Madhu[1], 39, works as an electrician in a private firm in Bangalore. In July 2020, while the pandemic was still at its height, his wife, elderly mother and father and Madhu all tested positive for Covid 19.
Madhu lives in a ward in Bangalore where the NGO Centre for Advocacy and Research (CFAR) is actively working with communities in providing Covid relief. CFAR had helped him get tested, they also helped him and his wife get admitted to a government-run Covid Care Centre (CCC). His mother was admitted to a private hospital. All three tested negative five days later and returned home. His father, who too had been admitted to a private facility, died.
Although Madhu and his family got support with food and supplies from volunteers and community based organisations, he faced stigma from neighbours once he got back home. No one would talk to his family anymore. The owner of a bakery close to his house would even abuse members of his family if they happened to walk past on their way to the grocery store.
NGO CFAR came across several such instances in the communities where they worked, offering assistance to those who had tested positive. That is when they decided to work on creating awareness to reduce discrimination against those who had recovered from Covid-19.
CFAR has long been working among marginalised communities, whether sex workers, transgenders, persons with disabilities or unorganised workers. In Bangalore, through mechanisms such as Single-window and help desks, they connect communities with the government; the focus is on helping such people gain ration cards, pensions and other things that they are entitled to, under different programmes of the government.
In August 2020, CFAR launched a project to ramp up testing in areas where they already work, to offer relief and support services to people infected with the Covid-19 virus. The objective was to control spread of the disease through better testing and timely treatment.
Work was undertaken in six wards of the Brihat Bengaluru Mahanagara Palike (BBMP). There were 57 helpdesks, manned by volunteers. Since the people of these areas were already acquainted with the team from work that had been undertaken earlier, there was already a rapport with the community.
Yet, CFAR staffer Sumithra says, the biggest challenge remained the poor knowledge that local people had of the nature of this new virus. It was hard to initially explain the need to get tested, when there was no apparent sign of disease.
The need for isolation too was poorly appreciated – people had never before heard of the need for healthy persons to stay quarantined. Such requirements caused people to fear the disease, and daily wage workers especially could hardly expect to earn their wages if forced to quarantine.
There were people who would refuse to be tested – construction workers, for instance, insisted that they were used to a tough grind and could not fall prey to the virus. They refused to get tested, even if they had symptoms.
CFAR project head Hegade explained that one grocery store owner fell ill and was treated at a Government CCC. He returned to his store once he recovered, but people were so in fear of contracting the virus from him that no one came to his shop anymore. Some even hurled abuse his way, saying he was out spreading disease. The man was left so distraught, so stranded with no means of earning a living that he died by suicide.
That was a clear indication of the need for heightened counselling services in the community. Many staffers explained that even though they had been working with the same communities for a while, they found it hard to convince them of the need for preventive measures to protect themselves. Volunteers themselves could spread disease, the people feared. To counter this, the volunteers offered to get themselves tested and even did so in many cases. With persistent efforts and constant communication, some headway was made.
The 57 helps desks catered to a population of around 87000 in 37 settlements across the six wards. There were construction workers, domestic workers, garment workers and sex workers in these communities. The local Primary Health Centre (PHC) coordinated in getting testing kits to the field; testing camps were held in the field to get more and more people to test for infection.
Street plays and community meetings were held to offer explanations about the nature of this new virus. Volunteers were educated about the suicide by the grocer, and instructed to keep track of those testing positive and in need of assurance. Volunteers also kept close watch over the family and neighbours of infected persons, and offered advice on any doubts they might have.
Four young men who shared a flat said they got all the help they needed from the security guard at their building, who brought them their groceries and checked on them when they tested positive and had to quarantine themselves.
CFAR staff had also been in constant touch, offering any counselling services and making them feel cared for, even though they lived far away from their native state and family. In October 2020, after spending two weeks in quarantine, and an extra four days after testing negative, they returned to work.
In some cases, it was almost like the fear was the bigger problem than the virus. Siblings Khaleda (19) and Akbar (24) tested positive and were moved to the CCC in Nagarbhavi. They initially felt horror at the disease, and were scared that the government facilities would only make a bad situation worse. They said they had been told that the government was forcing people to get tested, providing false positive results and moving people to the centre against their wishes. There were rumours that government staff was making a quick buck from accumulating positive cases. Rashid’s father had read about the poor conditions at government facilities.
However, Rashid himself was pleasantly surprised by what the facility offered him. It was clean, he could have a warm water bath, hot food and medication on time. What was remarkable was that all this was provided free of cost. The siblings now believe they have natural immunity, and no longer have any fear.
Reports in the media had caused ASHA worker Shantha too to be apprehensive. A frontline health worker, she knew that she was constantly exposed to the virus; once she felt the symptoms, she went in for a test and was found positive. Her husband too tested positive. Her six year old daughter tested negative, and they sent her over to her grandparents while Shantha and her husband moved into the government CCC.
Shantha said she felt very anxious initially and all the reports in the media offered her no comfort. She said she spoke to a psychiatrist without revealing her identity and found much relief. Now, looking back on it all, she says the experience has made her bolder.
CFAR, besides organising testing camps, also coordinated with the government/private facilities to ensure that patients were moved to centres of their choice. Ambulance services were provided for safe transport to the health facility. There was need for coordination with government staff and those working in other NGOs to estimate where beds were available. To counter misinformation about the care centres, videos of those who had good experiences of such centres were shown to those who needed to consider moving to them.
CFAR staff kept in touch with patients and their families, during the period of hospitalization and even afterwards. Rations and counselling services were offered even after patients returned home.
Once the lockdown eased, people relaxed and stopped using masks, practicing social distancing, etc. These too had to be countered using awareness measures, and volunteers were deployed to ensure preventive measures were followed.
With some initial training, volunteers were roped in to coordinate medical camps in collaboration with the private Ramaiah Hospital for persons with co-morbidities. Volunteers arranged for medicines through Primary Health Centres under the National Urban Health Mission (NUHM) and supported anganwadis with distribution of nutrition kits to pregnant and lactating women.
While 2000 tests were conducted in August 2020, by December more than 30000 tests were conducted;
A large network of organizations came together to handle the pandemic in Bangalore, with the BBMP staff coordinating with anganwadi workers and PHCs. Private organisations such as Ramaiah Memorial Hospital pitched in, and NGOs like Labour Net, Mercy Mission and community based organisations including the Cab Drivers’ Association and the Lorry Drivers’ Association collaborated to aid marginalized sections of Bangalore in dealing with the crisis.
In Karnataka, going by the number of cases reported daily, the pandemic seems to be ebbing. From a high of more than 10000 cases recorded on a single day in September 2020, cases have dropped to less than 500 in January 2021 (435 cases reported in Karnataka on 20/January/2021). This project by CFAR, funded by the Azim Premji Foundation, will run until March 2021, working in collaboration with five PHCs to assist in vaccination services.
Smita Ramanathan is an independent broadcaster and writer contributing articles to online portals and audio programmes to community radio stations (Women’s International Newsgathering Services) and the Bangalore based community radio station Ramana Dhwani.
[1] Name changed to protect identity. All names of survivors appearing in this article have been changed.
IF YOU LIKED THE ARTICLE SUPPORT PEOPLE’S JOURNALISM
