Home / Opinion / Columns /  The reality of this pandemic in our villages cannot stay hidden

Rural India

Soorma Bhopali is one of the several unforgettable characters in Sholay who inhabit the mindscape of our country without ever growing old. His language is his character. You have to imagine the following conversation in his language. “Maamu ko oxigun chad gaya." Second man: “Arre mian, maloom hai oxigun kisko chadta hai?" First man: “Tumhi bataa doh." Second man: “Oxigun raakeet ko chadta hai." First man: “Iskaa matlab?" Second man: “Samajh lo maamu ki upar rawaangi ki teyaari hai, raakeet ki tarah." I heard this conversation while running one morning in Bhopal. Here’s the gist of it: Your uncle is now on oxygen; oxygen is put in rockets, to power them upwards; so, this is preparation for uncle’s departure heavenward. Gallows humour has helped Bhopal cope with its tragedies, before and after 1984.

The city is under siege, like all others. Funeral pyres do not cease burning; graves cannot be dug fast enough. The local administration and healthcare workers do their best, waging a ceaseless battle against the raging scourge. The city is not in this state only because of the pandemic within. The virus is spreading like wildfire in rural areas. With the abysmal state of healthcare in villages, people flee to the nearest city at the first sign of covid—crushing already-overwhelmed hospitals.

I didn’t stay long in that city I love and grew up in. I was off to small towns and villages, first in Madhya Pradesh, then two other states—in the past 15 days. Here are some vignettes from there.

Our rendezvous was under a giant Banyan tree. Four farmers were sitting on a chabootara (platform) under the tree when we reached. They seemed reluctant to speak to us till another farmer emerged from a nearby hut. In no time, he shared that over 50% had covid-like symptoms in two villages close by, and slightly less in another three. In a few minutes, the five front-line officials we were supposed to meet showed up. Their leader gained control of the conversation, emphasizing that they were lucky that the pandemic had not reached those parts, surely in part because of their own good work. The voluble farmer smartly fell in tune with this new ‘official line’.

Then I asked them one of my basic questions. “How many people have died in these five villages in the past two weeks?" The farmers started listing; there was a bit of disagreement on a couple of deaths being within that period. Eventually, they agreed on 8 fatalities. What had they died of? The fidgety officials grew even more so. The farmers’ list: three from pneumonia, two from water-in-the-lungs, two from heart attack, and one they didn’t know. But none was covid, as per reports. Was this kind of death rate usual in the five villages? No. Had they heard of anyone ever dying of pneumonia or water-in-the-lungs in the heat of May? No, never.

The officials remained quiet as we discussed the effect of the lockdown on businesses. Vegetable and dairy businesses were down 60%, the flower business had vanished, grain prices were down by 20%—so the farmers didn’t want to sell, but were unsure whether they could outlast the lockdown.

In another part of the country, the collector and district medical officer had planned for second and third waves. So, they have enough oxygenated beds, even as the infected pour in. What they don’t have are doctors and nurses. The full strength of the district’s medical team is also short of what’s required. Now, 20% of their doctors and nurses are down with covid. Another 15% have vanished—refusing to report to work—despite charges of dereliction of duty being filed against them. All that the two officials said was, “If you can get us one MD medicine and one MD anaesthesia, we could save hundreds of lives." We have not been able to help yet. Healthcare teams are deeply stressed everywhere, and no one wants to go to that remote place.

The lab of a district hospital has the full set-up for molecular testing of the virus. The doctor in charge shared with us the day-by-day data of testing in the district since 1 April. The number of positive cases plateaued at about 800 per day in early May. The district’s positivity rate was about 20%. In the past 10 days, the numbers have declined to about 500 a day, with the positivity rate climbing to over 40%.

If you slice the data into rural versus urban, the story becomes clear. The positivity rate in the district’s two urban centres is just over 10%, and in its villages, it is nearly 100%. The doctor is in panic—it is very clear from the data that the virus is ravaging villages—even as the headline number of positive cases shows a decline only because they are unable to test the rural population adequately.

That is very much the story from the six states that I have travelled to in the past five weeks. The plateauing or declining headline numbers are hiding an escalating pandemic in rural areas.

It is not because all these states want to hide the real numbers—in fact, in three out of the six, I witnessed total fidelity to the truth at all levels. But because testing rural populations in large numbers is impossible, given our health infrastructure and staffing. And then there are those who are doing their utmost to bury the truth, including by burying their dead, across the border in another state. My sense is that a day of judgement will come, not just of history and humanity, but soon enough in the court of democracy.

Anurag Behar is CEO of Azim Premji Foundation

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