Key interventions at district level for preparedness of a COVID-19 before its outbreak- Activities and Learnings

Author- Mala Advani

Ensconced in the serene hills of Dalma and enriched by the mighty rivers Swarnarekha and Kharkai lies the district of East Singhbhum, literally meaning the “land of lions”. The lions are no more to be seen but the tradition and culture of this the district is as majestic as one. It is a potpourri of different cultures as this the district shares its borders with West Bengal as well as Odisha. East Singhbhum district which is situated at the extreme corner of the southeast Jharkhand, consists of 11 blocks and is home to 2.3 million people. This district’s natural and mineral feeds some of the biggest industries in India, like the TATA, HCL, UCIL etc. with raw materials. However, since a significant percentage of the population lives in the rural areas it is very important that the urban-rural divide is effectively managed during the times of pandemic, where core issues like food security, right information and awareness and discipline on lockdown measures are the most crucial issues. The district administration has taken several initiatives to address such issues in rural as well as urban areas in this direction.

Challenges as a District

As the district witnesses spread of COVID-19 pandemic across the country, it surmises that prevention is the key to preparedness for this disease. Positive COVID-19 cases started appearing in Jharkhand at the on-start of April and this was a harbinger for East Singhbhum district to advance its preparedness mechanisms. Dealing with the lockdown brought in numerous challenges like food security of various sections, incoming migrants, mapping travellers, etc.

Conventional yet contrasting

The common design to register and respond to public grievances has been creating a control room, which was done by our district. But the district headquarters being a cosmopolitan city in Jharkhand, expected overseas footprint has been very high. The main challenge for this control room and district administration has been identifying people with foreign and domestic travel, in addition to resolving public grievances. In this regard, the district sought for travellers’ history from airports (both Ranchi and Kolkata) and railways. Surveillance teams were then formed and these teams started visiting people with travel history to their houses. This step helped the administration multiply its database and travellers’ mapping. Surveillance teams came back with more names of people with domestic or overseas travel history. Soon, from hundreds, this database reached to having 14k+ records. This consists of travellers, migrants, tourists and pilgrims. To improve surveillance efficiency, the number of such teams were doubled and more data came in.

The next big challenge was the gap between travellers’ data and sample collection for testing. Somehow these two were having a huge difference just because the database was failing to flag important inferences. This is where the role of aspirational district fellow started. Assisting the administration in door-to-door surveillance, developing surveillance mechanisms, data analysis and handling, responsible data cleaning, following up with control room activities, etc. are being done by ADF. This led to an increase in sample collection. Also, a follow-up mechanism has been created to telephonically contact an average of 1000 people on a daily basis to understand their current health status. The control room consists of approximately 30 people, having a fixed 8-hour duty timing, for activities like data entry, calling people with travel history, registering and complying to general complaints and providing potential leads to medical surveillance unit to follow-up. This control room will be functional until the pandemic exists.

Addressing issues relating to sustenance:

Ensuring food security for all and awareness among vulnerable communities have been major broad objectives of district administration in terms of securing people’s well-being. For food security, more than 120 locations are identified and cooked food is being supplied to these locations through government schemes and civil society organisations. Apart from that, supplying of dry ration to those who don’t have a ration card and are eligible, is being supplied through coordinating and tagging various civil society organisations, so that no section of public remains unattended for food security. Community kitchens have been initiated in rural areas to ensure supply of cooked food in these areas. Home delivery services through various channels have been created to cater needs of the urban areas.

Interventions on Supply of Protective Gear

In this buffer time focussed on preparedness and awareness, the demand for protective gear grew manifold. Production and supply of protective gear increased in urban areas, but the administration’s concern has been that the possible demand and supply gap might lead to black marketing of these items. Therefore, to address this problem for both urban and rural population, some innovative collaborations have happened in the district in terms of production of protective gear and some of it is being distributed free of cost to citizens. Triple layers masks are produced by prisoners of Central Jail Ghaghidih, Jamshedpur. This jail is having a sewing machine unit which is now being used to manufacture face masks. This unit consists of 18 skilled people, a well-equipped and sanitized unit area. Since the start of face mask production, they have produced more than 26000 face masks which they have sold to government, NGOs and also have a retail counter for their product. They call it an effort to make a ‘home-made’ face mask.

Some disinfectant chambers have been produced and installed with locally sourced raw materials. It is targeted to be installed in some prominent city markets. Currently, two such chambers have been installed: one in Mahatma Gandhi Memorial (MGM) Medical College and another in Vegetable market, Sakchi.

Sanitizers also have been locally produced by district administration. More 8000 litres. of sanitizer has been produced and distributed in the district. This has been distributed in the urban areas for a nominal cost and also being provided free of cost in PDS shops in rural areas.

Synergizing with Civil Society Action

The civil society of the district has been successful in helping the district in some of its core challenges like distribution of cooked food and dry ration in urban slums and vulnerable rural pockets, promoting home-based livelihoods in rural areas, creating prevention-related awareness about the virus. The district has also created a platform for coaction of Civil Society organizations (CSOs), so that a dedicated rural level volunteer partnership can be created and the administration’s efforts can be effectively channelized.

Ready for COVID-19?

Currently, the administration is observing a buffer time before it gets its first COVID-19 positive case. The district major focus is to still track down the potential spreaders. Therefore, self-reporting has been requested to the general public at large. Preparedness on containment is the biggest priority. Training of identified personnel for survey in containment zone, mock drills on containment survey, digitised survey forms, protective gear for survey team, medical infrastructure for cases from containment, etc. all of this has been prepared. This time is being utilized for advance preparedness and learning from experiences of other states and districts.