‘Dharavi model apt for dense urban areas’: Kiran Dighavkar
Kiran Dighavkar, assistant commissioner of G-North ward which covers Dharavi, explains the Dharavi model.Updated: Jul 17, 2020 22:52 IST
What is the Dharavi model, which will be replicated in the Mumbai Metropolitan Region (MMR) to curb the rising number of cases?
The Dharavi model is most apt for locations where social distancing and home quarantining of patients and high-risk contacts is not possible, mostly slums. Aspects of this model can be used in dense urban areas with high cases, such as organising fever camps, early detection, quarantining suspected Covid cases and institutional quarantine of a large number of high-risk contacts.
WHO or ICMR direct contact-tracing on a massive scale. But in Dharavi, contact-tracing is difficult because 5,000 people are using one toilet block. The only thing in our control is proactive work. We are chasing the virus, as opposed to people identifying they are unwell, doing a test and coming to us. We arrange a large number of fever camps, screen residents, identify suspected Covid-19 cases and shift them to institutional quarantine facilities. When we aim to conduct maximum fever camps and tests, we will identify more cases and high-risk contacts and will need more institutional quarantine facilities. We acquired schools, colleges, installed beds and doctors monitored the facilities 24x7, supplied free medicines and gave free meals.
How will you be involved in helping municipal commissioners of the MMR to implement the Dharavi model?
I presented the Dharavi model before the municipal commissioners of MMR when I accompanied Maharashtra minister Aaditya Thackeray, on his request. The main point is augmenting capacity at institutional facilities, and ensuring they have good amenities. When a person is agreeing to leave his home and stay at a quarantine facility, it is our job to ensure he is comfortable. The more high-risk contacts you remove from the community, the faster the spread of infection stops.
Public-private partnership and community participation are crucial. The Dharavi model is about community support too. The support government received from private doctors, hospitals, NGOs, volunteers and elected representatives was excellent.
What is the present situation in Dharavi?
Our active cases are a two-digit number, hardly 97, and 2,070 people have been discharged. There are 2,415 cumulative positive cases. Doubling rate of Dharavi is 345 days. The infection growth rate is 0.4%.
Dharavi’s mortality is high with over 200 Covid deaths at least?
In G-North ward, including Dadar, Mahim, and Dharavi, there were 72 deaths in April, 167 deaths in May, 33 deaths in June, and two deaths in July. We are using early detection, hospitalisation and treatment.
Beyond this, mortality figures are not in the ward officer’s hand once the patient goes to a hospital.
A death is reported by the hospital to the epidemiology cell, which verifies it and then confirms it as a Covid death.
As the unlock process starts in Dharavi, what is the most challenging aspect?
The situation is very dynamic. Labourers who had left Dharavi in March and April are returning after seeing relief in the area. Many factories have started.
There are many house helps and sanitary workers, who work across the city, staying in Dharavi. There is a possibility cases will surge again, or they may not.
My only worry is this success should not go in our heads, and we should not assume we have tackled the virus for good, and no more cases should show.
We will keep screening and testing. We are working on behavioural change of residents for cleanliness and sanitary habits, especially while using community toilets.
I also want to create a permanent Covid health care infrastructure in Dharavi, like we built a 200-bed hospital in front of Maharashtra Nature Park, with oxygen supply beds in a record 15 days in April.
This will be converted into a permanent structure.