Rural Gujarat was 'complacent' as second wave took urban cities by storm

By IMPRI Team 
To discuss the ways to tackle the spread of the second wave in rural areas, the Centre for Habitat, Urban and Regional Studies (CHURS) and the Impact and Policy Research Institute (IMPRI), New Delhi organized a panel discussion on Rural Realities: Gujarat Practitioners’ Experiences in Tackling the Second Wave in Indian Villages.
The panelists for the session included Umashankar Yadav, Founder-Director at Ahmedabad International Literature Festival; Hiral Dave, Program Head at Cohesion Foundation Trust; Poonam Kathuria, Director, Society for Women’s Action and Training Initiative – SWATI; Rafi Malek, Director at Centre for Development in Ahmedabad; Dr Deepak Acharya, Consultant at Development Support Agency, Gujarat and State Medicinal Plant Board; and Shushila Prajapati, Program Manager, ActionAid Association.
The discussion was introduced by the moderator of the panel Dr Mansee Bal Bhargava, an entrepreneur, researcher, and educator from the Eco-Development and Research cell in Ahmedabad.
The discussion primarily focused on the impact of the second wave in rural India, which comprises nearly 60% of the population, and the need to acknowledge the privilege of living in urban areas, especially during the pandemic.
During the presentation, it was established that Gujarat had the highest case-fatality rate and the lowest doubling time, in the first wave of the pandemic. Gujarat’s test positivity rate was the third-highest in the nation, after Maharashtra and Delhi. During the second wave, as of mid-May, the cases in Gujarat were doubling every eight days, and as of March 23, 2021, a total of 1,641 people had died in the state. However, Gujarat is leading in vaccination with 69, 23,008 people vaccinated.
There are some emerging issues, though, in Gujarat, that need to be addressed. Firstly, there is a shortage of vaccination because of which vaccination for those 45 years and above was halted for three days. Secondly, there was a shortage of oxygen because of which more than 50 patients reportedly died in Navsari, Surat, Banaskantha, and Rajkot in 10 days. Thirdly, there is a need for an improvement in health infrastructure. The government must increase Covid-19 bed capacity by 15,000 new beds. And lastly, rising rural unemployment needs to be addressed immediately.
After the presentation, the panelists of the discussion gave their views on the second wave of the pandemic, its impact on the rural areas, and what policy decisions need to be taken to address the second wave efficiently.

Livelihood security

This was initiated with Hiral Dave who spoke about how livelihood was tremendously disturbed in rural areas, as a result of the second wave of the pandemic. There was a vast difference between the first and second waves since the first wave did not exactly reach the rural areas. The primary issue is that migrants who were working in the cities had no choice but to return to their villages. Additionally, there was no agricultural income as well since it’s summer and MNREGA isn’t efficiently functioning either.
In addition to livelihood, food security poses a major challenge as well. As for the pandemic, villagers do not have access to basic amenities that the privileged do in urban areas like basic medicines, RT-PCR tests, and oximeters. Since this strain is affecting the lungs even more so, oximeters are a necessity to monitor oxygen levels and thus, take necessary precautions for treatment.
Thus, organizations like Cohesion Foundation Trust, are working to help people with some of these issues. NGOs are stepping up to help with these amenities, rations, and other facilities. It is important to point out that single women, like widows and unmarried, are being affected the worst since they are unable to earn their own livelihoods. Thus, it is imperative to link with government schemes and develop and adopt specific models as well as create new models for livelihood.
There is also a need to eradicate and debunk myths and false ideas regarding the safety of vaccinations which is also something the NGOs in rural areas have been striving to do. Since NGOs are close to the community, their representatives provide them with relevant information through voice messages, pamphlets, and other reading materials. It is also very important to work closely with the Panchayat and the district since they are influential stakeholders of the community.

Information dissemination

The discussion was further taken ahead with Rafi Malek, who highlighted three critical points: first, lack of awareness; second, overconfidence, and third, lack of awareness.
During the first wave, the urban areas were more affected than the rural ones. It’s likely that because rural India was not affected much in the first wave, the state and the people became complacent during the second wave and thus, did not prepare for it.
Further, the patriarchal structure ensures that women are mostly busy with their agricultural duties and don’t venture out much whereas the men do. Since the men are exposed to more people and gather more information, it’s questioned whether the information the men gather is shared with the rest of their family or not. 

Malek pointed out that the caste structure is still very prevalent, especially in the rural areas and especially, in Gujarat. Even if Covid-19 related facilities are set up in rural parts of the country, it’s doubtful that the marginalized sections of the society like Dalits and Adivasis, have access to the said facilities.
Gujarat has not seen a pandemic of this scale ever, it has only ever faced natural disasters. Thus, it is critical that the State is asked whether they have prepared a roadmap or a plan to address this situation at all. It is also important to question the mandate of the National Disaster Management Authority (NDMA) and what role they play in such crises. 

Given that the rural areas in Gujarat do not adhere to social distancing norms, the State should give them a clear picture of the second wave and the deadly impact of the virus in terms of the number of cases, the death rate, and the recovery rate for them to understand the gravity of the situation.

Role of panchayat

Dr Deepak Acharya pointed out that the treatments given during the initial phase of the first wave of the pandemic were given keeping in mind that the virus had not yet reached its deadliest peak, or even close. However, the longer a particular variant remains in a particular community, the faster it modifies and mutilates into more variants. Panic and chaos amidst the second wave led to a lot of misinformation which further made matters worse.
Rural India was fully complacent even as the second wave of the pandemic took the urban cities by storm, thinking it would not reach them. This was the result of a lack of communication from the Government and relevant stakeholders with the people living in villages. The need to bridge the information gap was stronger than ever before. Dr Acharya emphasizes the need to take the Panchayat members and the youth in the rural areas into confidence since they’d be in a position to help rally forces to combat the virus in these places.
He also spoke about the need to get at least 60-70% of the population in India to get vaccinated as soon as possible. However, this is not at all an easy goal to achieve because of apprehensions about where the vaccine is concerned or vaccine shortage, or other such factors. This has resulted in a lot of mismanagement.
Moreover, the lack of accurate knowledge and incorrect information led to the wrong or negligible treatment which further led to many deaths in Indian villages. In order to avoid mismanagement and ignorance, it is imperative to give people a clear picture and help them understand the urgency of the calamity at hand.

Health infrastructure

Sushila Prajapati gave a clear understanding of what the rural realities are and how the second wave of Covid-19 in India has spread in rural India like wildfire. At present, the Government is not giving an accurate picture of the number of cases by not reporting most. She also cited an example of the Baroda district where her organization works. 

It was found that RT-PCR were tests done only within a one-hour slot in the entire day because of lack of resources. According to a regional newspaper in Gujarat, 1.23 lakh death certificates were issued by the Government of Gujarat in 71 days.
Prajapati suggested the following steps: First, the government needs to make the improvement of health infrastructure in rural areas a key priority; second, the government also needs to increase its budget allocation for health; and third, it is very important to make vaccination free of cost. The government should work with NGOs to reach the grassroots levels and tackle the impact of Covid in these areas.

Rural and urban differences

Umashankar Yadav focused on the negligence of medical colleges and how it is made near impossible to get admitted to medical colleges. The pandemic has given a serious reality check on the urgent requirement to improve the health infrastructure of the country.
He also emphasized the discrimination faced by the youth that migrates from rural areas to urban areas in terms of employability and other factors and how this has also been the case in terms of providing healthcare during the pandemic.
It is important to move away from the thought process that working in urban cities is the only key to success and even more so to treat rural India as a part of the country and not exclude it. Mr. Yadav specifically also highlighted the necessity of budget allocation, especially in the healthcare sector and in that, healthcare staff. This, in itself, will help solve numerous problems. The key is to accept that there is a problem, that the country is indeed vulnerable, and accordingly, address this.

Care giver burden: Gender based

Dr Poonam Kathuria talked about how things have gotten completely out of control and out of hand during the second wave. During the first wave of the pandemic, gender-based violence and domestic abuse as a result of the lockdown, had come to the forefront.
Dr Kathuria brought up key important points on how women getting Covid is dealt with, or if someone who is suffering from malnutrition and contracts the virus, how is their treatment addressed. Her organization, Society for Women’s Action and Training Initiative – SWATI, is doing a study on this of which she shared a few findings. She spoke about how the existing policies are either gender blind or gender-neutral, which do not address the basic differences between men and women.
During the study, Dr Kathuria’s team spoke to a woman who told them that while her husband had Covid, she took care of him but when she contracted the virus, her father-in-law telephoned her father and asked him what to do with her. Eventually, the husband and wife moved out of the house for that time, wherein the wife had to take care of everything and run the house, without any support.
Another story they were told about focused on the stigma attached. If a woman, while taking care of the people in the house, gets Covid, then it is not a problem. However, if the woman is the one to bring the virus into the house, she faces the wrath and anger of her family members. The findings, thus, so far, show that Covid or no Covid, the women continue to be the caregivers in the family.
Dr. Kathuria also pointed out that the COVID Centers in rural areas are considered as “shelter homes” for people, mostly, women, who have got COVID and have no means on their own to get treated. Had it been compulsory for all, the centers would not have been stigmatized. It is important to bring in relief, cash transfer, and tiffin service to help provide some relief to the COVID infected families and particularly, women.

Healthy society

Prof Ghanshyam Shah asserted that we are living in an extra ordinary time. The governments are approaching the NGOs to reach out to the people effectively. There has to be a ray of hope. Human development is lacking, therefore we need to work together as all stakeholders need to be involved. There is a lot of confusion. Health policies need more attention. 

Livelihood issue is a major concern. We have to see the society in the context of broader than our own experiences. The government has to come out of the denial mode. We have to build faith among the masses. We should think about the long term crisis.
In conclusion, the panelists talk about what the way forward should be, which primarily focuses on the need to empower and trust communities and NGOs that can help the government address the pandemic in the best way possible, not only in urban India but rural India as well.