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

Ganga world's second most polluted river, Modi's Varanasi tops microplastics pollution

By Rajiv Shah  Will the new report by well-known elite NGO Toxics Link create a ripple in the powerful corridors of Delhi? Titled “Quantitative analysis of microplastics along River Ganga”, forwarded to Counterview, doesn’t just say that Ganga is the second most polluted river in the world, next only to Yangtze (China). It goes ahead to do a comparison of microplastics pollution in three cities shows Varanasi – the Lok Sabha constituency of Prime Minister Narendra Modi – is more polluted compared to Kanpur and Haridwar.

Madhya Pradesh tops India's 145 instances of 'anti-Christian atrocities' this year

Counterview Desk  A report prepared by the Religious Liberty Commission of the Evangelical Fellowship of India (EFI), founded in 1951 as the national alliance of evangelical Christians of the Protestant denomination, in its just-released report, “Hate and Targeted Violence against Christians in India: Half Yearly Report 2021”, has said that an analysis of 145 cases of violence it has documented against Christians, mainly by non-state actors, “stems from an environment of targeted hate.”

Demolition drive: Why aren't high-end hotels, farmhouses treated same way as Khorigaon?

By Our Representative A public hearing, sponsored by the civil rights group National Alliance of People’s Movements (NAPM) to hear the affected citizens of Khorigaon, off Faridabad, Delhi NCR, has seen local people complaining how their houses are being demolished even as the entire area was converted into a prison through heavy police deployment.

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

Meaningful? Punjab govt's debt waiver offer for agricultural workers, landless farmers

By Dr Gian Singh*    On July 14, 2021, the Punjab government announced that it would hold a state level function on August 20 to waive the debt of agricultural labourers and landless farmers(pure tenants) of Punjab to the tune of Rs 590 crore. Prior to the 2017 elections, the Congress party had promised in its election manifesto and public speeches that the Punjab government would waive all the institutional and non-institutional debt of farmers and agricultural labourers of Punjab.

How real is Mamata challenge to Modi? Preparing for 2024 'khela hobey' moment

By Prof Ujjwal K Chowdhury*  Third time elected West Bengal Chief Minister, Mamata Banerjee is on a whirlwind tour of Delhi, meeting everyone who matters within and beyond the government, the Prime Minister, the President, some Cabinet ministers, Sonia and Rahul Gandhi, several other opposition leaders, et al.

How BSF, police, court turned Bangladeshi woman slave victim into accused in crime

Counterview Desk  Civil rights leader Kirity Roy has strongly objected to the manner in which the Border Security Force (BSF) , the police and the judiciary in West Bengal have treated a 35 years old Bangladeshi woman victim of human trafficking, who was subjected to sexual exploitation for 15 long years, has been declared guilty of violating the Foreigners Act, violating all human rights norms.

Buddhist shrines massively destroyed by Brahmanical rulers in "pre-Islamic" era: Historian DN Jha's survey

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".

Pro-corporate? New GoI circular 'blatant attempt' to control Adivasi lives, livelihoods

By Hemant Das*  The Indian Community Activists Network (ICAN) condemns the anti-forest dwellers circular jointly issued by the Ministry of Environment, Forests and Climate Change (MoEFCC) and the (Ministry of Tribal Affairs (MoTA), Government of India (GoI) on July 6. 

Covid impact on menstrual cycles? Young girls 'relapsing' back to unhygienic old-cloth rags

By Dr Sudeshna Roy*  Covid-19 pandemic has gripped the world in health and economic shock. Combating this public health crisis has diverted development resources earmarked for adolescents and the youth. India; having world’s second largest population; 1.38 crores as per UN mid-year 2020 estimation, also shelters the largest adolescents and young adult population, which at 243 million constitute 20% of the world’s 1.2 billion adolescent population.