ENTANGLED NARRATIVES OF COVID-19 PANDEMIC AND MISERY OF MANY
Faced with the collective forgetting, we must strive to remember
Reni Eddo-Lodge
SHALINA MEHTA
Professor of Social and Cultural Anthropology (Retd.)
Department of Anthropology
Panjab University
Chandigarh
We do not remember days, we remember moments
Cesare Pavese
I write this with a heavy heart as the World returns to a ‘state of near normalcy’; people celebrate travel and ritual with the same gusto, but we forget to grieve for innocent lives lost to this gruelling Pandemic. I pay homage to more than 60 lakh people who became its victims across the globe. Let us remember, the pandemic has not gone yet! Public health experts say it is endemic now!! My tributes to health care professionals, doctors, Nurses, para-medic staff, ward boys and girls, Asha workers, sanitary care workers, police, BSF and army personnel and millions of other unknown, unsung workers who not only managed an unknown pandemic but also sustained law and order and social support for weathering a kind of anxious but ordered social fabric.
India’s first case of Corona virus came to light on 30th January 2020, while the first case in the province of Hubei from Wuhan was reported in the public domain on 31st December 2019. In less than a month, cases of Wuhan Virus now called Covid -19 by WHO, and in medical terminology initially defined 2019-nCov, later renamed as SARS-Cov-2, severe acute respiratory syndrome, had engulfed several countries. Scenes that were witnessed through whatever media reports came out from China were now being reported from Europe and several other parts of the World. There were predictions that if the pandemic hits India with the same ferocity, a country of 1.38 billion, with woeful health infrastructure, with dismal or near absent diagnostic ability was going to face unprecedented mayhem. By the end of March, a group of international experts predicted that India would have hundreds of millions of infections and lakhs of deaths.
This was the beginning of an era of projections and accompanying politics of pandemics. It was responsible for creating a multitude of entangled narratives. For more than three years now, we are still living amid myriad of narratives, stories of misrepresentations, contested claims both based on science, orthodoxy, and some elements of tested indigenous knowledge systems. There is also entangled narrative of individual perception/ psychic conscious and socially conditioned human behaviour being tested for its resilience in the face of social and physical confinement. In this reminiscence of what many may have forgotten, I start by recollecting my reflexivity, fear, caution, and effort to survive in a surreal world.
MY STORY
In the last week of December 2019, I travelled with my family to Kenya and Ethiopia and was revelling in the experiences of having visited my dream destination of Masai Mara. I was still under the euphoria of having had a factual contact with a community that was always at the centre of my anthropological imagination-the Masai. My son also ensured that at the far end of my life, I do not miss out meeting paleoanthropological puzzle called Lucy. What I also noticed in these impoverished regions of the World was massive Chinese investments in infra-structure and hundreds of Chinese nationals manging these construction sites.
Whilst, my world view was confined to these unfolding realities, another story was playing in the city of Wuhan. I noticed it for the first time only after my return to Chandigarh on 17th January 2020. Vivid images of sick people collapsing on the roadside, overflowing hospitals, and herculean efforts being made to build hospitals overnight, human bodies clad in layers of plastic to protect from unknown virus and instant fatal infection filled my oversized television screen. India sent medical supplies, made herculean efforts to bring back its citizens without the virus in toe, back to their country. Initially evacuees came from China, but as the fear gripped Europe and America and the World declared an unprecedented lock-down, unparalleled refugee crisis was witnessed. Millions were stranded in the countries of their dreams. They realised these were temporary destinations and not home. Others were tourists, exploring their bucket list of destinations for fun and adventure, like my family and me! Seeing mayhem unfolding on the virtual media, I thanked my stars that we were back home!
But there was no fear, not for a moment I believed that virus would come to our country and hit us as hard as it did. I had some idea, how epidemics work having spent years studying and writing about HIV/AIDS, but what was going to unfold in few weeks was nowhere in my gaze. Initially, my travel was not restricted, nor streets where I wander deserted. In February 2020, I travelled to Delhi for few assignments and for addressing an international conference organized by Delhi University, returned to Chandigarh in the last week of February to address a seminar of Sociology department, and then travelled to Hyderabad for a meeting of Academic Council of Hyderabad University. I was not even cautious nor had any fear of living with several co-morbidities.
It was while traveling to Hyderabad in the first week of March that I experienced for the first time a sense of unease. I noticed for the first-time few Indians wearing face masks, sitting at a distance from each other, on the flight, a mild cough from any part of the aeroplane made most other co-passengers cover their faces. I was cautious, but not afraid. During the meeting, I realised, several outstation experts had abstained citing fear of the Wuhan Virus. When I walked into the dining hall of the international hostel, I found many residents from other parts of the World trying to find tickets to return home. It was then, the premonition of Wuhan virus hitting us sometimes in the future became a part of my cognition. I returned to Chandīgarh on 7th March, celebrated holy Milan with gusto without fear of human contact, hugging and laughing together. Two weeks later, our world changed.
MISERY UNFOLDING
On 24th March 2020, India went for what is described in epidemiological discourse as the strictest lockdown in any part of the World during the first wave of the Covid pandemic. Life came to a standstill. Initially lockdown was for twenty-one days. It was something none of us had ever experienced in our lifetimes before. As nature returned to the streets, air pollution levels fell to dramatic low; People fortunate to be home with enough financial security relaxed, having a compulsive break, re-discovering families, and family time, oblivious to the fact that millions are abandoned having nowhere to go.
Most of us enjoying middle class comforts and fixed incomes, did not even internalize misery of daily wage earners, who migrate to cities to earn a living, leaving their families behind. My son who works for International S.O.S had come home for Holi and was not able to get back to his office for two years thereafter, but this did not interfere with his earning ability, he switched to virtual mode with ease and kept working and getting his regular salary. I got my pension without any hitch every month, but with that one announcement by the Prime Minister of India, many livelihoods were abrupted without any assurance for any form of compensation. On that fateful evening, daily wage workers on whom we all depend for providing menial to skilled services became ‘no one’s children’!
When first ‘lock down’ was announced, assumption was that it will stay for few days and then lives would return to normal. Planning, going into it was inconceivably pathetic, and arguments about saving lives and developing diagnostic infrastructure devoid of any clarity and operational bottlenecks. Many thought it was unscientific, lacked rational thinking and was a nervous response. Vulnerabilities of the workers in the informal sector were not given due diligence, political leadership, and its advisers, assumed that these ‘no-one’s children’ would be taken care of voluntarily by their employers.
Appeals were made to them to stay wherever they were and maintain social distance, follow sanitation protocols, using hand sanitizers or washing hands frequently. To this regimen were added facemasks later. All public transportation was put on hold. Hasty announcement of national Lock-down happened without paying due diligence to the plight of most marginalized sections of the society, for whom day-day survival is a challenge even during normal times.
What followed exposed deception, in-built into the industrial and urbanization models of so-called ‘sustainable development’. It exposed myopic political planning, hollowed social sector, and failure of the social science theories to predict course of social actions and nature of social relations in situations of such unprecedented crisis. Scanty relief measures announced at the time of the lock-down barely ever reached the most deserving.
Several studies conducted across the country to map the impact of this unprecedented human catastrophe recorded that only 4% of the migrants in cities and industrial townships received rations provided by both the states and the central government. Those on the road without food and water were not even able to get subsidized ration. Unbelievable as it may seem to many, only 29% having a ration card received any ration during the pandemic. Many in possession of these cards were often denied ration because their cards were not registered with the local leadership. Imagine the plight of millions without ration cards or cash in hand to sustain themselves. A study across 179 districts in India from May 30th to 31st July 2020, recorded unfortunate details of at least 35% of the surveyed migrants having gone without a meal through the day (Pandit 2020).
Pictures of thousands walking at the peak of summer, barefoot hungry and thirsty with small children, pregnant women with only one burning desire to reach their villages and their homes. Images of those days gives sleepless nights to many of us even today. One out of every four migrants going back home walked on foot (Pandit, 2020). 1.08 crore migrants went back to the villages carrying with them the fear of onset of pandemic and had to take shelter outside their villages in temporary huts built for isolation.
We also know that many migrants died in unfortunate accidents because of overcrowded vehicles plying on the roads often illegally. Nearly 30,000/- people died on the roads of India during the first lock down and the assumption is that most of them were migrant workers. Hundreds died not due to Covid-19, but of hunger, exhaustion in seething heat. Large number of migrants came from two Adivasi heartland of Jharkhand and Chhattisgarh. Others came from socio-economically backward states of Uttar Pradesh, Bihar, Madhya Pradesh, and West Bengal.
Those of us ever having written anything about development models, felt ashamed of structured processes of economic upliftment, rooted in industrialization accompanied by demarcated special economic zones. We felt abashed that we believed in benign human instinct and its ability to provide food, shelter, and security to those who were instrumental in their unabashed wealth. Sudden realization dawned that these industrial units did not even provide food and shelter to those who worked for them for decades.
Our other fear was that once they reach their villages, they would carry the Virus with them and in the absence of adequate health infrastructure, testing facilities for covid and lack of communication networks, after surviving hunger, they will die of infection and medical emergency.
APATHY AND ADIVASI HEARTLAND
Adivasi determination and resilience once again proved its mettle. Contrary to common apprehensions, only 25 adivasi were diagnosed with COVID-19 in the first wave as per the information provided by the secretary, Ministry of Tribal Affairs. This to many appear unreal because data collected by an expert committee report in 2018 provides evidence suggesting that burden of communicable disease like malaria, tuberculosis, skin infection, sexually transmitted diseases, HIV, typhoid, viral fever, and cholera is highest among these communities. It was surprising indeed, because in the first wave of the covid -19 pandemic, Adivasi heartland largely remained covid free.
But in the second wave, one witnessed that the situation had altered significantly. The tribal states of Chhattisgarh and Jharkhand reported high rate of infection. Even the most protected particularly vulnerable groups came under its impact. On May 4th, 2021, three individuals from Bonda PVTG tested positive. It was surprising because this small group of Adivasi lived in scattered hamlets in remote and largely inaccessible forests. Epidemiologists and public health experts were puzzled as they were not able to trace the route that virus followed. These individuals lived in near isolation and had no possible contact with any infected person. They were immediately shifted to isolation ward but soon another set of 12 cases were reported, sending entire Odisha administration in tizzy as it threatened the entire community.
This was just another instance, but the reality of 2nd wave was that it moved beyond urban conglomerates and a study done by Down to earth reported that more than half a billion population of India living in rural habitats was far more severely impacted. While the first wave was relatively muted, but the scenario changed dramatically in the second phase. The 2nd wave came between 1stand 26th May 2021. 8.2 new million new covid infections were reported in these 26 days, that claimed 103,382 lives. One shudders recalling sad memories of bodies floating on the riverbanks, people dying outside the hospitals for want of oxygen, doctors crying seeing young patients collapse within minutes of reaching hospitals. The pandemic had reached our doorsteps, many close friends, prominent names from all walks of the society with or without medical care died. Certitude of death sent most of us in a semi-state of depression. The urban conglomerates also noticed people jumping from windows of isolation centres for fear of solitary confinement and politics of missing government during crisis, dominating the newspaper, television, and social media headlines.
ENTANGLED NARRATIVE OF NUMBERS
We have been independent for 75 years and celebrating Amrit Mahotsav, but we continue to face the brunt of hegemonies of other knowledge systems. Mismanagement of the first wave of Covid-19 was also a consequence of paranoia created by western hegemonic science. It was an unknown virus and as the famous Ladakhi saying goes “illness is caused by lack of understanding”, nobody knew anything, everyone was grappling in the dark. One of the first books that I picked up trying to overcome my personal fears and apprehensions was titled “Till we Win”: India’s fight against Covid-19 Pandemic, a small penguin publication of 2020, written by three most familiar faces on TV screens during the pandemic- Dr. Chandrakant Lahariya, Dr. Gagandeep kang and Dr. Randeep Guleria. Opening statement of the 1st Chapter of this timely work is titled, “Viruses, Ecosystems and the Inevitability of Pandemics”. It talks about eight billion people on earth and zillions of viruses, and the uncertainty of how, when, and in with what intensity they attack us. These experts acknowledged upfront that this shall always remain unpredictable, thus exposing vulnerability of zillions in the future.
Nonetheless, Science has myriad ways of forecasting, so the first prognosis for India that pushed us, one may say in hindsight into some unwarranted, unplanned decisions made public on 24th March 2020, on a modelling-based study led by some reputed international institutes, projecting that as there were no interventions, India could have 30 or 40 crore (300 to 400 million) cases of COVID-19 by July 2020. The study further predicted that though majority of the cases would be mild, yet we may see 10 to 20 million in hospitals, and we will need one million ventilators. It was on that day itself that India went into unprecedented lockdown, initially for 21 days which lasted for more than two months.
Hindsight suggests that as a society, as a state, we allowed western hegemony of science overrule our rational instincts and ability to take discerning decisions about our ability to tackle public health issues. This is a probable explanation that even after a very successful vaccination program, scholars from the other side of the spectrum continue to cast a shadow on our public health researchers. Epidemiological researchers from India have debunked exaggerated death projections during pandemic in India. However, this should not make us complacent as there were several lessons that the pandemic taught us about our fragile infrastructure, particularly in Adivasi and rural heartland. The major lacunae were absence of reliable data from the rural hinterland. Down to earth in one of the articles reported:
in these 26 days, India accounted for every other new COVID-19 case and every third death due to infection recorded globally. What escaped everyone’s notice is that every new case and death reported from India in May was from the rural districts.
In other words, it implies every fourth case reported in the World in the month of May 2021 was from India and most of these were from the rural districts of the country. As I write this, everyone has started saying that the pandemic has become endemic to the country and notable achievements of the covid vaccination programme may drive us in to a sense of complacency. Hence, it is critical to take a measure of the limitations of rural health infrastructure to face any future challenges.
In the 2nd wave, we did not witness the kind of migrant crisis or exodus that happened in the first phase, but the data from the 2nd wave is a stark reminder of the inadequacies existing within our health infrastructure and connectivity with remote areas. In this phase, 15 Adivasi districts were acknowledged as hotspots that required immediate attention. The fragile economic situation of these communities was further dented because of lock downs and loss of regular income. Another major deterrent faced by these communities was technology-based Aarogya App that was used to track infections and later for vaccination purpose.
Attention was drawn to it by a Public Health Resource Network (PHRN) study of 2017: it indicated presence of mobile phone in only 33% of the Baiga households in Chhattisgarh and a dismal 14% households of Sabar community in Jharkhand having access to this essential tool for availing health services during pandemic. Weak penetration of mobile networks in the rural areas vis-à-vis its 84% urban household penetration in the country tells another story of rural-urban inequality. Several newspaper reports documented stories of people travelling several kilometres to register their names for vaccination at the nearby health facility, as they had no access to smart phones. This gap visibly created the impression that the smartphone-based contact tracing tool, like the Aarogya Setu may have failed in achieving its objective of tracing all those impacted by the virus. In the absence of tele-consultation of health services in remote areas, where these are desperately needed, our public apathy to Adivasi and rural health care becomes evident.
A brief review of the Socio-economic and related health profile of the 8.6% of India’s Adivasi[1] population is summed up in a report by an expert committee of the central government (Tribal Health in India, December 2018). It tells us that 104 million tribal people in the country are largely concentrated in ten states and in the Northeast. Almost 90 per cent of the tribal population lives in rural areas. Only 45% Adivasi population lives in demarcated ‘tribal blocks’, while nearly 55 per cent of them live outside the 809 ‘tribal majority’ blocks. Many of these blocks lack basic amenities and access to quality health care.
Another distressing statistic is about the number of Adivasi communities living below the poverty line. According to the Ministry of Tribal affairs, in 2011, 45.3% Adivasi people in rural areas and 24.1% in urban areas lived below the poverty line. Some studies report that 40.6% Scheduled Tribe population lives below the poverty line as against 20.5 per cent of the non-tribal population. Economic distress pushes many people to urban industrial hubs in search of better earnings and a brighter future for their children. But data reflects that this push is not making significant difference to their economic conditions and make them far more vulnerable when challenges like covid-19 pandemic or any other natural or man-made calamity hits them. In industrial towns they live in subhuman conditions and have no social security.
According to 2018 report titled Tribal Health in India -Bridging the gap and roadmap for the future, several other structural disadvantages faced by Adivasi communities are brought to the fore. The prevalence of underweight is almost one and a half times more among children from these communities vis-à-vis ‘other’ castes. The estimated prevalence of pulmonary tuberculosis among the Adivasi population is 703 against 256 per 1,00,000 in other communities, indicating a significantly higher prevalence in comparison to rest of the country. To these numbers, add misery of displacement because of Industrial development and loss of Adivasi habitat and eco-system that has virtually wiped-out production of organic food in these localities.
Nutrition history of Adivasi communities takes us back to their dependence on organic millets. Over the years, components of their essential diet changed significantly, as they became dependent on PDS schemes that provided poor quality of rice and wheat. Dependence on external sources of nutrition may have helped remove stigma of starvation but it impacted their physical well-being and made them nutrition-deficit. Malnutrition, communicable diseases and high incidence of maternal and child mortality among the particularly vulnerable communities has remained an area of concern. Over the years lifestyle diseases like diabetes and hypertension, that had nominal prevalence earlier, have suddenly acquired worrying proportions. In a 2022 report premised on a study conducted by ICMR between 2015-2018 in 12 adivasi districts, 66% reported deaths were because of non-communicable diseases. 70% of these deaths occurred at home and this was attributed to lack of health infrastructure in these districts.
This reminiscence of what we witnessed just three years back is to acknowledge on the one hand relative success that the country witnessed in having saved many vulnerable lives from the wrath of the epidemic; but three years down the history books, let us not overlook the fact that if another pandemic hits us soon as is cautioned by the epidemiologists, we should not fail millions of vulnerable people, who have continued to live under the clouds of adversity. In recent months, one did witness rising political capital of these communities, but will this necessarily result in better quality of life for all of them remains shrouded in uncertainties of the future!!!
A forgotten past is a past that is yet to be. A forgotten history is a memory missing from our collective conscience. An incomplete history is like an incomplete mind that has forgotten who it is and where it came from.
A.E.Samaan
[1] I prefer to use the term Adivasi instead of tribal because tribal has colonial connotations and fails to incorporate huge diversity that exist within this collective, though the connotation of Adivasi is riddled with contestations.