Protect 10 million most marginalized people from COVID-19
June 14, 2021
Manorama Singh, Berojgar Mahila Sewa Samiti (BMSS)
BMSS works with rural and urban poor in Bhilai. Their focus is working on sex trafficking issues, reproductive and child health, and sustainable livelihoods for the poor, particularly migrants. BMSS is a CAC partner.
The state of hunger and panic is everywhere. Bhilai city has a population of 4 lacs, with many villages close by. Currently, for the pandemic our staff and volunteers are working in Bhilai and the neighbouring villages within 15 km. We are only able to focus on 68 wards including a few slums, and the surrounding rural areas. In some of these wards, there are as many as 2000 families who are poor. Few of the wards have less number of poor households, around 300. We decided to not focus on the middle class at all, because they will probably be able to manage on their own. We are only looking at those families, who have no ration, who are dying of hunger. Most are daily wage earners or factory workers who are not getting any pay during lockdown and have no savings. This wave no one is opening any business even for a day. In the first wave, we went to the District Collector and jointly requested the factory owners to open the factories so that labourers could go and work. They opened it for a few days but then told us there is no market for their products currently in the pandemic. This year they didn’t open at all even with our request. They are saying the cost of keeping the factory to keep the premises open. The situation is such that some will die due to Covid, while others will die from hunger.
Protect 10 million most marginalized people from COVID-19
In the second wave, we haven’t been able to give ration kits because most of our money is going into medical supplies. How to arrange for ration kits? It’s getting more and more difficult to get food. No one is ready to give ration on credit anymore. But that’s the focus. If the child gets covid, how will she have medicine without having wholesome meals? In the first wave, we gave ration kits to 3000 people. For this, we had reached out to local companies, and few donor agencies. Each kit was costing us Rs. 900. We don’t have the resources and bandwidth this time. But it’s difficult to not respond to people starving. We are trying to arrange for rice, dal, and if possible potatoes, and oil which is essential for cooking. We negotiated with wholesalers to give us potatoes for Rs. 2 a kg, instead of Rs 10. Oil remains most challenging, its price has doubled in one year from Rs. 80 per liter to Rs 150. For the rice, dal we used an innovative idea. We approached all the middle class people and asked them for their PDS card. Everyone in Bhilai has a PDS card, no matter how rich and this gives them access to 35 kgs of rice at Rs. 10 per kilo. However, the middle class usually don’t consume the ration given by the PDS system. The card gets cancelled if not used to collect the ration. We requested them to give us the cards, and Rs. 350 to collect the rice on their behalf and distribute it to the poor families. We distributed dal in the same way.
People have started looking for different income sources. Really small shopkeepers are most adversely affected. Some took loans to start businesses. They started doing work they hadn’t done before. For example, auto drivers or people with small clothes shops have started selling vegetables on carts. Grocery and medical shops didn’t face any troubles. However, unlike the first wave, this time even the grocery shops were asked to remain closed during lockdown. We met the District Collector to reconsider the restrictions in the view of people unable to earn their daily meals. Now the carts have been allowed to sell their products.
They are left with so little that they are selling the rice they claim based on their PDS card. They are entitled to 35 kgs of free ration if they have a BPL card. They are selling to get money to buy other cooking basics, or medicines for other illnesses. Otherwise, we wouldn’t have to give them rice in a relief package. The PDS would have been enough for rice. Making these relief packages is becoming more and more difficult. We used to depend a lot on individuals coming forward to support, their personal finances are also becoming weaker now. They have loans in the banks, whose EMI they are not able to pay. They are feeling grateful that they are able to meet their food requirements, and are being frugal in their donations. It’s understandable.
We have a lot of migrants here because Bhilai is a highly industrial area. This has created havoc in Covid times, especially the second wave as this was the time most migrants came back to work from various states. Now the infection is moving towards villages.
Awareness and proactive thinking is very important to fight the infection. Unfortunately here, the rural and urban poor are usually ignoring symptoms like cough and try to just deal with it, thinking its just a little cough, nothing serious. Then suddenly the oxygen level reaches 70 and we see people are dying overnight.
Another big reason for the spread is lack of isolation. In a middle-class household, people are still managing to isolate and save other members, but in a poor household, they dont have so much space. On an average, there are 5 member families (including 3 children), living in very small houses. It’s common for the infection to spread to all members of the family.
We are counselling people for homecare because people are getting more infected in the hospital. I have witnessed this, because I myself got many of them admitted initially. Only 20 percent of the people going to the hospital survive. The hassle they face in the hospital is also creating panic. The families have to fight to even get the bodies out. The hospitals refuse to give the body over unpaid bills of large sums like Rs 1.5-2 lakhs. That’s a lot for these people. I’m having arguments with every hospital.
At home, we give oxygen cylinders, and 80% of patients have recovered. We have purchased 35 cylinders. We brought them from reliable networks who believe in our work and got them at a reasonable price of Rs. 3000, with Rs. 7000 security deposit. We are negotiating to waiver the security deposits. Those who can afford it, we are recommending they purchase an oxygen cylinder for home care. But for the ones who are absolutely poor, the labour class, who don’t even have money, we’re having to help them in every way possible. We are also giving them oximeters, thermometers, sanitizers and masks to them as well. Only 12 people have passed away, of whom 4 died of heart attack.
We are following 3 simple things: home isolation of the entire family, wholesome diet, and medicines. We provide the cooked meal and medicines. They are not allowed to step out at all. We have to be very mindful of the nutrition small children need for whom we also send fruits. Medicines don’t work without food and the diet of the poor households is very limited.
And for medicines, we depend on government supplies. That’s why we get the patients tested for COVID at government facilities, so that they can access the medicines for free from the government. In case a few members of the family test positive and others don’t, we advocate that the government provides medicines for the entire family. They are doing that because we have seen the infection spread. So we have helped them get better by providing medicines beforehand. If there’s a shortage at the government facility, we have tie-ups with the medical stores run by friends in the community who arrange for the medicines. There are very long queues even for the test. The facilities are running at full steam but don’t compare to the demand. Its a large population and infection is spreading fast. Our volunteers get in the queue at 4 in the morning to support the patients. It used to take 5-6 days for the reports. So we started talking to the facilities and made arrangements for the report to come within 2 days.
We are also teaching yoga and breathing exercises that the entire family can do together. Our focus is to boost immunity and fight the infection. Poor people usually do a lot of physical work anyway.
We are a volunteer driven organization. We have a few paid staff but depended largely for our pandemic relief effort. From distributing relief packages to supporting patients at the testing centres, it has been completely driven by the volunteers. But the second wave has been ridden with fear given the spread of the infection. Those who used to come forward to happily deliver packages, are no longer stepping out. Currently, we have 45 volunteers. That’s not enough to serve 68 wards and surrounding rural areas.
In terms of material resources, we don’t have enough cylinders, oximeters and thermometers. It’s also because if an oximeter is used by one patient, it stays in his house for a few weeks because one after the other all the members in the family get infected by covid. Currently, wenace 200 oximeters, we need more.
We are temporary systems, the government is permanent. We can support, facilitate, advise the government but can’t take its place.
We had made a state level Covid committee after the chief minister requested us. All NGOs are its members. Can we not have a system that’s by community, for community, from community? The government, private sector and civil society need to come together. For our covid response, we had to constantly advocate with the district collector, who was very open to our advice and he further negotiated with the corporates and factories to pull in their forces too. Also, in instances where supplies like medicines in the government facilities are running short, we try to engage the private sector and have seen them offer medicines at even 60 percent discount.
If we involve more people, human resources and finances, it brings more ownership for the programme. It also helps end the panic which sets in by just sitting at home and watching TV. Whatever facilities I’m giving that’s fine, but the families need to keep up the hope, we encourage them by showing how many families have recovered in home isolation. We actively discourage people from watching television and social media. These have created an atmosphere of fear, people are panicking listening to news. We need a positive mind to fight the virus.
We also have to think about people’s livelihoods. How long can they survive on donations? We will have to work towards independence.
We are thinking of offering micro loans at low interest. We don’t expect the money to be returned for at least one year. Recovery rate is low, not more than 70-75%. We have been skeptical but now is the time to shed our hesitation and try everything that will make us resilient.
We need to use the loan wisely in micro businesses. All markets are closed, so we should start something that provides home delivery of services. Leaf plates are another growing market. People are using disposable leaf plates because it’s easier for covid patients as no one has to touch it after use to wash it. Even otherwise, people are without domestic help in the pandemic and they aren’t used to washing their own utensils.
Even NGOs need to learn to be sustainable. We can’t just depend on funding agencies. So if we don’t have funding, we should find innovative solutions but not stop working. We need to do as much as we can, as much as possible. But we need to keep continuing. Even if nobody comes forward, we will continue doing it. That’s what we tell people start working and you will eventually start seeing resources coming in. Even if one individual comes forward, they inspire others to follow.
(as told to Soumita Basu, COVIDActionCollab)
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