EMMS International’s partners are on the frontline helping their communities to prevent the spread and manage the impact of COVID-19. This week Dr Vandana shares what this looks like from Duncan Hospital in Bihar, north India.
What does your job normally involve? How is this changing during the pandemic?
My job as Project Director normally involves designing, monitoring & facilitating implementation of project activities in villages. Our community health and development project has about 47 staff working in the arena of mental health, anti-trafficking initiatives, non-communicable diseases including palliative care, disability, youth and mother and child health.
The COVID-19 pandemic is already affecting my job responsibilities. The needed village activities which involved forming, supporting and training community groups are stopped until further notice. All reporting and scheduled meetings which involved travel to different states have been cancelled along with all meetings with government and non- government organizations within the district.
All our efforts and minds have gone into response activities to COVID-19 which will affect all our ongoing projects and programmes. Personally, I fear that progress that has been made so far in our existing projects will be affected and, in some places, might also get reversed or go down.
How is COVID-19 impacting your region?
Lockdown declaration is an absolutely strange situation for our communities; it was unprecedented. People were not prepared for this, especially when it was announced in the villages through broadcasts by local administration, which made people panic. Due to the strict curfew and the lockdown people can't go to the market every day for daily basic necessities. When people can visit the markets, they are not able to follow social distancing while going for the purchasing of essential commodities. Due to lack of transportation facilities, those who have bank accounts are not able to go to banks which are far away from their villages and are facing financial problems as a result.
Project staff have raised awareness in the community through meetings of households. People are strictly instructed to keep their eyes on the migrant labourers who have returned from out of state and overseas in last 15 days. Migration tracking registers updated in the communities record some people who were working in Kathmandu, Nepal and from other places, coming back by foot as public transport is suspended due to the nationwide lockdown.
What are you doing to help the most vulnerable?
In the first phase we have helped ensure vulnerable groups get the information they need to stay safe and healthy, (including old age people, young children, people with chronic illnesses such as hypertension, diabetes, asthma, cancer, HIV/AIDS, tuberculosis and any other disease that causes decreased immunity).
Measures to contain the risk are in place: all the migrants, who have returned back especially from affected states and countries should follow safety precautions such as social isolation. We worked along with Panchayat (local government) to prepare makeshift quarantine facilities in schools and hotels where people can isolate safely. We have also assisted day laborers and migrant workers to access the food rations that government rules provide for.
We have been working with our networks and partners to make sure sufficient PPE kits and medical supplies are available in local hospitals to deal with the possible outbreak. All community health workers are being trained in awareness of COVID-19, necessary precautions, and other health strategies.
Our second phase strategies included working remotely with community groups, community mobilizers and volunteers who are helping to inform the villagers about the measures to be taken for Corona-virus.
Patients with chronic illnesses such as mental illness, diabetes, blood pressure and those with other disabilities are being followed by telephone and staff are assisting them for treatment.
Pregnant women are followed up for antenatal care by our nurses.
Awareness on Corona-virus through telephone calls and counselling was pursued with women and families where domestic violence cases were reported earlier. During the lockdown period, further cases that are identified are supported by the task force groups.
1,000 masks were distributed to police officials, health care workers and Council officers.
A local Corona-virus fund was established to help poor families. Local donation was motivated to help for the cause. We have also engaged in food distribution to 125 very vulnerable families. Following registration with local authorities to provide relief support to our communities, ration cards were facilitated for about 500 families. Further relief support was given to 100 widows and an additional 160 very needy families.
There is still more to be done and we look to support 1,500 more vulnerable families, including livelihood support for 25 very vulnerable families; distribute 3,000 more masks; continue with ration card facilitation and offer health subsidies to vulnerable families.
What challenges do you and the team face?
Staff are going through fear and stress in this environment, especially when the number of positive cases and the death toll continues to rise.
A challenge for our area is that our communities are a source of labourers and now many migrant workers are coming back from various states to our district and many of them could be asymptomatic so we will not know with whom our staff and patients are mixing. At the same time, we don’t have good testing facilities in our district for COVID-19.
A challenge in the future is the lack of adequate hospitals which could provide intensive care for very sick patients. We will be needing good and adequate health professionals who will be able to deal with these situations.
What has encouraged you during these long, hard days?
The fellowship and healing touch that I received from my colleagues and friends from across the world has encouraged me.
The support that I received from my family was something that I would like to stress.
The support of my husband in doing all household work along with me, the walks that we have together on our terrace, the beautiful conversations near our small terrace garden while having our daily tea make our lives so beautiful in the lockdown period.
We both also spend time in bible reading, its sharing and prayer. I was able to read and meditate on various chapters of bible which encouraged me and have kept me going.
My younger daughter is with me and though it had also been difficult with her to come to terms with not going to school and play freely outside, she also supported us through adapting to the changes in the world that are happening all around her so quickly. But at one time she mentioned she missed the school because she missed her friends so much. Also, at one time she thought that the end of the world has come through “Corona”.
Our elder daughter who is pursuing her first year Medicine in Punjab also got stuck, but I want to thank a beautiful family who took her in as one of the family members.
What keeps you going in the face of a crisis?
The things that keeps me going in the face of crisis is “Myself” playing my part in this great problem. Spreading love and comfort to those who have lost Hope. Every smile in their face keeps me going.