COVID 19 Outbreak Preparedness: A collaborative effort

About Latehar:

Latehar came into existence on 4th April 2001 before which it was a part of the Palamu district of the Jharkhand state. It is a predominantly tribal district with almost 46% of the population belonging to the scheduled tribes and more than 66% of the total population comprises SCs and STs. There are two subdivisions (Latehar and Mahuadanr) and 9 blocks in the district with a population of around 8 lakhs. The economy of the people revolves around the forest produces, agriculture, and minerals. Latehar is one of the most popular sites in Jharkhand amongst the tourists and has several waterfalls and hills and is blessed by the river Koel and its tributaries. It has 782 villages spread over 115 Panchayats and more than half of these villages are located in the depths of jungles with highly difficult terrains and limited resources.

The beginning of the fight against CORONA:

It was early March when there were scattered discussions on the cases of Coronavirus disease in different parts of India and to be honest, the public had no clue that it would turn their lives upside down in no time. And, in no time the country was put under complete lockdown. While this was necessary to contain the spread of the highly infectious coronavirus and save millions of lives, the decision brought a sudden unsettling situation and chaos.

Without any delay, the Latehar District Administration formed a District Task Force under the leadership of the Deputy Commissioner. The task force had the officials from different departments so that they can work in a coordinated fashion establishing coherence including Civil Surgeon. As members of the District Task Force on Coronavirus, the Aspirational District Fellows (ADFs) have been involved with- outbreak response plan, communication and awareness, procurement of safety equipment, planning of quarantine and isolation centers, preparation of the containment plan, and creation of a diverse volunteer base in the district.

On estimation and procurement of inventory (including safety equipment for the health workers) for the quarantine and isolation centers in the district, ADFs have been closely working with the Civil Surgeon, District Program Manager, and Integrated Disease Surveillance Program Manager. It was very crucial to establish a Pandemic Management Plan and assign defined roles and responsibilities to the officials and the frontline workers. The drafting of the District Micro Plan for containing the local transmission of COVID-19 in Latehar was also extremely critical as this required a clear understanding of frontline health workers and how to deploy them once containment and buffer zones are identified. And with collaborative efforts, soon the district was ready with a comprehensive plan. This whole exercise required collaboration between the health, social welfare, statistical, and education departments along with administrative units at the level of block and circles. A series of training have been conducted so far including district-level functionaries, block-level medical officers, and frontline health workers in the light of outbreak preparedness and management. These training have been planned in a way that no social distancing rules were violated and the majority of these were conducted locally at block and Panchayat level aided with video conferencing.

The idea behind the Micro Plan- a Holistic Approach!

This district micro plan is unique as it has been fine-tuned with the ‘village’ as a basic unit and will prove highly effective in case of an outbreak in the district and ensure surveillance on the quarantined cases. The immediate response team has a combination of the frontline health workforce, SHG (Self Help Groups) volunteers, and Rozgar Sewaks at the village level. The primary surveillance team includes an ANM (Auxiliary Nurse Midwife), a Sahiya (ASHA Worker), a Sevika (Anganwadi Worker), and a supervisor which includes an MPW (Multi-Purpose Health Worker) or a teacher or both. While the ANM will take care of the technical aspect, she will have added support from Sahiya and Sevika. The assigned MPW and teacher will be responsible for overseeing the village in terms of any requirement vis-a-vis essentials including groceries and medicines. Around 800 Sahiya didis are regularly engaged in a household survey in their respective villages and coordinating with their block response team.

Perhaps Latehar has gone a step further in terms of planning this at the village level utilizing the already existing frontline workforce and establishing coordination between them with the help of adequate training and sensitization workshops through regular video conferencing and other means of communication.

The Remarkable All-rounders- Volunteer Engagement

One of the most important tasks during the COVID-19 pandemic has been the formation of a large volunteer base for the district within a short time. Several civil society organizations (ex. Nehru Yuva Kendra, Starlight International Charitable Society), teachers, college students, and PDS dealers were marshaled in the district to ensure that communication and awareness reach to the interior, hard to reach regions of Latehar. The number of volunteers eager to participate in COVID-19 related relief work exceeded the district administration’s expectation. More than 3000 members of the SHG, 400 members from 7 civil society organizations, 200 plus teachers, mukhiyas, and rozgar sewaks have been operationalized in the district in this short duration. The creation of a large and diverse volunteer base from within the district has ensured that no single body/individual is overburdened with public information outreach, and the awareness is spread in areas where miking and IEC materials wouldn’t be able to reach otherwise. This team of motivated individuals will also help ensure quick response once a patient is identified, and the containment zone and buffer zone are marked.

To ensure the volunteers’ effectiveness, the foremost challenge was their training on important COVID-19 related information and safety measures. The training was coordinated in smaller groups via video conferencing. The volunteers were divided as per their respective organizations for this purpose to ensure two-way communication. Various district-level health officials were also pooled in to ensure accurate dissemination of information regarding their functions and safety. Once the volunteers were briefed about the important aspects of their tasks, they were encouraged to ask questions to strengthen their understanding. This training has been followed with a regular distribution of various educational materials via Whatsapp groups to the volunteers. These materials include video and written content on hand-wash, social distancing, the importance of masks, etc. The Whatsapp groups are also being used for reducing the communication gap between the volunteers and the district administration. They have been encouraged to reach out to the district team with their suggestions and doubts at all times without any hesitation.

The motivation of the volunteer workforce has been exciting, as they have been extremely forthcoming in taking up responsibilities. The young volunteers at Nehru Yuva Kendra, Vedic Society, Art of Living, Vikas Bharti, and Starlight International are spread across the district and are taking the challenge as an opportunity to contribute effectively. While these organizations are otherwise engaged with wide-ranging interventions in the district, to fight this pandemic they have joined hands. In a district-level meeting organized with all the active CSOs, the heads of these organizations pledged their unequivocal support to the district administration in fighting this pandemic.

Small Steps for a Big Leap

Concerted efforts of various partners involved in this fight are reassuring. The organizational strengths displayed by the health workers and diverse volunteer bodies is a testament to their vast enthusiasm. With their co-ordination and hard-work, the district administration will certainly be able to put their best foot forward whenever any challenging situation emerges.