Five lessons the second wave of Covid-19 taught us

As we see the second Covid-19 wave ebbing, it leaves us with five critical Cs as learnings — community ownership, collective effort, effective communication, capacity building of institutions, and committed health workers.

Zarina Screwvala
Updated: Jun 16, 2021 07:34:07 PM UTC
Shalia Mangesh Shelar on her home visits during the pandemic to counsel for COVID-appropriate behaviours

While our nation was still in the aftermath of the first wave, the second wave hit hard and led to a series of events that affected us at every possible level. The current wave spread to rural India and had major economic, health, and social implications.

However, difficult times provide opportunities to learn, improve and come out of any crisis stronger. While we saw many struggling, there were also inspiring responses dealing with the crisis in rural areas. I share five learnings based on these responses and my experiences with people on the ground in rural communities. These learnings will help us in overcoming obstacles that the future may hold.

Building a village health ecosystem equipped to address emergencies: The overload on the health infrastructure can be dealt with by strengthening the rural health infrastructure and building the capacities of frontline workers. It mitigates the pressure on cities as well. Augmenting the capacities of rural frontline workers ensures quick referrals and faster testing of community members. Shaila Mangesh Shelar, a frontline worker from Raigad, Maharashtra, conducted nearly 200 home visits across the Gram Panchayat for migrant workers who returned home. She did an initial screening of symptoms and advised them for mandatory home quarantine. She ensured adherence to Covid-19 protocols in the village that controlled the spread in her community. Such examples illustrate the importance of proactive frontline workers. Strengthening their role in the community will maximise their power to minimise any crisis while in incubation.

Trained workforce for emerging special needs:
Many hospitals across the country hired visiting doctors and paramedical staff, on an hourly basis highlighting the shortage of skilled workforce. A government hospital in Mumbai had enough ventilators, but since the medical staff had limited knowledge of operating them, it was all a waste. If this is the scenario in cities, it is hard to imagine better circumstances in rural India. To prevent this, we need to move beyond just supporting resources, and opt for a 360-degree approach where the protocol is to install, maintain and ensure the working of the equipment. Defined ownership, quality training, and refresher training should be a part of the equipment support. Every health facility and workforce must be certified as a part of the nation's Covid-19 recovery plan.

A corporate partner and non-profit supported government Health Facilities in Raigad, Maharashtra with Mobile Ventilators in April 2021. Standing from Left to Right: Nidhi Chaudhari, District Collector, Alibag & Raigad, Suhas Mane, Civil Surgeon, District Hospital (Alibag), Tushar Inamdar, General Manager, Swades Foundation, Hon'ble Cabinet Minister Uday Samant, Mahinder Dalvi, MLA

Benefits of collective effort: 
After initial hiccups, during both the waves, individuals, communities, non-profits, corporates, and the government worked hand-in-hand to deliver urgent resources and support to those impacted. Corporates generously opened their pockets, non-profits moved beyond their thematic areas of work to support the needy and the government. There are endless examples, from providing meals to the migrants to ensuring government hospitals have required medical equipment. For economic recovery, many non-profits and corporate are continuing efforts with the government to ensure community members engage in sustainable livelihoods.

Village Development Committee in Raigad, Maharashtra conducts a village meeting to address vaccine hesitancy in the community

Permanent change in health-seeking behavior:
I believe that any public health challenge can be tackled successfully if the public commits to the necessary behavior and discipline. We cannot expect change and a resilient future until we create a permanent change in our health-seeking behavior. There are many instances where the public failed to follow the Covid-19-appropriate behaviour. It's worse in rural and tribal communities as they rely more on superstitions and local gurus. Local community members can address this better than any external stakeholder. In Raigad, 1000+ Village Development Committees, which are participatory and democratic in nature, ensure accurate and timely dissemination of information regarding the pandemic in their villages. This is achieved under the leadership of the frontline workers, who are in constant touch with private and government experts. These frontline workers are currently working with the government and non-profits to address the vaccine hesitancy in their communities.

Challenges lead to innovations:
While the lockdown and pandemic restricted everyone's mobility and limited physical proximity, it was equally important that timely and accurate information reaches all stakeholders. For this, communities from 400 villages of Raigad used video conferencing platforms to connect with non-profits and subject experts. They shared updates of situations on the ground that led to faster delivery of required relief. Of course, this digital connection was possible only in villages with decent internet penetration. But it's noteworthy that volunteers from these well-connected villages spread the message to those villages with limited digital connectivity. This initiative has been one of the most efficient ways to reach tribal communities and remote areas. Currently, rural communities are being trained online for health and nutrition, economic development, farmer training, spoken English courses for youth, and more.

In a unique initiative, the district administration of Raigad trained 52 volunteers to counsel patients under home quarantine. These volunteers connected with patients and telephonically counseled them about an adequate diet, nutrition, their mental and physical wellbeing and their families.

As we see the second Covid-19 wave ebbing, it leaves us with these five critical Cs — community ownership, collective effort, effective communication, capacity building of institution, and committed health workers. While at the micro-level, these learnings can ensure rural communities are better prepared to handle such crises, at a macro-level, these can help restructure development plans that cater to the health of every Indian citizen in both rural and urban areas.

The writer is the co-founder, managing trustee and director of the Swades Foundation

The thoughts and opinions shared here are of the author.

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