Events & Issues
New Delhi, 8 April 2020
Release of Lockdown
GEARING OF HEALTH SECTOR VITAL
By Dhurjati Mukherjee
In a recent interview to a news channel, WHO Special
Envoy Dr David Nabarro praised India’s efforts in tackling the corona pandemic by
taking the silent enemy seriously, reacting early, getting people’s attention
even if it meant taking strong measures. However, what begs attention is when
will it be time to release the lockdown, to which his answer was it depends on
indicators—are hospital and its health workers prepared, have they got enough
protective gears, are the communities down to the panchayat level ready up and
do all people know the protocols.
There is no denying that the country’s public
health infrastructure and its workers are battling against this unprecedented
situation against heavy odds. Perhaps, it may not have been too to tough if
only health was not a low priority sector in the country, even compared to
emerging economies. It is well-known that allocation of resources for health is
quite low compared to the high population density.
Fortunately for us, the pandemic may not
percolate to the community level only due to the fact that most village people
are very poor and do not have the need and means to travel beyond the block
level, at the most. If one examines the corona cases in India, most of those
affected have a direct or indirect travel history and it is difficult to
believe that the virus has percolated to the community level, at least in the
rural areas.
As experts talk of human behaviour and
action, the rural populace are concentrated in their villages and the immunity
of those who can afford decent meals is quite high. The prolonged lockdown will
have a serious impact on hundreds of millions of Indians, who simply cannot
afford to stay at home without losing their means of sustenance for themselves
and families.
It is important to note that understanding of
a problem differs from person to person, more so if they belong to different
strata and income group. The urban elite or even the urban middle class are
totally ignorant of the problems faced by the rural poor or even the EWS. As
such, it is difficult to realise the magnitude of the problem of health
infrastructure existing in the entire country.
Insofar as WHO and its guidelines are
concerned, India obviously is much below in the index, even compared with
countries like Brazil, South Africa, not to speak of China. Over the years,
subsequent governments have ignored health infrastructure and allotted meagre
resources for its growth, specially in backward districts. Even all
sub-divisions of the country do not have a hospital today, even after over seven
decades since Independence!
At the same time, doctors with Jan Swasthya
Abhiyan and All India People Science Network are concerned over the lack of
testing facilities, even in big towns, and insist such testing needs to be carried
out to anyone having symptoms such as fever and dry cough and not merely
hospitalizing them. Regrettably, testing facilities are only now being gradually
expanded to big towns, which do not augur well for our health care system in
district towns, leave aside villages.
A major reason why the pandemic has been
somewhat under control is due to the fact that very few people travel, even
within the country, and contacts are minimal. Moreover, with the lockdown, this
has been even less. But questions arise whether such lockdown was necessary for
small farmers working in the field or very small traders concentrated within
their village? Do they have any chance of spreading the disease? Will not
production of various types of foodgrains be affected if there is continuous
lockdown, say for a period of 24 days as in a State like West Bengal (since
March 22)?
Another important aspect is regarding
temperature, which has generated a debate. It is generally believed and has been
confirmed in a recent MIT study that warm temperature, say above 180-200 C, makes
the chance of spread of infection less. In India, temperatures are mostly dry
and hot – sometimes humid – and poor people working in the fields are exposed
to this heat. Whether it could be argued that such people, without any contact
with people from foreign countries or even other States, as also daily exposure
to heat, are less vulnerable to the coronavirus, is a question for future
medical research.
It is unfortunate but true that many of us are
simply oblivious to the critical problems faced by the millions in our
villages. Way back in late 70s and early 80s when the undersigned was
propagating Gandhian thought, a veteran Gandhian had asked me about my
understanding of poverty, squalor existing in villages and repeated hunger
faced there. Unless you see the squalor with your own eyes and remain without
food for at least half a day, it would be difficult to comprehend the enormity
of the problem, he told me.
Again, about two decades back, a tea
delegation from India that toured China prepared a report, wherein it stated
that India was some 50-odd years back compared to its neighbour, including in health,
education and economic development. The way China tackled the disease eventually
has been widely appreciated, obviously due to its much-improved public health
infrastructure and doctors.
The steps taken by Indian government are no
doubt laudable. But here the situation is possibly similar to the dichotomy
between development and growth or between development and environmental concerns.
One is reminded that we are a poor nation plagued with not just high population
growth but also having high density of population, which needs proper health
facilities.
If only governments had a clear vision on
building upon health infrastructure over the years, the country would have done
justice to the delivery system in backward areas and where incidence of
communicable diseases are more. Perhaps, the present 21-day lockdown across the
nation, including villages, may have been avoided. Besides, we should not make
comparison with European nations because their lifestyle, food habits etc. are
different.
The leadership needs to be prepared for grave
economic consequences. According to economist Prof. Amitabh Kundu,
distinguished fellow at Research and Information System for Developing
Countries, nearly 2 crore people -- inter-state migrant workers in the informal
sector and 80 lakh vendors -- risk losing employment because of the lockdown.
Recession is bound to set in with demands being suppressed at least in the
coming two months, leading to the big question being asked whether the fear of
hunger is as grave as the virus.
Further, let us put behind the earlier observation
of Economic Intelligence Unit that India would be the fastest growing economy
at even 2.1 per cent growth in 2020-21. For a poor country like ours lacking both
social and physical infrastructure, far less than China not to speak of the
developed West, the challenges are beyond comprehension and the pandemic has
made it even worse. ---INFA
(Copyright, India
News & Feature Alliance)
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