Skip to main content

Rooted in mistrust? Covid-19’s march into rural India is a very different ball game

By Sudhir Katiyar*

As the Covid-19 virus penetrates rural India, the rural communities are responding very differently from their urban counterparts who rushed to the hospitals. The rural communities are avoiding the public health facilities and any mention of the disease. The note argues that this supposedly irrational response is based on a deep-seated mistrust of the state by the rural communities. It can not be resolved with routine Information, Education and Communication (IEC) measures suggested in the Government of India SOP for tackling Covid-19 in rural areas.
It is now acknowledged by all that the second wave of Covid-19 has reached rural India. Acknowledging the ingress of Covid-19 into rural areas, the Central Government issued Standard Operating Procedure (SOP) on Covid-19 Containment & Management in Peri-urban, Rural & Tribal Areas on May 16. The SOP proposes a three-tier structure from Covid Care Centre (CCC) to manage mild or asymptomatic cases, Dedicated Covid Health Centre (DCHC) to manage moderate cases and Dedicated Covid Hospital (DCH) to manage severe cases.
However, management of Covid-19 in rural areas is going to be a very different ball game. As Covid-19 marches headlong into rural India, a strange paradox manifests itself. The urban India saw an acute shortage of oxygen, ICU beds and ventilators as Covid infected patients in serious condition rushed to the hospitals. The pandemic also reasserted the primary role of public health systems in health care as it took the lead in managing the pandemic.
By contrast, the reality in rural India is completely different. While there are already reports of large number of deaths taking place, the rural communities are avoiding the public health facilities like plague. The public health system was never much functional anyway in rural India except for some notable exceptions like Kerala and Tamil Nadu. Rural PHCs remain unstaffed and the infrastructure created falls into ruins.
The number of functional rural PHCs in any district can be counted on finger tips. However, the Covid-19 pandemic has seen rural people enforcing an almost complete boycott of Government facilities. The people fear being tested and if positive, being confined to isolation facilities from which, they fear, chances of coming out alive are slim. In absence of any credible medicine to treat the infection, vaccination has emerged as the only strategy to manage the epidemic. While urban India has embraced vaccines, there is extreme vaccine hesitancy in rural areas.
A rapid assessment by the Centre for Labour Research and Action amongst migrant workers across eight migration streams in Gujarat and Rajasthan revealed that 80 percent respondents did not want to get vaccinated. The rumour mills abound. The disease has been spread by the state to kill off old people, pensioners, organs are being removed, it will not affect rural people, vaccine itself causes disease.
The SOP does have a component called Community mobilization and behavior change. It seeks to use the village level health workers, the panchayat raj and other Government functionaries, and Village Health Sanitation and Nutrition Committees. The last most probably exist only in papers in most places.
However, the behaviour and response of the rural communities is rooted in a deep mistrust of the state that is centuries old. It cannot be done away with the normal IEC type campaigns. Writing in "Autobiography of An Unknown Indian" 75 years ago, Nirad C Chaudhry wrote, "For centuries the political creed of the Indian peasant and the Indian worker has consisted of one single article, never to trust the professions, the motives and doing of their rulers. This distrust of the state and ruling order is virtually ineradicable". 
It is clear that nothing has changed in the last 75 years of independence to change this perception. To quote a Hindi couplet: "Ka nrip hoye, hamen kya haani" (Whoever is the ruler, how does it matter to us?).
Village people burning their own dead without any autopsies is fine as long as they do not start floating the bodies in the river
It is this division, that is sometimes framed as a division between India and Bharat, but it is actually a division between the powerful and the powerless, a division between the Savarnas and the Shudras, a division between the working classes and those who profit from their labour. It is a division that has stood firm for the last two millennia.
The middle classes have made sure that the ingress of modernity – education, health, dignified living, and social security – stop at their door step. To illustrate one only has to look at the state of basic education, the primary means of ushering in modernity. While the ruling elite sends its own children to private schools, it has made sure that the public schooling system becomes dysfunctional.
The Annual Survey of Education Reports (ASERs) that capture state of schooling in India, reveal that educational achievements in Government schools have been falling in the last decade. What needs a behavior change is the attitude of the middle classes not the rural communities.
The response of the rural communities suits the state very well. It is not likely to rock the boat besides issuing SOPs and making some formal noises. It is anyway facing a tough job in hiding deaths in cities with footage of funeral pyres adorning pages of national and international journals. 
Village people burning their own dead without any autopsies is fine as long as they do not start floating the bodies in the river. Then the state will employ its vast security apparatus for ensuring that these do not come to light. Sickness in rural areas remaining away from the limelight is good. As long as the large number of deaths do not get highlighted, it is fine.
Writing in "Indian Express" of May 18 in an article titled 'Virus in the Village', Dr KS Reddy, President of the Public Health Foundation of India, expressed the hope that perhaps the design of a new health system will emerge from the Covid crucible to serve as the platform for universal health coverage. Unless the liberal intelligentsia factors in this deep mistrust, and the ruling classes change their mindset, this hope is likely to remain a hope only.
---
*Centre for Labour Research and Action, Ahmedabad

Comments

In order to keep Covid-19 overtures engulfing the world humanity under prevention and control, it is imperative to take long term measures across the world as listed below:
1. Regeneration and restoration of forests both in density and diversity.
2. Linkage of waterbodies to facilitate distribution of water across the
world.
3. Effective recycling of organic and inorganic wastes and their conversion to
useful products for reuse thereby reducing land, water and air pollution.
4. Production of biological oxygen in human habitations thereby reducing the
need for artificial oxygen production, by planting trees identified for
the generation of vast amounts of biological oxygen.
5. Establishment of institutions for alternate medicines in addition to
allopathic medicine.

TRENDING

North Gujarat gram panchayat bars villagers from dealing with Muslim hawkers, traders

By Our Representative  A gram panchayat in North Gujarat has barred its residents not to buy anything from Muslim traders and hawkers. An order of the Waghasan group gram panchayat of Tharad taluka of Banaskantha district dated June 30 states that the decision has been taken in the wake of beheading of a Hindu tailor after he posted a derogatory writeup on Prophet Mohammad in Udaipur. The gram panchayat resolution says, anyone seen buying or selling any commodity from a Muslim hawker or trader would be fined Rs 5,100. Bringing this to light, Mujahid Nafees, convener, Minority Coordination Committee, in a letter to Gujarat chief minister Bhupendra Patel, says, the state government should take legal action against the panchayat chief who has signed the “unjust” order. The letter says, the act of the sarpanch and other signatories is a violation of rule of law of the state and threat to peace, pointing out, the move is in violation of Article 15 of the Constitution, which says that none

Unlike Soviet Union, Russia is no friend to India: Ukrainian scholar tells 'Indian friends'

Counterview Desk In an open letter to "dear Indian friends", Anastasia Piliavsky, born in Odessa, Ukraine, studied at Boston and Oxford Universities (on a Rhodes Scholarship), and now teaches at King’s College, London, has said that she faces "deep moral dilemma", personally and professionally, over the "astonishingly unified Indian response to the war in Ukraine." Based on her interaction with a "number of thoughtful and caring Indian friends", in this letter, she says, she is "reeling at the ubiquitous silence at, justifications of or outright support for Putin’s terror, which now prevails in India, at the ubiquitous #IStandWithPutin and #istandwithrussia hashtags." She insists, India must understand, "Unlike the Soviet Union, Russia is no friend to India. Soviet leaders, beginning with (the Ukrainian) Nikita Khrushchev – who declared hindi rusi bhai bhai – built up deep political and cultural exchange with India." Text : I

Technocratic globalism, tyranny? Health Ministry warned: bill to 'enslave' Indians

Sandeep Pandey, Tushar Gandhi By Rosamma Thomas*  Union of Concerned Citizens, a group comprising Magsaysay Award winner Prof Sandeep Pandey, human rights activist Tushar Gandhi, former judge of the Bombay High Court BG Kolse Patil, pediatrician Dr Jacob Puliyel and several renowned Indian citizens have written to the Union Health Minister cautioning him against tabling the draft Public Health Bill in the Monsoon Session of Parliament. “The Public Health (Prevention, Control And Management Of Epidemics, Bio-Terrorism And Disasters) Bill, 2017 and a Prospective Bill of 2022 as discussed in news articles, is straightforwardly violative of Fundamental Rights of the citizens of India and therefore, Ultra Vires of the Indian Constitution. It contravenes several International Treaties and Conventions including the Nuremberg Treaty of 1947 which was enacted to ensure that no country would repeat such inhuman medical atrocities on fellow human beings”, the 12-page letter reads. “Strangely, t

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Chennai residents 'suffering': Faulty design, implementation of storm water project

By NS Venkataraman*  The Greater Chennai Corporation is now implementing storm water drainage project in 559 roads, covering a distance of 1033 kilometres, which cost around Rs 4,070 crore. For this massive project, which is targeted to be completed between April and September this year, huge loan has been availed from World Bank, Asian Development Bank and others. Several technocrats have pointed out that the project has been designed with outdated technology and quality of the implementation is so poor that the residents have been put to great hardships. As part of the project, digging of the road has been done to around 5 to 6 feet deep and width of around 4 to 5 feet. The drains are being constructed using steel reinforced cement concrete with two walls on either side with provisions for manhole, chute etc. This has been done in front of several houses leaving little space between the gate of the house and that of the drainage structure. As the work has been going on for mor

'Drop all falsed charges': 150 citizens demand early release of AltNews co-founder

Counterview Desk  About 150 concerned citizens have demanded the release of Mohammed Zubair, co-founder of the fact-checkng newsportal AltNews, arrested over a 2018 tweet which allegedly hurt religious sentiments, even as booking for criminal conspiracy and having received foreign funds in violation of the Foreign Contribution Regulation Act (FCRA). Denied bail last weekend and sent to 14-day judicial custody, the concerned citizens, in a statement, regretted that while the Delhi High Court issued notice to the Delhi police on a petition filed on behalf of Zubair challenging the legality and propriety of his police remand and the seizure of his electronic devices, the “frivolous case” continues. Excerpts: The illegal arrest of Mr. Mohammed Zubair happened on June 27, 2022, by the Delhi Police for allegedly hurting religious sentiments and promoting enmity over a tweet from 2018. The IPC Sections included 153(a) (Promoting enmity between different groups on grounds of religion, race,

Prime Minister's 'affordable' housing policy fails to help Gujarat slum dwellers: Study

By Rajiv Shah  A new study on the implementation of one of the major policy initiatives for the urban poor by the Narendra Modi government after it came to power, Pradhan Mantri Awas Yojana (PMAY), has said that in Gujarat, which happens to be the Prime Minister’s home state, has quoted state officials as “confirming” that no progress towards tenure regularization, a key requirement for providing housing to the state’s slum dwellers. Stating that this particularly true of smaller town, the study, carried out by the non-profit Homes in the City (HIC), which is based in Bhuj, district headquarter of Kutch that saw a devastating earthquake in 2001, says, the failure to provide affordable housing is there despite the fact that there has been “significant demand” in all the 83 out of 153 Gujarat municipalities studied by experts involved in the study. According to the study, out f a total of 1.41 lakh demands for housing under the Beneficiary Led Construction (BLC) category, 94,232 (66.7%)

Electricity Bill: Centre's reform measures contain 'carrot and stick package' for states

Counterview Desk  The Peoples’ Commission on Public Sector and Public Services (PCPSPS), claiming to be a network of eminent academics, jurists, erstwhile administrators, trade unionists and social activists, seeking consultations with stakeholders with those who are against the government’s decision to monetise, disinvest and privatise public assets/enterprises, has said that the proposed Electricity (Amendment) Bill-2022 will have far-reaching impacts on the finances of states. Insisting that the proposed Bill would lead to “assault on India’s federal structure”, in a statement, it says, it would weaken the finances of states’ power distribution companies, have adverse impact on utility employees, cripple the states' finances, impose a heavy cost burden on the smaller subsidized consumers (especially farmers), and benefit only corporate business houses. “States cannot afford to ignore the far-reaching implications of the Bill on their economy, finances, agricultural and industria

'Highly abnormal': AltNews journo's arrest suggests 'deterioration in media freedom'

By Bharat Dogra*  Leading media organizations have come out in strong support of recently arrested journalist Mohammed Zubair. These organizations include, among others, the Editors Guild of India, the Press Club of India, the Delhi Union of Journalists and DIGIPUB, a platform for several important digital media organizations. All these organizations have condemned the recent arrest of the noted journalist and demanded his immediate release. While leading human rights organizations and political parties have also made somewhat similar statements, the strong support of media organizations is particularly important as the effort of the authorities has been to try to present the arrested journalist as someone who has been indulging in irresponsible journalism.  In such a situation the support of those media organizations who are familiar with his work and who are most capable of judging the quality of his work is very important. In this context it is important that some media organization

Majoritarian silence helping Hindutva forces 'handover' national resources to corporates

By Bhabani Shankar Nayak*  The majority of Indian citizens are witnessing the persecution and everyday violence against their fellow citizens who are Muslims and religious minorities. The growing assaults on reason, science, secularism, Indian democracy and constitution are going to be landmarks in Indian history of diminishing democracy and citizenship rights. It is clear that Hindutva ideology is directly promoting sectarian politics of hate which is dangerous for the unity and integrity of India, peace and prosperity of Indians. The majoritarian silence helps in empowering Hindutva and their electoral dividends. From witnessing the persecution in the sidelines to the active participation and cheering loud or silence accelerates violence against our neighbours and our fellow citizens. How and why do majority of Indians stay silent and contribute to the persecution of their fellow citizens who are Muslims and religious minorities? The question baffles me as an Indian because I have gr