It is clear that a successful strategy for rural India will go a long way in dealing with the pandemic. However, the solutions have to be organic and community-based for them to work. And the war should be fought on two fronts — healthcare as well as on the economic front
As we near the end of the lockdown on May 3, there are indications that the exit strategy is likely to be a staggered one as the Government tries to beat the Coronavirus from sweeping across the country. Union Health Minister Harsh Vardhan has indicated that the Covid-19 strategy will remain, the same: Locate, test, isolate and treat.
While it is true that our villages have not reported many cases so far, but if the virus spreads to rural India, can our public healthcare system manage to deal with it? Is there a contingency plan for such a situation?
Right now the Government seems to be banking on the Covid-19 not reaching rural India. It is hoping that the million migrant labourers who went back home to their villages soon after the nationwide lockdown began on March 25 might not be infected or vectors.
This is for two reasons, Dr Vardhan says. “Personally I feel that these migrant labourers would never have come in contact with the carriers of the disease. The Coronavirus arrived in India with international travellers and, therefore, most cases so far have been in the cities. The second is that they have already covered the two-week quarantine period. Had they been infected it would have been detected by this time,” he explains to this columnist.
Also, the rural folks have become alert and do not allow strangers into their villages. They are keeping constant vigil. Awareness about the virus and how it spreads has increased because there are 117 crore phone subscribers who get information through their mobile phones.
State officials have told village councils to prevent labourers returning from the cities from entering the village or meeting people due to the fear that they might be infected with the Coronavirus. In view of all these precautions, the Minister is confident of meeting the challenge if it reaches rural India.
“Money is not an issue. We have given Rs 4,000 crore to the States. We are supplying them test kits. We can do much more,” he assures.
However, data show that though urban residents are more at risk due to proximity to international travellers and cheek by jowl housing, the rural folk are not off the hook as they face several challenges including inadequate access to proper healthcare, low insurance penetration and a growing chronic disease burden.
With two-thirds of the population living in rural India, we need a different strategy to take care of their healthcare needs, particularly as the pandemic looms over us. As a priority, the quality of rural healthcare needs to be stepped up.
The health infrastructure data published in the National Health Profile, 2019, found that Government hospitals would run out of beds in rural India even if the virus hits 0.03 per cent of the population in the villages. The pressure of handling patients in rural India is twice as much as the national average. While for every 10,000 people in the country, there is one doctor available; in rural India one doctor is available for every 26,000 people.
There are also practical difficulties in implementing Government guidelines on health and hygiene. For instance, rural folks wonder how they can follow social distancing in a limited space? Or wash their hands often when they are in the fields or even at home because there is no running water or soap? They wonder how they will be able to afford masks when they don’t have money to buy them? Or how could they get proper healthcare in the event of an outbreak when there are not enough Government hospitals in the vicinity?
The widening urban-rural divide is also evident in the inequalities in consumption, quality of life and availability of physical and social infrastructure.
The Union Government announced a Rs 1.7 trillion financial package on March 26 for direct cash transfers and free food and the second one is to follow soon. But this barely amounts to one per cent of India’s Gross Domestic Product (GDP).
What is needed is a strategy suited to rural India. For an inclusive economic growth, there is a need to focus on the agrarian economy. Second, the panchayats should be utilised in the fight against Covid-19 and also for economic recovery.
Realising the need for this, Prime Minister Narendra Modi himself addressed the gram panchayats and sought their help last week. Similarly, realising their importance, Odisha Chief Minister Naveen Patnaik has pragmatically vested on sarpanches the powers of District Collectors.
In Kerala, its network of local bodies and the women empowerment programme ‘Kutumbashree’ has taken the battle against the Coronavirus to the community level. Gram panchayats could be the engine to deal with the problems unique to the villages. It is clear that a successful strategy for rural India will go a long way in dealing with the pandemic. However, the solutions have to be organic and community-based for them to work. And the war should be fought on two fronts — healthcare as well as on the economic front.
(Writer: Kalyani Shankar; Courtesy: The Pioneer)