India is passing through the second stage of the most serious health crisis in its recent history. How we respond to it as a society is crucial to mitigating the effect of COVID 19 virus on our individual health. Democracy is ultimately a system of social relationships, of everyone with everybody else that respects the twin principles of equality and individual autonomy, so that everyone becomes responsible to everyone else without the use of threat, fear, and social power. If there are many characteristics of our society and government which make us undemocratic, this crisis can also be an opportunity to strengthen our democracy.
India has a very unequal medical delivery system. While the prosperous Indians can get as good health services in private hospitals and clinics as available anywhere in the world, vast swathes of rural India are bereft of any public health services. Areas of urban poverty are also similarly deprived.Indian government takes care of only 27% of health expenditure, spending only 1% of GDP on health. In China government takes care of more than 56% of the health expenditure. In many other countries public expenditure on health is more than 80%, which ensures everyone gets required health care, rather than only those who can afford. Given the state of affairs of public health system in the country, poor and rural Indians are likely to be the primary sufferers of acute health crisis from corona virus. It is essential that state machinery resolves to provide equal quality care to every Indian, and all available health resources are pooled in and distributed according to the requirement of individual sufferers, rather than on the basis of how much they can pay. Resources of private hospitals too must be diverted to meet the pandemic and opened to every Indian free of cost. Government of India has advertised a separate test price of Rs4500/ for private hospitals. This will only mean that people who can afford this price will get tested, poor will be left to languish in stressed public health system. Instead of this discriminatory practice, widespread testing at zero price should be started urgently. This is how pandemic has been contained in China, South Korea, Japan and Singapore.
Indian state authorities have historically been more intent upon imposing their power on people, rather than taking care of their own responsibilities. Government of India has lost precious three months window available for preparing for the impeding crisis. Even basic masks, and personal protective equipment are not available to our nurses and doctors. ICU beds and ventilators are going to be in short supply. In the national address announcing three week countrywide lockdown, Prime Minister Modi did not mention that essentials of everyday life will remain available, which led to an unnecessary panic. It is obvious that daily wagers, contract workers, and people working in the informal sector are going to be the worst economic sufferers of the lockdown. State plans for how they are going to be compensated should have been in place before the lockdown was announced. Like during demonetisation the PM thinks that his grandstanding will take care of problems people are going to face. Before stopping bus and train services the government should have ensured that millions of migrant workers, who need to be with their families, safely reach their native places. What kind of quarantine a working family of five living in a dingy room in a slum can afford? State needs to immediately open places for public quarantine in all empty public buildings like schools, colleges, stadiums,and even shopping malls.
Indian state authorities need to understand that public lockdown under an extended health emergency like corona virus must be fundamentally different from a curfew imposed after a riot, when the assumption is that anyone on street is a potential trouble maker. Telangana chief minister is already threatening shoot at site orders to make people stay indoors. Minister, officials and prosperous people may have enough supplies at home to last them three weeks. How can ordinary people stay indoors for that long? While enforcing the lockdown in Wuhan, the Chinese government had ensured an elaborate delivery system employing thousands to provide essentials to people at home. It seems Indian state authorities are more focussed on forcing people indoors, rather than providing them services so that they can stay indoors.
Social stigma, public humiliation and even lynching are endemic to our society. If anything, the ideological attacks of the ruling dispensation on minorities, oppressed castes, and the so-called ‘anti-nationals’ generally have heightened these tendencies. There is an acute danger that patients suffering from corona virus, their families and friends, and hospital and other staff taking care of them, may end up facing ostracization. There are already some cases of nurses being asked to vacate by their landlords. Even airline staff that brought back Indians from countries infected with the virus have faced problems in their housing societies. Since in popular media China is presented as responsible for the pandemic, people of North-East living in other parts of India have faced public humiliation. Certain steps of our governments, like physically stamping people ordered to remain in quarantine, or putting public notices outside houses of such people, further encourage such behaviour. The identities of corona virus victims have been revealed in media in many places. These steps not only violate the right to privacy of people suspected of having the virus, but also their right to personal safety and dignity. Only Orissa government has issued orders that the identity of corona virus sufferers cannot be revealed. Other governments should also issue similar orders.
Given the nature of Corona virus, probably more than half of Indians are going to infected by it in coming months. Only the most vulnerable, namely little children and the elderly in already weak health will require hospitalisation and critical medical care. It is necessary that rather than panicking and stigmatising victims of this virus, we as a society provide all necessary care, medical, psychological, and economic, to any person who is going to suffer.
PADS demands that
1. Indian state ensures equal and quality medical services to every Indian suffering form the Corona virus. In particular, no double streams of medical services, one comfortably curative in private hospitals for the rich, and the other understaffed and undersupplied stream for the poor in government hospitals, be allowed to continue. All medical resources available in the country should be distributed only on the basis of need, rather than wealth and status.
2. Measures to financially compensate people working in the informal sector of the economy should be announced and enforced immediately.
3. Enough places of public quarantine are made available to the poor living in crowded conditions.
4. Doctors, nurses, and safai karamcharis attending to victims of corona virus are provided protective gear immediately.
5. Elaborate systems of pubic delivery of essentials at door-step are made.
PADS appeals to the people of India to refrain from and confront any stigmatisation of sufferers of Corona virus and their families. Overcoming the crisis would require significant voluntary effort from all Indians in providing help and care to the needy. Only that will deepen our democracy.