A LOOMING CALAMITY
India Today|May 10, 2021
POOR MEDICAL INFRASTRUCTURE AND LACK OF PREPAREDNESS ARE SEVERELY COMPROMISING THE FIGHT AGAINST COVID IN RURAL AND SMALL-TOWN INDIA
RAHUL NORONHA

Giridhari Lal Thakrey, 50, a school teacher in village Katang Tola, 50-odd km from the district headquarters of Balaghat in eastern Madhya Pradesh, complained of fever, cough, and cold on April 12. He was taken to the government health centre in Waraseoni, the block headquarters, where he died the following day. His wife Tomeshwari Thakrey complained of similar symptoms on April 14 and passed away the same evening. Soon, Giridhari’s elder brother, Kunwar Lal, developed symptoms, tested positive for Covid and was admitted to a hospital in Waraseoni. Katang Tola and adjoining Jhaliwada village have at least 300 people with influenza-like symptoms, but most of them are resisting Covid testing or treatment, believing it to be seasonal flu. Now, following the deaths, a degree of concern has set in.

After overwhelming the health apparatus in cities and towns across states, Covid is spreading into the rural areas, which had largely remained unaffected in the first wave in 2020, creating a myth among many that Covid is an urban phenomenon. It’s not only in MP that villages are witnessing a surge in cases. Rural Maharashtra is perhaps the worst hit and is contributing more cases to the state’s total tally than its urban areas. Rajasthan, too, is reporting a rapid increase in Covid cases from the rural areas while the spread in rural Uttar Pradesh is being blamed, among other things, on the flouting of Covid protocols during the panchayat elections being held through April.

While lack of awareness and reluctance to submit to testing and treatment make the rural population more susceptible to Covid, the problem is compounded by the fact that most of the medical infrastructure, especially the tertiary centres, is concentrated in the cities, where serious patients from the villages are now heading in the hope of finding treatment.

Caught off guard, both the Centre and state governments are exploring strategies to stop the second wave of Covid from sweeping the rural areas, where the bulk of the population lives. Prime Minister Narendra Modi, speaking on the occasion of Panchayati Raj Diwas on April 24, said that the challenge from Covid was bigger this year and efforts were required to stop villages from being affected. “I am confident that if someone is going to emerge victorious first in this fight against the coronavirus, then it is going to be India’s villages and the leadership of these villages. The people of the villages will show the way to the country and the world,” he said.

State governments have mounted a response to this spiralling health emergency. But, as the following reports from states by India today correspondents show, with much of the machinery engaged in battling the challenge in the urban areas, resources are scarce to mitigate the Covid threat looming over the rural belt.

MADHYA PRADESH

Of the nearly 150,000 people identified, since April 5, with influenza-like symptoms in the rural areas of Madhya Pradesh, around 26,000 have tested Covid positive, indicating a positivity rate of 17.3 per cent, which is not far behind the state’s overall figure of 23 per cent as on April 27. These rural patients constitute about 14 per cent of the total 189,055 new cases reported in MP between April 5 and 25.

Given the woefully inadequate medical facilities in the rural areas, villages are as good as on their own in the fight against Covid. Of the 819 Covid treatment centres, only 69 are located in rural areas. Of the total 21,637 isolation beds in the state, only 3,039 are in the rural areas. While the urban areas have 22,145 oxygen beds and 9,271 ICU beds, respectively, there are only 338 oxygen and 51 ICU beds in the rural belt. Villagers living near the big cities are making a beeline for hospitals there. “About 30-35 per cent of the patients in hospitals in Bhopal are from villages and small towns located within a 200 km radius. It’s the same story in Indore,” says a health department official.

What explains the spread of infections in the hinterland? Large parts of the population in southern and eastern MP have cultural and economic ties with towns and cities in Maharashtra, and public linkages continued even as the second wave of Covid swept the latter. Many migrant workers returned to their villages in MP from Maharashtra around Holi. While symptoms began to show up in the villages in the first week of April, they were largely ignored until deaths began to be reported. “Within MP, the rural population was also exposed to infections in towns such as Waraseoni, Katangi, Baihar, Lanji and Malajkhand in Balaghat district, where most go for accessing citizen services, selling their products or for jobs. For health services, most rural folk in eastern MP rely on Gondia and Nagpur, but hospitals there are full,” says Gaurav Singh Pardhi, a social worker from Ansera village in Waraseoni.

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