Community involvement bolsters Nuh’s fight against Covid-19
Ten days ago Nuh district became coronavirus free temporarily after discharging the last five Covid-19 positive persons until a new case emerged three days later on May 26. From having the highest number of cases in Haryana in the second week of April, the district seems to have come a long way with only seven people undergoing treatment currently for the deadly disease.
Nuh has recorded a total of 73 cases, out of which 66 have recovered so far, while results of 173 samples are awaited. Among the country’s most backward regions, the district was able to turn the tide, much to the surprise of people who were skeptical about its health care infrastructure and socio-economic backwardness, and is one of the few districts in the states to have active cases in single digits.
In April 2018, NITI Aayog had identified Nuh, earlier known as Mewat, as the most backward district in India. In an assessment on multiple parameters such as education, health, agriculture, financial inclusion, skill development, and infrastructure, Mewat scored 26% — the lowest across the country. The district has also had a chequered history with immunisation programmes. Yet, despite various limitations at play, the district’s efforts at containing the spread have been encouraging, and no deaths have been reported so far. No new case was reported in the district for ten straight days between May 16 and May 26.
Nuh’s deputy commissioner Pankaj (who goes by his first name) said the administration worked in tandem with local community leaders and village heads to contain the spread of coronavirus in the district. In April around 513 villages of the district, health department teams surveyed around 2, 35,000 households and screened over 14.5 lakh people in the district, according to the chief medical officer (CMO) of Nuh, Virender Yadav.
“A large number of cases were reported in April here. During this period, anyone who came from outside was quickly traced within two days and quarantined. These included people who had some contact history with the Tablighi Jamaat congregation in Delhi. Everyone including asymptomatic individuals who have had a history with the congregation were tested. Much of this could only take place due to cooperation from local people and community leaders,” said the deputy commissioner. So far, the district has sent 5,305 samples for testing as many as 645 people found to be in contact with Covid-19 positive persons were put in self-isolation.
CMO Yadav said the district recorded the maximum number of cases between April 2 and April 23 and the situation was brought under control by treating everyone with symptoms as a suspected patient. “We saw a rise in cases till April 23 and during this period, we ensured that the patient was immediately isolated and samples from the patient’s contacts collected were collected the same day,” he said.
To ensure that the process of screening, testing, and isolating people with symptoms took place without any hurdles, the administration reached out to the local community, made them stakeholders in all its efforts, and took a number of confidence-building measures.
Overcoming Challenges
Apart from the efforts of the health and police teams, support from locals helped to propel Nuh’s fight against the disease and ward off challenges. One such challenge was to allay the apprehensions of the Muslim-concentrated region that people in quarantine could be ill-treated, a fear that became palpable with the Tablighi Jamaat congregation in Delhi hitting the headlines.
The Tablighi Jamaat headquarters in Delhi had emerged as a big Covid-19 hot spot in March, after which at least 2,346 persons were evacuated, out of which many had been admitted to hospitals and more than 1,800 people were put under quarantine.
“Initially, we were anticipating law and order problems when many Jamaatis were quarantined, but we tackled the reservations of people though our transparent mechanisms and active communication. We kept the Jamaatis accessible, and we informed the community leaders that they would be given escorted visits to meet the Jamaatis anytime in the quarantine centres. This worked as a confidence-building measure and helped to allay fears in the mind of the public,” said Pankaj.
Additional deputy commissioner Vikram said multiple meetings were held with religious and community leaders to assuage the fears among the locals. “Initially, there was some kind of apprehensions among people. They wondered how the Jamaatis would be treated. We got all religious leaders on board and took them to quarantine facilities and the shelter houses, and assured them that the Jamaatis were being kept properly. They were satisfied and helped us in our efforts,” said Vikram.
Community patrolling
At the peak of its coronavirus crisis, Nuh had around 45 containment zones, including 23 villages and two urban areas. During this period, the administration formed 289 teams that started screening people for Covid-19 symptoms. To ensure the success of the screening process, the administration reached out to village heads and imposed ‘thikri pehras’ outside the villages. Thikri pehras, a provision under section 3 of the Punjab Village and Small Town and Patrol Act, 1918, was invoked to regulate the movement of people to and from villages.
“We placed thikri pehras outside the villages under which village heads (sarpanch) and other local leaders placed checkpoints at the entrances. This system ensured that outsiders couldn’t enter the villages without informing anyone. We conducted screening for anyone entering the villages from outside to ensure that infection from outside didn’t enter the village. This system was put in place around 317 panchayats. Locals maintained a vigil during the day and night,” said ADC Vikram.
The involvement of village heads in halting the spread of the diseases proved useful with locals playing an active role in ensuring that their villages remained on guard. From extending help to those managing quarantine facilities to aiding the screening process, local leaders ensured that people with a travel history were quarantined and reported to the administration.
Sabir Hussain, sarpanch of Malab village—where a polytechnic college was among the seven quarantine facilities in the district— said village heads and leaders played an active role in maintaining vigil, especially in the containment zones.
“We kept a close watch and ensured that people coming from outside and those with symptoms were screened. Village heads shouldered a lot of responsibility and ensured that everything in quarantine facilities, from food to cleanliness, was taken care of. In our village, we took over the responsibility of delivering food at the quarantine facility after taking permission from the administration,” said Hussain.
He added that many had feared that Covid-19 would rapidly spread in Nuh, but proving such expectations wrong people in the district stepped up and ensured that safety measures were followed and the situation could be brought under control. “Everyone, including the administration, perhaps thought that it would be difficult to contain the spread of coronavirus in the region, yet people proved them wrong and surprised everyone with their resilience.”
Efforts by the administration and the locals have left Nuh with just one containment zone (Tauru block).
CMO Yadav said the health department was able to quickly trace, test, and isolate individuals returning from Covid-19 hot spots and other states due to intervention of locals who informed the administration on time. “While we made efforts of detecting cases, the locals helped us by ensuring that anyone coming to the villages from outside was screened.”
Dispelling rumours
With the initial lockdown restrictions disrupting the reach of newspapers, the administration took support from community leaders in relaying reliable information timely and dispelling rumours. This was a much-needed step in a region that has had a tumultuous history with immunisation drives with misinformation hindering the efforts of health teams.
Around March 2017, rumours that the government’s immunisation campaigns were a conspiracy to make children sterile had spread like wildlife in the region. Doctored videos circulating on social media had further heightened the fears among the local population.. To avoid a repeat of the episode, the district administration reached out to community leaders for effective outreach among the local population.
“Religious leaders in Nuh cooperated with us a lot. We organised three or four meetings with them initially. The leaders would make announcements from mosques and madrassas emphasising that people should offer prayers at home and support the health team in all their efforts,” said deputy commissioner Pankaj. He recalled that some people were reluctant about sharing samples during the holy month of Ramzan, but they were pacified after the much helpful intervention of religious leaders.
“Some people were not willing to let health teams collect their samples during Ramzan, but religious leaders stepped in and clarified through videos that giving samples wouldn’t affect their fasting in any way,” said Pankaj.
Mufti Zahid Hussain of Nuh’s Bada madarssa said he has been in constant touch with the administration ever since coronavirus cases started emerging in the region. “ It was a mutually beneficial relationship for both sides. People followed the lockdown rules and stayed inside. We made sure that people cooperated with the health teams. People abided by the lockdown rules and offered prayers, including the Eid and Jummah prayers at home,” he said.
Along with making announcements over loudspeakers in mosques, social media and community radio stations were also used to quell misinformation and spread awareness on physical distancing. Community radio stations such as Radio Mewat and Alfaz-e-Mewat aired special programs on Covid-19 providing reliable information and serving as a bridge between the government and locals.
Siddique Ahmed Meo, social activist and community historian, said the administration’s approach of working with the locals had strengthened its fight against the pandemic. “Village heads were asked to inform the authorities about outsiders who had their concealed travel history from the administration. Village heads communicated with these individuals and convinced them to get in touch with the administration. At some places, people themselves reached out to the government, and in other instances, the administration came to take them to quarantine facilities. The mutual arrangement worked for the district,” said Meo.
