WE SHOULDN’T HAVE TO CHOOSE BETWEEN HEALTH AND ECONOMY
It has been more than a month since the strict national lockdown has been in place and there are all indications that exit strategy is likely to be a staggered one, as it will take a long time to come back to normal. Health Minister Harsh Vardhan has indicated that the Covid-19 strategy will continue to remain what it has been till now. “Look for them, test them, isolate them, and treat them,” is the current strategy.
While it is true that the villages in India have not reported many cases of the Covid-19 so far, but if it spreads can our rural public healthcare manage to deal with it? Is there a contingency plan to deal with such situation if it spreads?
The government claims that the Covid 19 has not reached the rural India. Even if the million migrant labourers go back home the villages might not be hit harshly. This is for two reasons. Harsh Vardhan told this columnist: “Personally, I feel that these migrant labourers would never have come in contact with the carriers. Coronavirus arrived in India with international travellers, and therefore most cases so far have been in cities. The second is that they have already gone into quarantine period and come out. They have already covered the two- week quarantine period. Had they been infected that would have been detected by this time.”
Also the rural folks have become alert and do not allow strangers into the villages keeping constant vigil. Awareness has increased because there are 117 crores phone subscribers who get information through their mobile. State officials have told village councils to keep returning labourers from entering the town or meeting people due to fears they may be infected with the coronavirus. In view of all these, Harsh Vardhan is confident of meeting the challenge if it reaches the rural India. “Money is not an issue. We have given Rs 4000 crores to the states. We are supplying them test kits. We can do much more,” he said.
However, data shows that though urban residents are more at risk for the spread of the coronavirus, the rural folks are not off the hook as they face several challenges including inadequate access, low insurance penetration and a growing chronic disease burden. With two thirds of India living in rural India, we need a different strategy to take care of the rural areas. As a priority the quality of rural healthcare needs to be stepped up.
The India Today Data Intelligence Unit (DIU) shows that the health infrastructure data published in the National Health Profile 2019 found that government hospitals would run out of beds in rural India even if the virus hits 0.03 per cent of the rural population. The pressure of handling patients in rural India is twice as much as the national average. While for every 10,000 people in the country, there is one allopathic doctor available; in rural India one doctor is available for every 26,000 people.
There are also practical difficulties in implementing government guidelines on health and hygiene. For instance, the rural folks wonder how could they follow social distancing in a limited space or wash their hands often when there was no running water or soap or wear masks when they don’t have money to buy them or how could they get healthcare when there are not enough government hospitals.
The widening urban-rural divide is also evident in the inequalities in consumption, quality of life, and availability of physical and social infrastructure. The Union government has announced an Rs 1.7 trillion financial package on March 26 for direct cash transfers and free food and the second one is to follow soon. But this barely amounts to 1 per cent of Indian’s GDP.
What is needed is a strategy suited to the rural folks. For an inclusive economic growth, there is need for focus on the agrarian economy. Secondly, the Panchayats should be utilised in the fight against Covid-19 and also on economic recovery. Realising this, Prime Minister Narednra Modi himself addressed the gram panchayats and sought their help last week. For instance, Odisha chief minister Naveen Patnaik has pragmatically vested powers on Sarpanches the powers of district collectors. In Kerala, its network of local bodies and women empowerment programme kutumbashree has taken the battle to the community level. Gram Panchayats could be the engine to deal with the villages. Thirdly, the International Labour Organisation had warned last week that about 400 million workers engaged by the informal economy, risk falling deeper into poverty during the crisis. Ever since the lockdown, migrant workers have suffered excruciating conditions and have been seeking to return home. NITI Aayog Rajiv Kumar says that, “people who have gone back will return to their urban centre when the economy picks up.”
It is clear that the successful strategy for the rural India will go a long way in dealing with the pandemic and it should be fought on two fronts – the health care side as well as the economic front.