Covid-19 · Medicine & Doctors · Politics · Public health

COVID-19 in India – Society and Culture – PPEs, Frontline workers, and their families

For the previous posts in this series, see here, here, and here.

[Throughout history epidemics have served as excellent windows into social and cultural beliefs and norms. While this contagion-catalyzed uncovering of a society’s thought processes helps historians understand past societies in better ways, for present societies it can potentially be utilized as a way to understand our hidden biases, prejudices, and even kindnesses. Besides, epidemics could make our anti-intellectual society finally start listening to intellectuals, activists, and academics who have always tried to drive our attention to fault-lines that we don’t take seriously before a crisis (like COVID-19) ultimately bares them open for all to see. My attempt here is to collate different media and personal narratives from the COVID-19 epidemic in India that throw light on the social and cultural aspects of how we have reacted (and will continue to react) to this crisis. There are a lot of lessons we can learn and implement, but whether we do that or not is, again, dependent upon what general direction our sociocultural norms take as the epidemic progresses and dies down.]

One of the many events to go viral in recent days was of a 48-year-old Telangana woman, “headmistress of a government school, [who] drove 1,400 kms on her scooty from Nizamabad in Telangana to Nellore in Andhra Pradesh to back to bring back her son who was stranded at a friend’s house.” No doubt the story of a mother’s determination and love moved people.

Meanwhile, on the other side of COVID, parents and family members of frontline workers have been having a hard time. Not long back I conversed with the mother of a doctor working in Mumbai’s Kasturba Hospital. She seems to be perennially anxious now, and frequently said that she felt scared about his well-being. Her worries are natural, especially considering the criminal laxity that India’s central government has shown when it comes to being well-prepared for the pandemic. In this respect, two reports are important.

Wikimedia Comm, Simon Davis-DFID

The first is from May 22nd, at the start of the callously declared 3-week national lockdown in the country. Here journalist Vidya Krishnan describes how the Govt of India’s response was inefficient and delayed when it came to ensuring India had sufficient stocks of protective equipment for its health workers: “The Indian government waited till 19 March to issue a notification prohibiting the export of domestically manufactured PPEs and the raw material for the same… As a result, India’s doctors and nurses have paid the price and will continue to do so, as they walk into this public-health nightmare without adequate gear to keep them safe.”

The other important report appeared in HuffPost India on 5 April, by journalist Piyasree Dasgupta. This was an informative interview of the convenor of the Preventive Wear Manufacturers’ Association of India, Sanjeev Ralhan.

Ralhan says the problems go even deeper — the Modi government’s early inaction has cost vendors precious weeks in which they could have sourced raw materials and machinery. When the guidelines finally came in, the country had already been put under a lockdown making manufacture and transport a logistical nightmare. That apart, Ralhan said that the kind of suits the government wants them to manufacture are “practically impossible for us to produce under these circumstances”. Meanwhile, the desperation of health workers have led to the manufacture of sub-standard suits, which the former are being forced to use in the absence of proper gear.

Public health experts Pallavi Rohela, Soumitra Pathare, & Anant Bhan recently wrote a very thoughtful piece on how the rhetoric of ‘war on coronavirus‘ is counterproductive and ends up disproportionately hurting the frontline workers.

Equating the pandemic response to a war equates India’s healthcare workforce to members of the country’s Armed Forces. The same kind of stoicism and public silence that characterises our Armed Forces is now expected of physicians, nurses, community health workers and allied healthcare personnel. The result is Healthcare Professionals (HCPs) are being subjected to expectations of heroism and supreme sacrifice. There is little wonder that those speaking up against the shortage of Personal Protective Equipment (PPEs) is seen as unpatriotic and runs the risk of official punishment.

I will end with another thought-provoking commentary, this time by physician-writer Sanjay Nagral.

The gap between promises of personal protective equipment (PPE) and the ground reality is very big. While interacting with resident doctors and nurses in the last few days, I realised there are other equally important issues we could be ignoring in the focus on PPE. One such area is lodging and food conditions. There is a lot of resentment on this front… Organising comfortable transport will be welcome – something that Uber seems to have kick-started in the North. And in case they do get infected the quarantine facilities need to be comfortable and pleasant… A policy of enhanced payment over and above the basic salary to those working on the frontlines is worth considering. No amount of platitudes replaces pay. We could do well to remember that these sections are in any case underpaid. This is one of the main reasons for the mass migration by trained nurses over the last decades. Our ward boys, cleaners and sweepers are integral to care and hygiene. Many of them support their families and will find it very difficult to do so if they catch the virus… Attempts by the junior staff to speak out have been ignored or snubbed by invoking authority. There is no contradiction between doing one’s duty and simultaneously asserting one’s rights. Transparency and openness need to be encouraged and it is also crucial that they feel involved in key decision-making. This has not been our culture and needs to change.

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