Response to COVID-19

Containment and Welfare: Rajasthan’s Two-Pronged Response to COVID-19

The strategy of strict containment, screening and lockdown was popularized as the ‘Bhilwara Model’. Other districts were encouraged to adopt it to tackle and limit the spread of COVID-19. But as the District Magistrate of Bhilwara himself suggests, the Bhilwara Model is applicable only in the context of small towns and districts where the population density is low, and it is easier to practice social distancing. In bigger cities and slums, it is difficult to adopt this approach. Thus, it is best to have a decentralized and customized approach depending on the context and conditions prevalent in the district.

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Containment and Welfare: Rajasthan’s Two-Pronged Response to COVID-19

By Indira Patil

With an increasing rise in the number of COVID-19 cases and the announcement of Lockdown 4.0, India’s fight against COVID-19 continues. Rajasthan currently ranks fifth in the country (after Maharashtra, Tamil Nadu, Gujarat and Delhi) in terms of confirmed COVID-19 cases at 5,952 as on May 20, 2020.

Ever since the spread of the pandemic, the state government has responded actively to the emerging needs. The response of the government can be understood as a two-pronged approach: one, containing the spread of the virus through lockdown, screening, quarantine, testing and treatment. Two, taking a host of welfare measures to alleviate the impact of COVID-19, particularly among the vulnerable groups.

Containment Strategy

The first positive case in Rajasthan was that of a 69-year old tourist from Italy, reported on March 2, 2020. Soon after the first case, the state government issued an order asking people to practice social distancing in public places. Also, rapid response teams at district levels and control rooms at sub-divisional levels were created to disseminate COVID-related information and curb fake news.

Lockdown
The number of COVID-19 cases suddenly saw a spike when health workers including doctors from a private hospital in Bhilwara district tested positive (March 20, 2020). The district administration responded immediately by sealing the city, block and district borders and imposing a curfew in the entire district. Markets were shut except for the essential goods’ and medical shops. The state government announced a statewide lockdown the following day, becoming the first state to impose complete lockdown.

Screening
In order to screen and identify COVID-19 carriers, the government started screening through door-to-door surveys by Anganwadi and ASHA workers. Questions on travel history and health conditions were asked to identify people with a recent travel history and they were asked to home quarantine. In some cities like Udaipur, household surveys were also conducted by the municipal corporation and the district administration.

In Bhilwara, over 30 lakh people were screened, of whom, 7,000 people were quarantined at home or government isolation centres. A District War Room comprising of the health department, local administration and police was set up to coordinate the containment efforts. The district administration took over four private hospitals to tackle (anticipated) increase in the number of cases. Also, a testing centre was established. Through these efforts, the number of positive cases in the following two weeks was limited to one. This strategy of strict containment, screening and lockdown was popularized as the ‘Bhilwara model’. Other districts were encouraged to adopt the ‘Bhilwara model’ to tackle COVID-19 and limit its spread.

As the District Magistrate of Bhilwara himself suggests, the Bhilwara model is applicable only in the context of small towns and districts where the population density is low, and it is easier to practice social distancing. In bigger cities and slums, it is difficult to adopt this approach. Thus, it is best to have a decentralized and customized approach depending upon the context and conditions prevalent in the district.

Quarantine
Government schools, hostels and hotels have been converted into quarantine centres. Government school teachers and community health workers are involved in identifying and screening migrant workers coming from outside the town/village and quarantining them in school buildings or their homes. Also, in districts like Dungarpur, vigilante committees of youth and community representatives have been created to monitor the entry of individuals and workers via alleys and other routes. A mobile app called, ‘Raj COVID Info’ has been developed to track quarantined people.  Quarantined persons are required to click and send their selfies at regular intervals through this app.

Testing
For testing, there are 18 government and 4 private testing centres across 33 districts.1 As of May 20, 2020, over 2.65 lakh people have been tested. Non-availability of testing centres in all districts has resulted in delayed testing. The state government is gradually increasing its testing capacity. Currently, around 12,000 tests are being conducted per day.2

Treatment
In terms of medical infrastructure to treat COVID-19 patients, Rajasthan has 3,090 ICU beds (8% of total ICU beds in India) and 1656 ventilators (9% of total ventilators in India).3 Also, over 29,000 isolation beds have been set up in hostels, community centres and schools. After Bhilwara’s success, the state government has taken over as many as 30 private hospitals for treating COVID-19 patients.4 In all, there are 81 Dedicated COVID Hospitals (DCHs) across 33 districts.

The growth in the number of positive cases stands at 2.35%, lower than the national average of 3.92%. The doubling rate is 18 days, higher than the national average of 12 days. The mortality rate is 2.83%, lower than the national average of 3.3%. Rajasthan’s recovery rate from COVID-19 is 58.53%, almost double the national recovery rate of 31.15%, and much higher than that in other states like Maharashtra (19%), Gujarat (33%) and Delhi (36%) (as of May 12, 2020).

The following graph represents the total number of confirmed cases, active cases, recoveries and deaths (as on May 20, 2020).
Source: http://www.rajswasthya.nic.in

It can be observed that the number of active cases had flattened for a period of 18 days between April 22 and May 9, 2020. However, now, with the increasing number of migrant workers returning from other states, the growth in the number of positive cases has increased.

Welfare Measures: Implementation and Gaps

The COVID-19 crisis has disproportionately affected the vulnerable groups – migrant workers, marginal and daily wage workers, tribal, agricultural labourers and marginal farmers. The Rajasthan government has taken many welfare measures for these vulnerable groups.

Migrant workers
Rajasthan ranks third after Uttar Pradesh and Bihar in terms of inter-state out-migrants. It constitutes 6% of the total number of inter-state out-migrants in India, which is around 12 lakh migrant workers. Further, about 46.26% of rural households from the state have one or more family members who migrate to other places for work.5

The COVID-19 pandemic and the corresponding lockdown has resulted in an unprecedented exodus of migrant workers from cities to rural areas. With no means of transportation, many migrant workers are walking hundreds of kilometres towards their villages. Others are stranded in cities, living in difficult conditions.

Initially, during lockdown 1.0, the state government had arranged buses at inter-state borders to ferry migrant workers. This arrangement was done by the local district administration in districts like Dungarpur. Further, the state government started a Corona War Room Helpline 181 to reach out to the stranded and moving migrant workers. Initially, the helpline could not handle the large number of callers, then, the government increased the call-handling capacity by adding 15-20 more lines for better service.

Also, the government has started online registration of workers who wish to come into or move out of the state on the Jan Soochna Portal, an online website for information dissemination. According to the government, around 10 lakh workers have applied to come back to Rajasthan.6

With the return of migrant workers, the COVID-epicentre would shift from urban to rural areas. Thus, the government must take urgent measures and be prepared to deal with an increased number of cases in rural areas. This can be achieved by stepping-up the screening, quarantining and testing of the returning migrants.

Livelihoods
MGNREGA
With an increasing number of returned migrants in villages, there has been an increase in the demand for work under MGNREGA (Mahatma Gandhi National Rural Employment Guarantee Act) and work has started in most of the Gram Panchayats (GP) by maintaining social distancing, covering faces and washing hands regularly at the worksite. To enforce social distancing, the government is not allowing more than 50 labourers at a worksite. Till now, 8.45 lakh people have worked in MGNREGA during the Financial Year 2020-21. Out of 11,000 GPs in Rajasthan, work has started in about 8,500 GPs. In each GP, one or two worksites have been started (as of May 5, 2020).

The GPs are making a list of job-card holders demanding work under MGNREGA and preparing the muster-roll. However, the provisioning of work is still much less than the demand. Also, there has been a shortage in the provision of PPE kits and masks for MGNREGA workers.

Further, a group of sarpanchs have written a letter to the government regarding the increased price of materials hampering the implementation of MGNREGA work. The government must urgently look into these issues to ensure a smooth implementation of MGNREGA. Also, it is important to focus on stand-along works like construction of farm ponds, recharge pits etc. that enable working with social distancing at the worksites.

Minor Forest Produce (MFP)
The tribal population of western and southern Rajasthan are dependent on MFP as one of their primary sources of income. Every year around 2,70,000 people sell Tendu Patta in Rajasthan, income from which constitutes around 10% of their total annual income. However, this year, traders are not coming to purchase Tendu leaves because of the lockdown, due to which the livelihoods of tribal are at risk. This could further impact the Kharif cultivation as they buy seeds and fertilizers from the income generated by selling MFPs during the months May-June.7 The government needs to take urgent action to procure the MFP at Minimum Support Price to support tribal households.

Micro, Small and Medium Enterprises
There are about 4.5 lakh Micro, Small and Medium Enterprises (MSMEs) in Rajasthan, providing employment to over 50 lakh people. Many local products like blue pottery of Jaipur, block-printing, marble carving, metalcrafts have high demand across the country. To promote MSMEs, the state government has declared Chief Minister’s Small Scale Industries Promotion Scheme as a flagship programme. The MSME Act and the Rajasthan Investment Promotion Scheme, 2019 have also been declared as flagship programmes. Declaring schemes as flagship programs implies that they will have high priority and will be tracked on a daily basis.

Public Distribution System and Food Supplies
The government has permitted Fair Price Shops to sell products, such as masalas, sanitisers, and hygiene products, in addition to food grains. A WhatsApp helpline has been set up for complaints regarding hoarding, black marketing, and overpricing.

Provision of wheat at Rs 1/- per kg has been declared as a flagship program. Social distancing is being practised as the government is doing door-to-door distribution of ration to select beneficiaries in rural areas.

Further, in Dungarpur, the district administration has employed a decentralized, three-tier food bank structure at district, block and gram panchayat-level to supply ration to the most vulnerable families. In this, food grains like wheat, pulses from the department of Food and Civil Supplies, Mid-Day Meal quota, and that donated by individual donors and civil society organisations (CSOs) are collected and stored at the food bank and supplied to the needy families. Also, if any organization wants to distribute food directly, they can distribute to the beneficiaries mapped by the local administration. Till now, dry and cooked food has been provided to over 1.5 lakh people in the district.

Famers and Agricultural labourers
The government has declared village service cooperatives as secondary markets to facilitate farmers to sell their produce in their own villages. It has announced free renting of tractors and other equipment for small and marginal farmers.

Agricultural labourers from southern Rajasthan go to Gujarat for the harvest of wheat from January to March and get wages in the form of wheat. Through this, they pile up their stocks of grain for the whole year. However, this year, due to the lockdown, many labourers could not go for the harvest. Those who went before the lockdown, managed to reach their homes, but without wheat. This could create more demand on the Public Distribution System.

Health
The state government has announced an aid of Rs 50 lakh to the families of frontline health workers who lose their lives due to COVID-19. Drug Supply Control Room has been set up at the Rajasthan Pharmacy Council to ensure uninterrupted supply and home delivery of medicines. Also, the government has issued instructions to provide free medicines to senior citizens and other patients with chronic illnesses.

With decreased income, nutrition needs, particularly of women and children will be affected. The government must ensure that the take-home ration is made available through Anganwadis and immunisation drives are conducted regularly.

Also, there is a need to take initiatives on mental health issues. In times of uncertainty and crises, it is important to create grievance and counselling helplines to address these.

Education
The government launched ‘Project Smile’ to connect students and teachers online during the lockdown. Under this project, study material and content videos prepared by the Education Department are sent through specially formed WhatsApp groups to students.

The online mode of teaching has largely not been successful, particularly at the primary level and has further reinforced the existing inequalities between urban-rural and government-private schools. In remote rural areas, many students do not have smartphones and internet connections. Thus, they cannot access WhatsApp lessons. In government schools and low fee private schools, most parents cannot support their children in studies, due to illiteracy or the burden of work. In the case of primary students, parents may be hesitant to provide (the only) smartphone (available in the family) to their child.

Further, many teachers in low fee private schools are losing their jobs as the schools are unable to pay their salaries, due to fee-payment dues of students from the previous academic year and anticipating a decrease in admissions in the coming academic year.

Cash transfer schemes
The Rajasthan government is providing Rs 2,500/- to identified beneficiaries, which includes Below Poverty Line (BPL), State BPL, Antoyodya, street vendors and Labour Card holders. A one-time cash transfer of Rs 1,000/- to over 15 lakh construction workers has been announced.  Similarly, cash transfer of Rs 1,000/- has been announced for poor people deprived of livelihoods during the lockdown, particularly those with no social security benefits. Data from the Aadhaar database will be used to identify such families.

Further, over 5 lakh children are getting benefits of Palanhar Yojana (monetary aid to orphaned and vulnerable children). Social security pension (for widows, single women, aged and people with disabilities) are being distributed at schools where banking correspondents (BC) are providing the money in cash. The government is ensuring speedy disbursal of pensions. However, people have to wait in long queues to get their money, as a BC visits only one panchayat on a particular day.

Strengthening local governance
The government has allotted Rs 60 crore (approximately Rs 50,000 per panchayat) to Panchayati Raj Institutions to deal with COVID-19 at the local level, and to purchase PPE kits and sanitizers. The GPs have been asked to sanitize community zones including GP offices, Fair Price Shops and ATMs.

Active role of civil society organisations
In Rajasthan, Non-Governmental Organisations (NGOs) and Civil Society Organizations (CSOs) are playing an active role in alleviating the impact of COVID-19, particularly among the vulnerable groups. They are involved in the distribution of food (dry and cooked), masks, PPE kits and sanitizers. Also, in some districts like Dungarpur, they are stimulating MGNREGA in villages by preparing lists of people seeking work under the scheme and submitting it to the GPs. Women Self Help Groups (SHGs) are preparing masks which are being distributed to community health workers and others through the panchayats. Also, these organizations have set up helpline numbers to reach out to stranded and moving migrant workers.

Further, letters with recommendations on improving the implementation of MGNREGA and the purchase of MFPs have been submitted to the government to take urgent measures on the issues. The NGOs/CSOs are complementing the efforts of the government to minimise the adverse impact of COVID-19 on vulnerable groups.

Continuing fight against COVID-19
The two-pronged approach of containment and welfare measures is driving Rajasthan’s response to the COVID-19 crisis. The number of positive cases is increasing — 31 of 33 districts have reported confirmed cases, of which Jaipur is the worst affected. The recent spread of the coronavirus in the Jaipur jail has spiked the number of cases in the district which is a matter of concern. Further, an increasing number of cases are being reported from districts of southern and western Rajasthan where migrant workers are returning to their villages, mostly from Maharashtra and Gujarat (worst affected states).

With the possible shift in hotspots from urban to rural areas, the government must recalibrate its containment strategy and strengthen the health infrastructure in rural blocks. Also, presently, a trust deficit exists between the government and the migrant workers. The least the government can do is to assure migrant workers about their livelihoods and safety. The government must focus on reinvigorating local livelihood work under MGNREGA by diversifying to generate more stable and greater number of employment opportunities.

Also, gender-responsive interventions are the need of the hour. Awareness about the on-going relief announcements and COVID-related information must be created through district helplines, disseminating hyperlocal information.

AUTHOR
Indira Patil is an alumnus of the Azim Premji University (MA Development, 2013-15 Batch). She is currently based in Udaipur and is working on a research project on Accountability Relations in Education (RAISE). She is also associated with the I-CARD project.

Disclaimer: The views and opinions expressed in this article are those of the author/s and do not necessarily reflect the official policy or position of Azim Premji University or Foundation. 

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