Knowledge is Power only when it is Shared

April 15, 2020

By – Arnaz Dalal
(Equitable Healthcare Access Consortium)

The Pathanamthitta, the Bhilwara and the Agra models are shining ‘beacons of hope’ for the Indian Government in the turbulent COVID waters. As the number of Covid-19 cases are leaping through the charts across India these three districts respectively in the states of Kerala, Rajasthan and Uttar Pradesh have shown a decline in the spread of this pandemic.

So how exactly did they achieve this? Can this knowledge be bundled as a Best Practice and disseminated to the masses quickly? Can lessons learnt the hard way be imparted to healthcare and civic authorities across India in an easy to consume fashion? Can the policy makers at the federal government acknowledge that “not one shoe fits all” and accept that a decentralized approach to COVID-19, which gives autonomy and keeps in mind the geography and local dynamics is the need of the hour for India today?

Even before the Indian Government could come around to taking stringent steps to limit movement of people and spread of COVID-19, Kerala’s Health Minister K.K. Shailaja had ordered screening of passengers to begin at all the 4 international airports within the state in January 2020. People with symptoms were taken to government facilities, where they were tested and isolated and samples sent for further testing to labs some 600 kms away. By February 2020, one saw a 24-member state response team coordinating with the police and public officials across Kerala. Such was the efficiency and speed with which the unfolding Corona crisis was handled that the media nicknamed Shailaja as the “Coronavirus slayer” This was not an unusual situation for Kerala to handle as they have always been forward-looking in their health policy planning and have one of the best healthcare systems in India.

“The Pathanamthitta Model” in Kerala soon became an example of how an Indian state could flatten the curve purely through contact tracing. Every person who had entered the district was screened; a database created so that they could be reached when needed. Graphics were created showing the travel route of the positive cases and publicised. This included details of all places the family had travelled to, and the potential contacts they would have made. The Corona RM App which was designed by engineering students of IHRD College, Chengannur was used to monitor those under home quarantine. Today the growth of new cases has slowed down and Kerala in the last week only saw single digit rise in the number of new cases.

[Source – Indian Express]
( models/ar-BB12wJpJ)

Next came the “Ruthless Containment Strategy” adopted by Tina Dabi, an IAS officer who is Bhilwara’s sub-divisional magistrate and who took the call of sealing the district. Since April 3rd, a 11 day long aggressive “all down curfew” has been imposed to arrest the spread of the coronavirus. Better known as “The Bhilwara Model” the strategy here comprised of six very basic but crucial steps: isolating the district, mapping the hotspots, door-to-door screening, aggressive contact tracing, ramping up quarantine and isolation wards and readying a monitoring mechanism for rural areas. Notably, the total lockdown in Bhilwara started on March 20, when the first case was detected and four days before the three-week nationwide lockdown was announced by the Prime Minister.

Some of the highlights of this model include: the over preparedness of the authorities by having a crisis plan in place to tackle this challenge; constant monitoring of the high-risk population through telemedicine and call centres; leveraging the private sector to use hotels, college hostels, etc., as quarantine facilities; and deploying community leaders as “Corona Warriors” to monitor if social distancing norms were being followed in the community. These are some of the noteworthy features to implement in other hotspot areas.

The “Agra Model” emerged in early March as the best model to tackle cluster containment so far. The Union Ministry for Health and Family Welfare has praised the effectiveness of this model and it has also shared it as a Best Model practice with other states to implement in their hotspot areas
[Source: Inshorts-13th April’20]

The success of the containment in the Agra Model has largely been due to the Team Effort that went in to it. The State and District administration were focused on setting up facilities for isolation, treatment and testing. They implemented the Public-Private Partnership (PPP) investment model where necessary. They deployed technology to monitor the movement of infected people through mobile phone GPS, drones and CCTV cameras. Frontline workers used the existing Smart City Integrated Command and Control Centres as war rooms. Supply of food and essential items for those in need was ensured. Doorstep delivery and e-pass facility for movement of essential goods was put in place. Numerous Helplines were set up to reach out to the citizens and teams set up to coordinate responses. All efforts were taken to ensure that communication flows seamlessly and food supplies reach the needy. Over two thousand Asha Workers worked tirelessly to improve outreach by conducting door to door surveys for identifying suspected cases in rural and urban areas.

These three models are ample demonstration of the collective power of a nation in crisis, on display!! Are the remaining 717 districts in the country ready to be inspired by these three exemplars and innovate their own pathways out of the COVID-19 crisis? All they need is a determined leader at the district level, and blessings from the state leadership.

“…sharing knowledge occurs when people are genuinely interested in helping one another develop new capacities for action, it is about creating learning processes.” (Peter Senge)


The author is the CEO of Equitable Healthcare Access Consortium, a not-for-profit organisation that seeks to enhance equitable access to healthcare, education and livelihood to the people of India. The opinions expressed are her personal views

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