Covid-19 · Culture & Life · History of Medicine · Medicine & Doctors · Public health

Covid-19 in India – Society and Culture – The Lockdown and its Pain -2

[For the previous post on lockdown and its pain, see here. For other Covid-related pieces, see here, here, here, and here.]

The lockdown in India, implemented in haste and more for political brownie points than for people’s welfare, continues to exact a massive toll – now more in terms of its lingering after-effects than direct effects.

It is clear that the government, in its usual haste to do something big and macho, totally screwed up India’s chances of a mild to moderate level of epidemic by stopping migrant workers from going back home in March. Two public health experts recently wrote a piece titled ‘Forcing migrants to stay back in cities during lockdown worsened spread of coronavirus.’ They studied the trends in migrants returning to Rajasthan and the trends in Covid at a government health centre there, and examined if there was any correlation. They concluded that:

Most migrants who returned soon after lockdown [on their own, on feet, without government arrangements, in March and April] had much lower risk of being infected and did not contribute to any significant spread subsequently. [This is because the epidemic had still not spread widely in the big cities where they were coming from. But this was just some proportion of migrants, as many others chose not to go until some transport was made available. These were, in other words,] held back in cities when the epidemic was raging there, and picked up the infection. When they finally returned from May 4 [after the government formally did what it should have done right at the beginning], the epidemic spread to the rural areas. Allowing the migrants to return before the lockdown would have contained the epidemic in the cities, in addition to saving so much misery and violation of human rights that will continue to haunt all Indian citizens for decades to come.

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One aspect of Covid and PPEs that needs to be talked about more is how these have adversely affected women health workers. Many platforms carried thoughtful pieces on this aspect, including some written by health workers themselves. Here are some of those:

“During periods, we lose additional water and blood, which makes us weak and dehydrated. In safety suits for six hours, we can’t even afford to go to the bathroom to change sanitary napkins. Then come the cramps that burn us out.” (from here)

“Dr Sudeshna Salvi from the Grant Medical College, which is also known as JJ Hospital, said how once she had forgotten her date of menstrual cycle and started bleeding in her PPE suit. ‘I had no option as I was on my duty and I couldn’t open my PPE which could have been too risky. I spent six hours standing as I couldn’t sit,’ she said.” (from here)

“Meet Dr Kamna, an anesthesiologist who wonders why having periods makes her superhuman, or Dr Sumedha who powered through her shift only to feel weak and dizzy afterwards and then finally realise she has her periods. Then there is staff nurse Linda Rose who says her male supervisors are supportive of shift changes according to their menstrual cycles. Janki says working in a PPE makes her feel like ‘I am swimming in a pool of my own sweat. Everything was drenched, even the pad.’” (see the video here)

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As if things were not bad enough for the underprivileged in India, they had to deal with yet another challenge: providing smartphones to kids so that they could access the online schooling which most schools in India have turned to during Covid. Journalist Parth MN describes these dilemmas in this report:

That phone cost Rajesh roughly what he earns in a month of work as a labourer – at between Rs. 250-300 a day. His son’s generation, even in the difficult terrain and conditions of difficult Talasari taluka – with a majority Adivasi population of low-income families – is far more adept at using smartphones. But undermined by both costs and connectivity. This tribal belt along the Gujarat border is just 130 kilometres from Mumbai – but very poorly connected to the internet. “Even electricity supply is intermittent, especially during the monsoons,” says Rajesh, who belongs to the Warli tribe. So if you see a group of boys in Dongari sitting under a tree, it’s a safe bet that the spot has some semblance of network. One or two among the group would have a smartphone, while the rest would be staring at it in excitement. And yes, they would be boys. It’s hard to find girls here who own a smartphone.

In fact many such stories about how Covid is affecting rural and small-town India are hardly discussed in mainstream media. So do take a look at this extensive coverage by the People’s Archive of Rural India.

History nugget:

Excerpts from the article How Epidemics End by historians Jeremy Greene and Dora Vargha:

Indeed, many epidemics have only “ended” through widespread acceptance of a newly endemic state. Consider the global threat of HIV/AIDS. From a strictly biological perspective, the AIDS epidemic has never ended; the virus continues to spread devastation through the world, infecting 1.7 million people and claiming an estimated 770,000 lives in the year 2018 alone. But HIV is not generally described these days with the same urgency and fear that accompanied the newly defined AIDS epidemic in the early 1980s. Like coronavirus today, AIDS at that time was a rapidly spreading and unknown emerging threat, splayed across newspaper headlines and magazine covers, claiming the lives of celebrities and ordinary citizens alike. Nearly forty years later it has largely become a chronic disease endemic, at least in the Global North. Like diabetes, which claimed an estimated 4.9 million lives in 2019, HIV/AIDS became a manageable condition—if one had access to the right medications.

Those who are no longer directly threatened by the impact of the disease have a hard time continuing to attend to the urgency of an epidemic that has been rolling on for nearly four decades. Even in the first decade of the AIDS epidemic, activists in the United States fought tooth and nail to make their suffering visible in the face of both the Reagan administration’s dogged refusal to talk publicly about the AIDS crisis and the indifference of the press after the initial sensation of the newly discovered virus had become common knowledge. In this respect, the social epidemic does not necessarily end when biological transmission has ended, or even peaked, but rather when, in the attention of the general public and in the judgment of certain media and political elites who shape that attention, the disease ceases to be newsworthy.

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