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Kerala’s Covid numbers 'realistic' unlike states like Madhya Pradesh, Uttar Pradesh

By IMPRI Team
In continuation with the ongoing discussions on the Rural Realities around the country, the Centre for Habitat, Urban and Regional Studies (CHURS), Impact and Policy Research Institute (IMPRI), New Delhi, and International Institute of Migration and Development (IIMAD), Kerala, organized a Panel Discussion on “Rural Realities: Kerala Practitioners’ Experiences in Tackling the Second Wave in Indian Villages”, as the second wave of coronavirus pandemic was engulfing the length and breadth of India, and hitting its heartland, rural areas.
The IMPRI team informed the discussion by locating for the event participants the situation of Covid-19 in India and Kerala. The team also provided an insight into the geography and socio-economic conditions of the State. The rationale was to provide the participants with an overview of the state of Kerala.

Saving lives and livelihood during the pandemic

Moderator of the webinar, Prof Irudaya Rajan, Chairman, International Institute of Migration and Development (IIMAD), Kerala, said that Kerala needed to learn lessons from the first wave thereby replicating and reorganizing current existing policies. He said the way Covid was tackled in the first wave was one of the best models to tackle the pandemic scenario.
He added that in the first wave we talked about lives and livelihoods with migrant issues being the major one, while in the second wave everything moved to lives, whereas migrant issues and livelihoods were pushed back and saving lives became the priority.

Good governance

Reni K Jacob, Legal Consultant, International Justice Mission (IJM), talked about the governing initiatives and actions during the pandemic. Jacob stated that people of Kerala somehow appreciated the Covid response of the Kerala government. The Kerala government’s health system is better compared to health systems of the country with committed staff, good governance, and vigilant people along with good convergence between police, health and panchayat.
Elucidating on the good governance perspective of Kerala he said that in rural areas ASHA workers in Kerala played an important role in communicating cases to the concerned authority for taking immediate actions.
He threw light on the work done by NGOs in the current pandemic scenario by giving various livelihood opportunities to people and reaching out to them in adverse conditions. He appreciated the efforts of panchayats and their coordination with Kudumbashree Kerala Yojana. Various NGOs provided community kitchen food and free ration. He also talked about NGOs’ working with tribal people in the State providing livelihood opportunities and prompt services in coordination with the government.
“In the present scenario with families losing their livelihood opportunities and number of families where children are becoming orphan, it may lead to child labor and human trafficking”, said Jacob, adding, “We are happy the way Kerala government has worked during the pandemic with all of its capabilities.”

Proactive approach in responding to Covid-19

Dr Sriram Venkitaraman, Joint Secretary, Health and Family Welfare, Government of Kerala, stated that the pandemic is not only concerned with health vertical but it has affected every aspect of human beings life, hence it is important that all stakeholders from the society work diligently in all the roles and responsibilities allotted to them.
“Kerala is known for its strength and resilience in coming up in difficult scenarios which has been proved again”, said Dr Sriram.
Throwing light on good governance aspects of Kerala, he stated the Kerala has grass root level decentralized structure with bottom up approach that came to rescue and acted as a pillar of strength during both the first and the second wave of the pandemic.
Stating the government took on the pandemic crisis head on, he said that right from the first wave the Kerala government acted proactively to understand that the pandemic is going to be big in the future and prepared accordingly keeping in view the crisis, we all have undergone during the second wave.
Elucidating, he pointed that the Kerala government formed a rapid response team at the state level for responding to any urgent or unexpected situation that would come in the future. Talking about the infrastructure vertical he said that the Kerala government was quick to realize that hospitals alone would not be able to handle the situation and decided to establish frontline centres outside hospitals for taking care of patients who were mildly symptomatic and did not require full hospital setup.
There were more one lakh beds set up outside the hospitals in the scenario. Kerala was proactive in testing with contact tracing, preparing route maps and ensuring that all the contacts were quarantining and tested. He added, human resource of Kerala in every sector is probably its biggest strength.
“Strings of proactive steps taken by the Kerala government with a comprehensive vision enabled us in pulling off the pandemic crisis effectively”, said Dr Sriram.

Ward-based Covid management in panchayats

TM Sathyan Coordinator (Kerala), Action Aid Association, talked about stated that the Action Aid during first wave worked closely with panchayats and municipalities while focusing more on Dalit communities. Sathyam focused on panchayat level convergence that is happening with efforts of volunteers, ASHA workers and community youth.
The existence of ward level task force, a special initiative in Kerala, brought in good results with respect in curtailing Covid positive cases in rural areas. Political parties along with their youth volunteer teams were also helpful during the pandemic crisis.

Civil society

John Samuel, Former International Director, Action Aid Association, highlighting on the first wave and the second wave crisis in the State, said that looking at the Covid situation early March 2020 onwards, the NGO did very well amidst strict restrictions, but after the initial four months, the extent of the Covid spread started increasing in the State.
He criticized the carelessness observed during political campaign conducted in Kerala in view of elections and highlighted that it was probably the major reason of losing control over the situation during second wave. In the second wave Kerala’s action was delayed due to elections and it failed to curtail the pandemic effectively. “For three months during the election phase the government took people and public policy for granted”, said John.
Talking on the positives of the State, he said, Kerala has the highest per capita beds in the hospitals with public healthcare system right up to the PHCs. Secondly, there exists a very good local governance system. Thirdly, the state also has one of the best private health care system. He further stated that Kerala has a very active civil society with active NGOs, resident associations and political parties. There exist collective sense of responsibility and social capital and solidarity in Kerala.
Talking about economic consequences, John said that Kerala has a huge number of vulnerable middle classes which have been severely pushed back by Covid crisis and government should take measures to protect them. “In Kerala, the private health care too played an important role in Covid response and management”, he said.

Decentralized governance

Prof Vinoj Abraham, Professor, Centre for Development Studies, Kerala, shared his observations and said that Kerala was one of the States that ideally could have seen much more number of cases, deaths and Covid related problems due to a higher percentage of urbanisation. There exist hardly any difference in rural and urban scenario and facilities in Kerala during the pandemic.
Kerala has one of the lowest death rates in India whether it be rural or urban areas. Talking about healthcare facilities, he said, it’s the decentralized governance that form a pillar for improved health care facilities in the state.
Throwing light on the livelihood aspect, Prof Vinoj said that largest number of affected were international migrants who either came back or lost their jobs in Gulf countries. Since around 25% of state GDP consists of remittance, there would be a huge impact on the states economy. Since Kerala being a consumer society, when remittance falls, it affects the entire state.
“The period after pandemic needs to be seen very carefully as it can be very difficult phase for Kerala”, said Prof Vinoj Abraham.
He highlighted that Kerala is dependent on tourism sector as the most important revenue source. As tourism is completely washed away, there are fewer possibilities of it reviving in the near future. He stated that though Kerala has been able to manage the pandemic very well, there exists a huge livelihood issue in the State.

Community resilience

Dr Dilip Diwakar Assistant Professor, Department of Social Work, Central University of Kerala, commented that Kerala has strong social system with acts providing strength to Dalits and tribal people. Kerala also has strong health system and with convergence of strong social system and health system Kerala state is resilient in addressing various catastrophic situation.
Talking about pandemic, he highlighted that till June 2020 the State was able to work in best possible way but when the State failed to receive required support from the centre, its condition worsened; that was the time Kerala opened up various sectors for livelihood of people, which led to increase in number of positive cases in the state.
Sreenath Namboodiri, Assistant Professor, Chinmaya Viswa Vidhyapeeth, Eranakulam, said that the first surge of the virus did not see community spread as compared to the second surge, and hence the second wave needed contact tracing to which Kerala was much more ready and experienced.
He stated that all of these things has led to a position where we see some kind of nationalism coming up in Kerala which has given a more of community sense to the people, thereby giving boost to bureaucrats, society and civil society to perform well.
Another important aspect of the state is the investment that has been put in the science, technology, engineering, and mathematics (STEM) education, which has led to better understanding of digital modules in every family of the society. However, he said, the gap between rural and urban economy has been widened by the pandemic in the state.
TK Arun, Consulting Editor, The Economic Times, stated that when we compare Kerala Covid numbers to the other states we have to understand that Kerala’s numbers are more realistic than the numbers given by states like Madhya Pradesh and Uttar Pradesh. The number of positive cases in Kerala are reported correctly as compared to other parts of the country and hence Kerala would have probably one of the most accurate databases in terms of Covid cases and mortality.
Esther Maria Selvam, Action Aid India, pointed out that it is important to understand how well we can response to the situation using an effective model. The new challenge of stigma and discrimination faced by Covid is highly prevalent in the State which causes high spread of the virus. According to her, the existing stigma and discrimination associated with the disease should be given high priority and efforts need to be taken to eliminate it.

State of efficiency

Chairing the session, Dr Nivedita Haran, former Additional Chief Secretary, Department of Home Affairs, Government of Kerala, and Honorary Chairperson of the Centre for Migration and Inclusive Development (CMID), Kerala, said that watching Kerala from outside is a different thing altogether. She commented that in spite of having one of the best health care infrastructure with very good networks of doctors and social deliverables, Kerala was hit hard by the second wave.
She added that the second wave was very much brought in by the suicidal mentality of challenging the virus. She said that she would have expected Kerala to have performed much better.
In the first phase of the pandemic the guidelines, SOPs, lockdown and direction issued showed that the government meant business, but during the second wave everything seemed very half-hearted. This happened even though decentralized governance is a plus point of Kerala
“The role performed by the other non-state actors in Kerala during pandemic needs to be learned by other states”, said Dr Nivedita Haran.

Migrant worker crisis

Taking about the migrant workers she said that the pandemic has drawn attention to the fact that internal migrant workers are there for good, and no State can do without them, as 40% of India’s economy is controlled through migrant population. Thus we need to put our attention in providing well-being and livelihood facilities to these migrant workers.
“We have to find some ways in which either the source state or the host state take care of the migrant workers and their interest”, said Dr Nivedita Haran, adding, good scientific data collection is extremely important in Kerala as the state has different profiles of population with high percentage of ageing population. Thus, the impact of Covid-19 on Kerala is probably felt much differently as compared to states like Bihar and UP.

Pertinent questions

Responding to a question on impact of pandemic on tourism sector and Kerala’s economy, Prof Rajan said that tourism sector has more number of internal migrants working in Kerala, hence the issue of internal migrants needs to be relooked at carefully by compiling a database for internal migrants.
Responding to a question of international learning for Kerala in handling Covid crisis, John said that as far as Covid is considered, international comparison is very difficult because context matters a lot. In tackling the Covid crisis the State has won the battle but unfortunately lost the war due to political intervention due to elections.
Responding to a question on comparison with other states, she stated that decentralised governance system makes a real difference in Kerala and other States should learn from it. Also voluntarism and empathy in Kerala are aspects from which other states can learn.
Responding to a question on stabilizing financial situation of the state, Prof Vinoj stated that we need to look at the financial condition of the State as Kerala is already in very big financial trouble and the Government of Kerala should look into providing income support to the poor people and some amount of monthly transfers should be given to at least people who are directly affected.
Responding to a question on vaccination, TK Arun said that there is a global shortage of vaccination and thus without increasing the production and supply of vaccination within India, Kerala will not be able to get their vaccines.
Responding to a question response of social worker with respect to Covid pandemic Dr Dilip said that whenever we talk about social workers’ response, it can be seen at individual, group, local, or national level. Usually response becomes effective when there is empathy. And when the response becomes institutionalized, it becomes more concretized and more enforced in terms of carrying out the work.
Answering other questions, John said, “The state needs to evolve its own strategy and its own policy measures and requires a completely new perspective.”. Added Jacob, “Monthly grants should be given to vulnerable communities to support them in livelihood crisis.” TK Arun suggested, Kerala needs to have greater ambition of having its own biotechnology industry.

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