

8.     A curfew after that is unlikely to find these people roaming on the roads.

C.    If people refuse to stop

1.     The suddenness of the lockdown and its resultant impact on the people who were forced to choose to walk hundreds of kilometers in a bid to reach home, and have already endured hunger, thirst, heat and rain and emotions that we may not even be able to fathom, it is very possible that they hesitate and even out rightly refuse to stay in any shelter for long. In such a case, the government must ensure that they are provided transport and safe passage to their homes and food to last the lockdown.

How to act?

All the parties need to act together, with speed and ensure that each process of creating temporary accommodation as well as bringing in people should be completed within a 24 hours period. It is a daunting task but not an impossible one. A will and a coordinated effort between the Centre and the State Governments can get this done.

Besides saving lives of these people who have been pushed to the brink, it is also imperative to take this action to ensure that the lockdown, that is meant to prevent the spread of Covid-19, can serve its real purpose. Time is of essence, in this fight against the virus. The Government cannot afford to ignore the situation of these migrants, because in doing so, it will simply render its own lockdown ineffective.

Parvez

28.03.2020

(The author is an erstwhile medical doctor who continues to engage with public health issues. He currently lives as an artist / filmmaker.)

Covid 19 infection and what India needs to do

How will a one day curfew (Sunday from 7 am - 9 pm) prevent Covid 19 spread in India? What happens to the virus spread after that? Even more important is, what is happening before that?

The number of incidents, of people skipping quarantine and taking trains or even flights to travel long distances within the country, are cropping up every day. The latest one, being the UK returned actress, who attend a dinner party that was also attended by some so called VIP's who then went around to meet many others. And now that the actress has been found to be corona positive, after two days, the number of people who have put themselves in self-quarantine include not only those who were with her at the dinner, but many others, whom they met over the course of the next few days, including the President of India who hosted a breakfast, two days ago, where one of the persons from that dinner was also present.

Or the case of a UK returned son of an IAS officer, who did not quarantine himself because of his assumed 'VIP' status and also delayed the testing for corona virus, while his mother, went routinely to the secretariat in West Bengal (same building where the Chief Minister also sits) and attended a number of meetings, only to find that the son is corona virus positive after a couple of days.

These and many other similar incidents point to the lack of adequate information among the public and an overall lackadaisical attitude, in spite of the alarming global situation Covid 19 has triggered. What makes us think that there are not already hundreds and thousands of people moving around with the virus, without being aware of it?

Time is of essence in tackling this infection. The PM's address took place finally on the 19^th of March. The speech in itself seemed geared towards the rich and at best the middle class standard upwards of perhaps the larger cities. The idea of people coming to their Balconies for five minutes to clap, ring bells or play upon metal plates to thank all those working during this time, taken from Spain and some other European countries, seems appealing. However, there are far more urgent tasks that need to be undertaken.

The other key point, the 'Janta curfew' by the people, is scheduled for Sunday. The hyper-nationalism that we have all been a witness to off late makes the idea of ‘by the people’ a bit uncomfortable. If it were to be considered a ‘preventive distancing between people’, scheduling it for Sunday (3 days later) means not only losing precious time it also raises other questions on the overall preparedness.

There seems to be no clear plan for the homeless people who constitute at the very least 1.8 million of the Indian population? Where shall they go during this curfew? The daily wagers: the ricksha pullers, auto drivers, the small shop / dhaba owners and their workers, the labourers, the sex workers, the ragpickers, the people who beg for food and those living under other dire circumstances and below poverty line etc. etc., would number in millions. Has the government a blue print to ensure that atleast food can be ensured for everyone on this Janta Curfew Sunday, and if such measures are to continue, then even beyond?

The middle class and upwards on the socio-economic ladder are likely to happily loiter around their houses, cook nice meals and post social media statuses about how they creatively engaged in some hobby and felt great and also made noise on their balconies to exude their patriotism to the hilt. The sport stars and other celebrities are likely to express and endorse this further.

However, millions who neither have a balcony nor another similar space, if they do have a house at all, will be lucky if they manage to store some food for themselves or their children to pass over the Sunday. And who will ensure that a poor man, woman or child, who may step out to find food or due to some other necessity or who may be unaware of the janta curfew, will not incur the wrath of someone high on nationalistic pride that we have witnessed quite a bit over the last few years?

The need:

The government cannot afford to lose time on a crisis like this. Instead of endorsements by Sport stars and celebrities, what is needed right now is a serious engagement with public health experts, epidemiologists, health policy researchers, social scientists and the likes, to ensure a robust plan to tackle the problem. It needs an action plan with atleast two clear focal points: 1, Social and 2. Medical.

On the Social front, the first and foremost is to ensure food for all the homeless, the daily wagers and other such people in need. It must be followed with shelter for those who need, with enough space and proper sanitation to prevent the spread of Covid 19. This is important to also be able to follow up or ensure quarantine in case a person catches the infection. A coherent and relevant information flow right down to the last person to keep the people informed, assured and avoid needless panic. It is important to understand that no matter which part of the socio-economic strata the infection explodes in, the crisscrossing of the Indian society is such that it may be difficult to prevent the spread all across, right up to the top.

On the medical front, the entire health system needs to be swiftly reorganized to deal with the crisis. Testing, quarantine, treatment of the severely ill and care and safety of the health professionals themselves should be the cornerstones. Safety of the health professionals is an important lesson to be learnt from Wuhan medical professionals who have flagged this issue as it can weigh heavily in the fight. And from Spain we need to learn to bring the private health care system under the government’s purview, atleast until the situation gets back to normal. Every single hospital and its resources will be needed to check the explosion of the infection, if that happens in India. Being unprepared would only amplify the impact and the blame will be on ourselves.

To sum up, the government needs to realize that populist measures will not help in prevention of Covid 19 infection. Time is of essence and acting swiftly can save the population as well as the economy from a huge burden. It may seem like a difficult task, but India, with all its resources and more so, man power, can rise to the occasion.

Parvez

(The author is an erstwhile medical doctor who currently lives as an artists and filmmaker and remains concerned with public health issues.)