In the face of the crisis we are currently facing, our leaders need to show decisive leadership in not only controlling the surge of the virus, but also providing better healthcare and vaccine supply to the population
India is reporting the highest number of cases in the world, with over 1 million recorded every three days — the highest in the world. This has put an enormous strain on the mostly privately run diagnostic industry. The diagnoses that used to be made available in less than 24 hours are now taking up to five days in some cases.
This has resulted in several patients dying before they are even hospitalised.
The crisis reminds us how an out-of-control public health situation and healthcare infrastructure failure can lead to a much higher mortality rate than would otherwise be the case.
As the crisis escalates, the poor are once again fearing a return to lockdown and economic hardship.
Migrants have started fleeing from cities to their home villages in order to avoid the pain and trauma they went through a year ago when Prime Minister Narendra Modi enacted a nationwide lockdown. Many cities have already announced curfews.
For now, the Centre has just asked states to focus on “stringent containment and public health measures”, including testing, tracing and inoculations. Modi has also appealed to people to get vaccinated.
However, the situation remains grim.
Even though India is one of the world’s biggest coronavirus vaccine manufacturers, many states are experiencing vaccine shortages.
At the same time, lack of social distancing and new variants of the virus are causing infections to potentially spiral out of control.
When the poor suffered unimaginable horror
When Covid-19 first appeared in India last year, the Modi government was quick to bring the country together.
In a speech to the nation last March, he announced a 21-day nationwide lockdown of 1.3 billion people with only four hours’ notice. All means of transportation were suspended. The rich and affluent started hoarding food and medicines, while the poor worried about their livelihoods.
A mass migration ensued as hundreds of millions of migrant workers headed from the major cities back to their home villages on foot. This was the most visible face of the humanitarian crisis. Others, however, suffered out of the public eye, such as the street vendors, waste pickers, domestic maids and shopkeepers in slums, who were all forced to stop working.
Economic recovery since the lockdown has also been slow. By mid-November, one-third of respondents had still not fully recovered their pre-pandemic incomes. Many had been hired back at their old jobs on a part-time basis or at a fraction of their former pay. Many jobs simply disappeared.
The poor survived by cutting back on their food, borrowing money and helping each other.
Given these struggles, there is now a sense of anxiety in these slum communities and a mistrust of the government, especially Modi.
Says Ajay, 35, a street vendor who lives in the Kankarbagh slum: The government finds it is easy to lock us down but not to provide financial and livelihood support. PM is busy campaigning for an election where thousands of people come without masks and are violating social distancing norms.
Undoubtedly, Modi still remains popular among most ordinary people. However, making public speeches will not be enough during this second wave.
And while Modi insisted he would not politicise the pandemic, he has done exactly that. In states like Maharashtra, Punjab and Chhattisgarh, which are facing a spike in cases, Modi’s party is pointing the finger at the state leaders, who come from opposing parties. The states, meanwhile, are blaming Modi’s government for failed leadership.
As numbers of Covid cases are rising every day, the fear of a return to lockdown is ever-present, haunting the poor. Many have yet to recover from their previous debts, and Covid is now threatening their livelihoods again.
Last year, several not-for-profit, grassroots organisations came forward to help the migrants and urban poor dwellers, but this is going to be more challenging this year. Not only have their funds been depleted, but recent changes brought by the government have stopped the flow of foreign aid money to many organisations. Amnesty International announced in September it would halt its operations in India after its bank accounts had been frozen.
India’s humanitarian disaster
• There is no doubt that a humanitarian emergency is unfolding in the country
• Until March 2021, case numbers were low leading many to think that the worst was over
• An old theory, the hygiene hypothesis (the idea is that poor hygiene trains people’s immune defences, so when people are exposed to the coronavirus, their bodies are well-equiped to deal with it) was dusted off in an attempt to explain the low numbers
• Much like in Brazil though, jingoism, overconfidence and false reassurance from the political elite negated hard-won progress
• Stories of a collapsing health system, lack of oxygen for hospitalised patients and bodies burning on pyres in the streets are numerous
• What’s more, total health expenditure in India represents only 3.9% of GDP, well below the 5% minimum recommended to achieve universal health coverage
• Despite a recent expansion of primary care centres and a large health insurance scheme for the poor, infrastructure remains poorly aligned with need
• India has locally made vaccines, which are being rolled out, including the AstraZeneca vaccine
• Unfortunately, the proportion of the population that is immunised is still very low- only 12%