Empowering RWAs – Innovative and Decentralized Health Management

Chandrachur Singh

Unprecedented times solicit unprecedented policy responses that are both innovative and effective. Given the rate of the spread of the coronavirus and its ravaging impacts, the need for innovative and participatory health management policies focussed on enabling basic access in healthcare is perhaps more profound and pertinent than ever.

It is in this context that an executive order issued by the Lieutenant Governor of Delhi directing district magistrates to tie up with Residents’ Welfare Associations in setting up COVID-care facilities within their premises needs the widest possible appreciation. The initiative is significant given the fact that Delhi is likely to undergo a massive surge in positivity rates that even now are alarmingly high at 30 percent. The impacts of the fourth wave of the pandemic are debilitating and have already categorically exposed the gaps in Delhi’s health facilities and infrastructure.

Given that both the political class and citizens have been found lagging in adhering to COVID-appropriate behaviour, it is now futile to argue or to even to identify, where one or the other went wrong. Electoral outcomes in the times ahead may possibly be indicators of such a question. At this juncture, however, the most important focus should be on saving lives.

It is here that empowering RWAs to set up COVID care facilities makes sense. Being inherently flexible in their work styles and possessing a ground-based understanding of social facts and realities, they are the bodies that can easily bridge the moral distances between human and social capital or the ‘self’ and the ‘other’.

Members of RWA share mutuality and reciprocity in a social relationship for accomplishing socially common objectives. That said, it must be reiterated that the role and responsibilities of the civic associations should not be seen as an alternative to the state responsibilities. Instead, it should be seen working in concert or in coordination with the State.

Allowing RWAs to set up COVID care facilities within their premises has distinct advantages.

First, the exercise will be socially reinforcing in forging members into bonds of mutual love, respect, and appreciation. Almost all gated communities in urban settings have residents belonging to different professions, including medical professionals. And, naturally, such care units would not only gain from the human capital of their respective medical professionals but in so doing would easily flow into social capital by enhancing closer and personal interactions between patients and doctors in the given physical space — fusing rights into reciprocal duties, strengthening civic solidarities in the process.

Second, in so doing, the arrangements would certainly ease pressure on the hospitals allowing them to undertake not just necessary critical care functions but other day-to-day ailments as well. It is evident that even several highly-placed bureaucrats have found it an uphill task to get medical care once infected. Government hospitals come across as callous and private ones, even for many middle-class people, are out of reach.

Additionally, given the fact that the virus is now spreading to villages that do not have adequate medical facilities, it would allow hospitals to accommodate patients from such areas.

Third, the RWAs already have a proven track record in handling the impacts of the initial waves of the pandemic. Recall that while the lockdown was enforced and a huge poor population was struggling to reach their villages, struggling to get food, it was the common people, the NGOs, the professionals who stepped up and gave help wherever they could.

Fourth, these associations could also chip in by adopting small clusters of people called domestic helpers who live in hutments around the gated communities and provide services and depend on them for their livelihood. The RWAs could undertake educative roles in allowing the underprivileged sections to develop an understanding of the disease and the basic protocol that should be followed.

Additionally, they could also be instrumental in putting these helpers in touch with the local government and party functionaries who are directly accountable to them, in case of infections so that a clear protocol of home quarantine or hospitalization could be provided without too much hassle.

It goes without saying that these associations could easily generate resources to provide financial support to the most vulnerable sections in their fight against the virus by undertaking efforts for reskilling or upskilling their human capital and allowing them to get back on their feet.

The political class has been too callous in its attitude qua the pandemic. However, here is an opportunity, by opening itself to the social capital it might as well prove itself worthy of the trust citizens have placed on it.

This article first appeared in The Indian Express: Empower RWAs in fight against COVID on April 22, 2021.

About the Author:

Dr Chandrachur Singh

Chandrachur Singh is an associate professor of Political Science at Hindu College, University of Delhi and a visiting professor at Kautilya School of Public Policy Hyderabad.

Picture curtosey: Yogendra Kumar/HT photo