Close to 70 percent of Covid-19 cases in rural India can be treated at home to reduce the burden on district-level hospitals, says Ajay Piramal, chairman, Piramal Group. On June 8, his Piramal Foundation, along with government think-tank Niti Aayog, announced plans to provide Covid home care support systems to nearly 20 million people living in 112 backward rural districts, called aspirational districts, under an initiative called ‘Surakshit Hum Surakshit Tum Abhiyaan’. Aditya Natraj, CEO, Piramal Foundation, tells Forbes India
that they estimate up to 20 million cases in these areas over the next three months, and will facilitate the availability of trained people to monitor the health of those asymptomatic or with mild Covid symptoms, and help them recover at home. “Our volunteers will go door-to-door to check oxygen levels, set up tele-consultations with doctors etc. This way, the facilities [block and district-level hospitals] will not get overwhelmed,” he says. Piramal, in an interaction with Forbes India
on June 8, also spoke about plans to create more awareness around vaccines, the new vaccine policy announced by PM Narendra Modi on June 7 and its impact on the private sector, and whether the economy can become more resilient if the supply constraints reduce and pace of vaccination improves. Edited excerpts:Last-mile village -and-district-level infrastructure has been a major concern in the public health care system. How do you plan to address that in its full scope?
About 16 percent of India's population lives in the 112 aspirational districts but, unfortunately, only 1.5 percent of CSR [Corporate Social Responsibility] allocation goes there. People have forgotten about these districts and those living there. We need to divert some of our funds to these areas. That is why we are collaborating with district collectors and magistrates who are the persons in-charge, and also hyperlocal NGOs, which have people dedicated to working in a particular district or block. These people understand the issues, but they don’t know how to take it forward. So we have volunteers in all the 1,143 blocks across 112 aspirational districts, and want to help the panchayat samitis and local colleges to be more involved. Almost 70-80 percent of people suffering from Covid can be treated at home. If you are asymptomatic or have some mild symptoms, you just need to have good nutrition, hydration, and ensure basic medicines are available while you are isolated. So even if the infrastructure in the villages is minimal, we want to make sure 70-80 percent people can be treated at home itself. We are also building 100 Covid-care centres, which will have 30 beds each, staffed with oxygen concentrators and basic equipment. There will be nurses and paramedics who will be in regular contact with the doctors. Almost 90-95 percent issues will be contained here, and the rest can be taken to the district hospitals. That’s the way forward immediately. You are investing Rs 100 crore towards this, so what is the extent of impact you want to have?
The Rs 100 crore investment is only in the Covid Care centres. Here [for Surakshit Hum Surakshit Tum Abhiyaan], we want to mobilise funds, not only our funds, but also funds from governments and other global and Indian Foundations. There are very few people who are working on the ground today, and that is the strength we bring. We have, in these 112 districts, more than 750 people of our own. Overall, we want to collaborate with 1,000 NGOs, 1,000 [local] colleges and about 150,000 volunteers. The impact we expect is to reach 20 million people. What are the specific health care delivery challenges in rural areas during the pandemic? Is the Foundation also focussing on vaccinations?
Vaccination is a big challenge. Besides availability, there are many misconceptions around vaccinations. We are now educating people in these districts. We have also talked to faith leaders. In each district, we want one faith leader to convince people that vaccination is the way forward. Once you educate and inform people well, they are willing to go ahead with the vaccination and they also spread the word in the community. We have also seen that very often, enough resources are available at the district-level. Enough funding is available at the Centre and state-level also. But how do we ensure that it reaches the last mile and is used properly? We are trying to make sure that it reaches the right person and there is proper governance. Do you feel the new vaccination policy will help?
I think this is the right policy. This was the original vaccine policy and then there was a lot of demand from individual states that they should be allowed to do it [vaccine procurement], but I think they have realised it is better to be controlled at one place at the Centre.The pandemic has been a learning curve for all stakeholders working on the ground. What are your strategies with respect to rural health care?
The key strategy is collaboration. This cannot be done by an individual, or a government, alone. You need participation at every level. We have to see that sarkar, samaj and bazaar are collaborating together. Basic Covid-appropriate behaviour, like wearing a mask, keeping distance, maintaining hygiene, is very important. People have to be constantly reminded. Even people like us in cities, who are more aware and in touch with what’s happening, need reminders, so at the rural level, this is required even more. How will the new vaccine policy impact the role of the private sector? Does it alter your plans to vaccine employees?
We have already got enough vaccines for not only all employees, but also their families. We are in the process where that is being rolled out. They are being vaccinated on a daily basis across all our facilities. This new policy is good for those who have not got it as well. Lack of access to both technological platforms and financial resources also leads to a gap in health care delivery. How can we bridge this gap?
Financially, the government has announced that everybody above the age of 18 will get free vaccines. Therefore, the question of accessibility in financial terms is not there. As far as the physical accessibility is concerned, that’s where our initiative comes in. Do you feel the slow pace of vaccination and state of the health care system has impacted economic recovery?
The slow pace of economic recovery is because of the pandemic, and not due to the slow pace of vaccinations or the health care [infrastructure]. I think we have to separate the two. Can the economy become more resilient if the pace of vaccination and supply of vaccines improve?
Vaccination is a key thing for economic recovery and for people to get confidence that they can do activities. I think what’s happening in the second wave is that people have lost confidence and are feeling more concerned. At the end of the first wave, we were all a bit relaxed and felt that the worst was over. The second phase came in a much stronger and virulent manner. So if you have a vaccine, it’ll make a big difference. It’s all about educating people and informing them.