How Mumbai’s Dharavi defused the covid-19 bomb

MUMBAI: On April 1, when Dharavi, Asia's largest slum, reported its first covid-19 death, a 56-year old man, panic ensued.

Though, by then Mumbai had recorded 181 positive cases and nine deaths, it was Dharavi that the local authorities and healthcare associations did not want to take a chance with.

But the deadly coronavirus had spread.

"We knew if the virus spreads further it would be catastrophic. So our team of Mahim Dharavi Medical Practitioners Association and members of Indian Medical Association (IMA), together with 25 doctors, roamed for 10 days in the major hotspot areas of Dharavi, testing thousands of residents," said Shivkumar Utture, a general surgeon, practising in the area.

Mumbai's civic body, Brihanmumbai Municipal Corporation (BMC), partnered with this team, isolating and quarantining possible cases. The municipal body also supplied free personal protective equipment (PPE) kits to private doctors, giving them confidence to open their clinics, which had been shut since March.

"So when in April only two or three clinics were open in Dhavari, now we have over 100 clinics open. This gave us the strength to detect more cases," said Utture.

Since late May, Dharavi has seen a decrease in number of cases. While average new cases have come down from 47 in May to 27 in June, the doubling rate of cases rose to 44 days against 21 as of May 24. So far, Dharavi has reported 1,964 cases and 73 deaths, while 939 people have recovered from the disease.

Kiran Dighavkar, assistant municipal commissioner of G-North ward, which Dharavi falls under said, "Our aggressive testing and screening of people through fever clinics helped in tackling this challenge. We identified people using common toilets and home quarantined them too.”

Thousand of volunteers joined the BMC officials and doctors to test, trace and isolate.

According to BMC, around six lakh people have been screened in Dharavi, which has a population of nearly 8.5 lakh.

This was not the only strategy. In the absence of testing kits, the doctors' team decided to use oximetres to check oxygen level among the ones being tested.

"Normally oxygen level should be around 98-100%. If it is less than this, then there is high suspicion that the patient needs to be investigated. So we are catching hold of a lot of patients with low levels of oxygen," said Utture, adding that the biggest challenge is that many people have 80-85% of oxygenation and are unaware of any health issue.

"These people are asymptomatic carriers. And with oximetres, we could weed out the possible cases."

The exodus of migrant labours and creation of quarantine centres within Dharavi also supported the efforts of authorities in containing the spread of coronavirus.

Dharavi may have seen nearly 2-2.5 lakh migrant labourers leave the slum clusters after the lockdown was announced in March. This helped the decongesting efforts of the BMC and doctors.