By Nandini Garikipati
The new coronavirus outbreak has put to test the efficiency and resilience of the public health systems across the world. The pandemic wreaked havoc in several powerful countries and communities, resulting in heavy losses in terms of human lives and economic activity. In these days of despair and mayhem, some unlikely success stories came up from different parts of the world. While some of them, like Kerala’s success in flattening the Covid-19 curve, got international acclaim and appreciation, some others went unnoticed. The most prominent among them is Odisha, one of the poorest states in the country.
At a time when Covid-19 was just bad news from distant Wuhan, Odisha was recovering from cyclone Fani that devastated the state a year ago. The state government sensed the danger posed by the outbreak and chose not to be complacent. Odisha is among the worst performers in Niti Aayog’s health index, but the state government led by chief minister Naveen Patnaik drew from its experience in tackling a series of natural disasters and put together a plan against the deadly virus outbreak. The Disaster Management Act 2005 and Epidemic Disease Act, 1897 were imposed even before a single case was reported. As this article is being published, the state has only 536 active cases and only three people have died of the disease.
A step-by-step approach
Screening, monitoring, restricting entry: To begin with, the state government sought permission to screen international passengers and put up a portal on March 3 for mandatory registration. This was followed by 14 days of home quarantine/ isolation and incentivising with Rs 15,000 on successful completion.
Lockdown: Odisha was the first state to announce a lockdown in a phased manner from March 21. More stringent conditions were imposed for 48 hours in Bhubaneswar, Bhadrak and Cuttack to facilitate contact tracing and pre-empt community transmission when there were a few cases. Containment zones or hotspots were identified. The state then sought extension of the lockdown and requested the suspension of train and air traffic into the state.
Timely welfare intervention: In March, the Chief Minister announced a Rs 2,200 crore package for the economically weaker sections of the society to deal with the impact of the outbreak. The state ensured advanced disbursement of welfare resources to beneficiaries; pensioners in cash and ration stocks for card holders for three months. The cash-in-hand mode reduced chances of corruption and minimised crowding at banks as was seen at other places. Poorest of the poor were provided with food.
Testing, treating: On March 16 when Odisha reported its first case, there was only one testing centre. Today, it conducts more than 4,500 tests per day in 15 testing centres and plans to increase testing to 15,000 per day.
Covid hospitals: Initially, Covid-specific wards in four existing hospitals were opened. To pre-empt transmission within a hospital, decision was taken on April 2 (when Odisha had only five cases) to have exclusive Covid hospitals. Today, the state has 34 Covid hospitals spread across the state with 5,493 beds, and 296 ICUs. It has plans to increase the number of beds to 10,000. It has also set up 14,795 temporary medical camps with 6,28,686 beds in 6,798 gram panchayats for quarantine and isolation of people returning from other states.
To address the shortage of N95 masks and Personal Protective Equipment (PPE) without compromising on quality, the officials explored all possibilities and coordinated with the Union government to ensure timely delivery.
Health workers and their safety: To meet the increasing requirement, along with existing staff of about 8,000 doctors, staff nurses, pharmacists, lab technicians, radiographers, and health workers, 1,039 medical graduates and other professionals were engaged. Further, 500 medical students were also trained.
While attacks on doctors and denial of entry into their residences poured in from other parts, Odisha invoked National Security Act against attacks on/dishonouring of doctors, healthcare personnel. And when health workers in some other states had not been receiving salaries, Odisha paid four months advance salary to them and also announced a slew of other benefits including ex-gratia of Rs 50 lakh to the kin of all health workers (including support staff) as well as police and sarpanches.
Police force: Odisha police and its team including Commissioner of Bhubaneswar-Cuttack, and others have shown great tenacity in maintaining cyber safety and sternly handling mischief mongers and those violating rules. They used social media, humour and creativity to spread awareness. At all 12 border checkpoints, Odisha police is doing all it can to welcome returnees.
Involving village heads: Anticipating the return of lakhs of people to rural areas, the State delegated powers of district collectors to sarpanches of Gram Panchayats in a historic move. The intent was to ensure smooth return and proper monitoring under quarantine. The government was to bear all expenses during quarantine, and announced a relief of Rs 2,000 per person on completion of quarantine.
Role of SHGs: Women self-help groups have been engaged in making reusable face masks, managing fair price shops under public distribution and preparing meals to be served in quarantine centres and camps. Many of them have also helped spread awareness about social distancing and safety in rural areas.
Communication: The state appointed a chief spokesperson, Subrato Bagchi, who has been communicating with the masses through daily updates. In one of his early speeches, he drew parallels with Lord Jagannath’s anasara (annual quarantine after falling sick) and that helped strike a chord with the masses preparing the public for a long-drawn war on Covid-19.
Civil society and experts: In the past two months, the administration has responded positively to feedback from civil society, citizens forum, experts and NCDS policy briefs.
Criticism from media: Along with praise by the media for its decisive measures, swift disaster preparedness and humane approach, the government has also gathered criticism on issues like spending, confusion over dissemination of information and condition of migrants.
Return of migrant population
Border influx: As the state government deftly moved ahead, there was a sudden rise in coronavirus among the people coming from West Bengal. Efforts had to be doubled to clear this roadblock. They had to first track all such returnees. Rapid response teams were then rushed to corona-hit districts and feedback from panchayat representatives was taken to ensure quarantine and care of ‘our brothers and sisters’ as the officials addressed them.
Migrants from other states: Coordination with states like Kerala, Gujarat and Maharashtra among others (including Jharkhand another receiving state like Odisha) as also the Centre and Railways led to the return of some migrants by special Shramik trains under Operation Shubh Yatra. These returnees had to register to facilitate prior information to facilitate logistics on their arrival.
Aadhaar: One difficulty that the migrants faced was the requirement of Aadhaar details as the sole and mandatory proof to validate registrations. Scores of migrant workers’ hopes were dashed as they could not register. A PIL was filed calling it arbitrary and illegal. Subsequently, the High Court issued a notice and the government dropped Aadhaar as a mandatory requirement permitting other documents for identification (including a certificate by the sarpanch).
Return conditional: The next hurdle came when the High Court made entry of returning migrants conditional, subject to their testing negative for Covid 19. Many scheduled trains were cancelled because of this, derailing the migrants’ journey back and leaving thousands stranded. Luckily, there was relief soon, as the Supreme Court stayed the High Court order.
International migrants: With resumption of flight services, international migrants have also started trickling in. The task ahead is to continue with their quarantine/isolation, regular monitoring and treating.
The road ahead
Odisha has undoubtedly done well so far in tackling the Covid-19 crisis. Patient preparedness, step by step practical, sensitive and humane approach; delegation of powers to sarpanches, alertness, and human resource management have been the highlights of the state’s crisis management strategy. Timely coordination with Centre and other states helped in procurement of necessary equipment.
The Odisha government has put in place a network of infrastructure from rural-to-urban to handle the return of migrants and this seems to have paid off as almost all the current active cases have been returnees. Odisha has been a quiet success story in India’s battle against the pandemic. A bigger challenge awaits the state after the withdrawal of the lockdown. It will have to ensure that the virus is contained, the returnees are taken care of, and the economy is put back on track.
(Nandini Garikipati is a journalist based in Bhubaneswar. She specialises in economic and social issues.)