In continuation with the ongoing discussions on the Rural Realities during the pandemic around the country, the Centre for Habitat, Urban and Regional Studies (CHURS), IMPRI Impact and Policy Research Institute, New Delhi organized a panel discussion on “Rural Realities | North East Practitioners’ Experiences in Tackling the Second Wave in Indian Villages” on May 16, 2021.
The IMPRI team informed the discussion by locating for the event participants the situation of COVID 19 in India and North East. The team also provided an insight into the geography and Socio economic conditions of the region. The rationale was to provide the participants with an overview of the North Eastern region.
In the introductory remarks, Dr Simi Mehta, CEO & Editorial Director of IMPRI, spoke on the necessity to discuss the way rural practitioners and population were coping with the pandemic. Moreover, there was a need to focus on the way forward in tackling the pandemic.
Moderator Prof Utpal De, Professor and Former Head, Department of Economics, North Eastern Hill University (NEHU), Shillong, Meghalaya began the session by tracing the journey of India in the first wave, and the trajectory it assumed in the second one. He remarked that the approach of the government in the second wave differed from the previous one. He highlighted certain issues with the government response such as uneven imposition of lockdowns across the states and their impact in hampering market channels of agriculture and the industrial sector.
Following Prof Utpal De’s opening remarks, a brief presentation was made on the North East states reflecting their socio-economic characteristics. The presentation reflected that Tripura is the second most-affected state in the North East after Assam. Administrative efforts specific to North East were highlighted in the presentation such as: Corona Protibodhi Dol– community participation at grassroots level to increase awareness, Antiflip– an app that easily connected grocers with consumers in Assam’s Lakhimpur.
Mr. Sadam Minjabam, Founder Ya All, Manipur, spoke about the situation prevailing in Manipur for the past ten days. According to Mr. Sadam, Manipur had 7000 active cases and only 1800 beds for COVID care.
Home isolation was proving to be a challenge as people were unable to access medicines, oximeters and oxygen cylinders. The oxygen (PSA) plants commissioned in Manipur weren’t yet functional. Further, there were only four-five oxygen refill centers across the state.
He stated that costs of basic services and products such as Ambulances and pulse oximeters had drastically risen, people were getting fleeced and black marketing was widely prevalent. For instance, ambulance ride for five kilometers cost Rs. 5000, while the pulse oximeters cost Rs. 2500. He stated that the state government had been unable to increase the capacity of COVID specific hospitals.
Awareness Building Mechanisms
Dr. Sunil Kaul, Founder and Managing Trustee, The Action Northeast Trust, Assam, shared his observations on Assam. He stated that the number of positive cases diagnosed increased by almost sixty times in the past few weeks in Assam. The positivity rate too increased from 0.3 % to 7-8% within a month. Further Dr. Kaul stated that unlike the Kamrup metropolitan area where cases increased 42 times, the rest of Assam saw higher increase in cases. This reflected that the rural areas bore the brunt of the pandemic in excess to urban areas.
He observed that home isolation was a good method of tackling COVID. However, isolation in homes and community centers had to be based around strengthening the ASHA workers and creating awareness among them. Further, informal practitioners had to be utilized to spread awareness among the people. Material translations in local languages was another imperative to increase awareness at the ground level. Speaking on mental health program, Dr. Kaul referred to the state government program called ‘Monon’ and remarked on its salience.
Lack of Infrastructure & Coordination
The next speaker was Mrinal Gohain, National Lead Person and Regional Manager (North East), Action Aid India spoke about the lack of infrastructure in North East, and how the governments had approached NGOs and small care centers to accommodate COVID positive persons.
The next topic of his focus were the vulnerable communities. The poverty-zones/ slum-dwelling areas of cities, the disabled, refugees, street vendors, domestic workers and the tea workers were the hardest hit by the pandemic. This scenario required the government to approach these communities, catering to their varied needs.
He remarked that state governments in the region had approached the pandemic in an isolated manner. This resulted in a lack of coordination between government agencies, hampering efforts. Further, he observed that the governments focused more on urban areas than rural areas. In the latter regions, absence of governance forced the communities to deal with the pandemic themselves.
The next speaker, Netaji Basumatry, Regional Head (North East) at Indo-Global Social Service Society (IGSSS), spoke about the situation prevalent in rural areas. He stated that rural dwellers approached quacks rather than medical practitioners to treat the virus. This resulted in preventive medication being highly practiced in the rural areas.
Secondly, Mr. Netaji spoke on the economic repercussions that arose due to contrasting policy decisions.
Third, like other panelists, Mr. Netaji spoke about the lack of information and communication dissemination; and how these gaps resulted in negligence of COVID appropriate protocols.
Prof Manjit Das, Professor and Dean, School of Social Sciences, Bodoland University Assam was the next speaker. He attributed the rise of COVID 19 cases in Assam to two factors: state elections and Bihu celebrations. In Assam, Kamrup metropolitan area had the highest number of cases followed by Dibrugarh district. Further, he explained that the wide distribution of cases across the state could be linked to factors such as connectivity with outside areas, higher migrant population and different testing capacities between the urban and rural areas.
The second topic he chose to highlight was the infrastructure in hills areas. Between the first and the second wave, infrastructure had considerably improved in the hills’ region. This included public as well as private sector infrastructure.
Third, Prof Das spoke on the vaccination rate in Assam. According to data, only 3 million people had been vaccinated as against the total population of 3.33 crores. He said that the rural areas lagged behind in vaccination. He attributed this to vaccine hesitancy. Also, he stated that digital divide was preventing rural dwellers from registering on the Co-Win portal.
Like other speakers, Prof Manjit Das stated that financial aid from the government was restricted unlike in the previous wave. Also, private donors and businesses were reluctant to help the poor as compared to last year.
The next speaker was Tirtha Prasad Saikia, Joint Director of North East Affected Area Development Society (NEADS), Assam. Mr. Tirtha spoke on the importance of undertaking a needs-based assessment of different communities. He stated that the pandemic was creating secondary disasters such as: psycho-social car, malnutrition, food insecurity and domestic violence.
Further, he highlighted the risk of floods that Assam was prone to; and the immediate need to effectively manage and plan for these floods that reel the state from June-September.
As far as the vaccination program was concerned, Mr Saikia spoke about the relevance of the pulse-polio program, and how the government could devise similar strategies to ensure that vaccinations reach each and every community.
Discussants: Grassroot Governance
Christopher Lun, Secretary, Goodwill Foundation, Aizawl discussed the situation prevalent in Mizoram. He discussed the efforts made by civil society organizations such as Young Mizos Association and the church in aiding the government. He brought to notice the local-level task forces that had been created to tackle the pandemic in both, rural and urban areas. These task-forces comprised of local civil society organizations rooting the approach of the state in grassroots governance.
Dr Bibeka Nanda Gogoi spoke on the need to prepare, plan and manage the pandemic. Also, he said that the pandemic would not abate quickly. Hence, there would be a need to continuously undertake mitigation-related activities to prevent the spread of the virus.
Concluding Remarks and Q & A
Dr. Kaul spoke on the need to ensure sentinel surveillance prevalent to catch the spread of any infections. Though the northeast had relatively lesser infection rates compared to the rest of India, there was a need to remain vigilant about future looming threats.
On a question relating to a rise in cases of black fungus in India, Dr. Sunil Kaul provided two reasons that could explain this situation. One was the irresponsible use of steroids. Second could be usage of industrial oxygen instead of medical oxygen. The latter are produced in highly sterile conditions as compared to industrial oxygen.
Regarding a question on how NGOs could alleviate their performance, especially during times of a disaster, Mr. Mrinal Gohain highlighted the information gaps that many NGOs help plug. Leakages and the bottlenecks in bureaucratic outreach can be bridged by roping in NGOs. They can help spread awareness and engage with the community in a much better way than the government agencies.
On an open-ended question regarding the need to create a framework on ensuring mental well-being, Prof Utpal De spoke on the fear-psychosis out of his own personal experience. Further, the uncertainty regarding lockdowns, work from home were taking a toll across the entire society.
Dr. Arjun Kumar asked a question related to the positivity rate in the North East and whether this parameter varied differently from the rest of the country. To this Dr. Kaul replied that as long as testing is confined only to specific urban centers and district headquarters, the chances of missing patients was higher. Dr. Kaul stated the need to increase testing in the rural areas using the help from ASHA workers.
Posing a question to Mr Christopher Lun, Mr. Indrajit Pathak wanted to inquire whether high literacy rates was the primary reason behind low COVID case fatalities in Mizoram. Elaborating on the local-level task force, Mr. Lun replied that the grass roots membership of these task forces that came to the aid of the local people. Each locality had a specific local level task force chaired by the local councilor and vice chaired by the leader of the Young Mizos Association. These taskforces directly coordinated with the District Disaster Management Authorities and other state agencies.
These local task forces were responsible for contact tracing and setting up COVID -care community centers. Such de-centralized approach to pandemic management proved to be effective across all eco-geographic localities of Mizoram.
Concluding the session, Dr. Utpal De remarked that pre-emptive measures were the necessary tools to control the pandemic from reaching the rural areas. Ensuring survival and livelihoods of the rural folks has to be the primary aim of the government. This should be done to prevent the pandemic fallout from dragging for years to come.