Mahesh Chander Sudan
We, the people of JKUT, are concerned to note that the prevalent infectious virus is no more urban centric and has started affecting rural people. It is a serious challenge for both the people of rural India and health care system to adopt focused strategy to educate people, activate available health centers to follow standard COVID protocol for tracking, testing and treating affected patients. The rural health care infrastructure is grossly inadequate, insufficient and undermanned in terms of trained medical and paramedical staff to handle the situation. The presence of private entrepreneurs in health sector remains limited to urban areas owing to commercial viability of the business. It therefore demands that local governments are to solely undertake the responsibility and fight the surging infection with professional competence to minimize loss to rural segment of population and the rural economy. It is also an established fact that rural health services lack capacity and competence both and the complacency gained by the rural population during first wave of COVID 19 needs to be tackled diligently.
As it stands that the participation of private enterprises in health sector in JKUT is negligible, the responsibility of local administration therefore increases manifold. Analysis of the existing health infrastructure across UT indicates that there are around 3300 health institutions categorized into seven types based on their infrastructural capacity. Most of the rural territory of JKUT is covered by Primary Health Centers and sub centers manned by health workers for outreach services such as immunization, basic curative care services, maternity and child care and preventive health services.
A look at the average rural area and average radial distance covered by health institutions in JKUT is much below the all India average. Few examples of average rural area (Sq. Km) for sub center is 117.21 for our UT against 21.47 national average and the aerial distance of 6.111 against 2.61, for Primary Health Centre it is 591.67 against 139.40 and for Community Health Centre it is 2766 against 771 for All India average. This comparison clearly indicates that health care infrastructure in rural area is substantially weak and it therefore needs revamping to meet the challenge posed by most infectious virus. There is acute shortage of doctors and para medical staff especially in the rural areas and this issue has time and again been given highlighted in the local media.
Existing minimum rural health care system with acute shortage of doctors needs immediate attention of the senior officials of the Health Department to cope up with emerging health concern of the poor people and to contain surge of infection in the country side. Consolidation of health infrastructure in terms of Primary Health Centers, sub centers and ASHA workers could be an asset to help medical and para medical staff to handle COVID patients. Local revenue staff, VLWs, BLOs and other panchayat officials could help the system in establishing a direct and on ground contact with the rural population.
We may have to modify COVID protocol suiting to local conditions for effective management of containment zones with least disturbance to farming, dairy, poultry and other vocational activities depending on the geographical location of the affected area. Far flung hilly habitations scattered in small groups may be handled in localized method without losing focus on scientifically proven health care methods. It may therefore require a multipronged approach for educating people about the epidemic, methods of prevention and specific protocol of using mask, keeping physical distance and necessity of maintaining hand hygiene to break transmission of virus.
Education. It is seen that the virus during first wave remained by and large restricted to densely populated urban towns and cities and hardly affected countryside. This somehow made rural population to believe that COVID is an urban disease that can hardly affect them and this caused them to be complacent about it. They are therefore required to be educated about the disease, its method of transmission, precautions required to be followed and ultimate consequences of the disease in case it turns serious. Each aspect of the protocol needs to be explained repeatedly to make them believe that the virus is serious, infectious and its chain of human transmission is dangerously potent. Stay home, stay safe is the essential tool to avoid spread of epidemic. They are required to be acquainted with COVID appropriate behavior and significance of strict adherence to dos and don’ts. Educating villagers about national vaccination drive may also help in preparing them to opt for vaccination without any hesitancy.
Patient Management. All primary health centers of the rural area may possibly be converted into mini COVID hospitals that would help treating mild and moderate patients locally and only seriously affected patients could be transferred to district/Provincial Hospitals accordingly. Home isolation/ quarantine may not be practical for lack of sufficient para medical staff to provide required medical supervision especially in hilly terrains. However, tracking and testing of the people in rural area may be activated through trained ASHA workers. The role of local panchayat officials in bridging the gap between health care workers, doctors and the patients would prove practical in arresting the spread of disease and cure of affected villagers with least loss of life.
National Vaccination Drive. Local UT administration of the rural areas is required to speed up vaccination process in villages to prevent virus from spreading uncontrolled. It is almost an accepted fact that the required vaccination drive has so far remained largely restricted to urban areas owing to logistical arrangements and less human resource. Vaccination is considered to be an effective measure to prevent and control human transmission of virus as on date.
A large segment of population lives in villages and spread of virus in the rural areas will hit us very hard. It is rightly said that no one is safe on this planet until the last person is vaccinated. Infection has already invaded rural areas and it would certainly turn into a seriously unmanageable issue for UT administration due to geographical nature of the involved territory unless we rise to the occasion and build an invincible force aligning all stake holders to fight the pandemic by providing required treatment to affected citizens and ramp up our vaccination drive to create herd immunity to save precious lives. Jai Hind, Jai Bharat.
The author is Wg Cdr (Retd)
feedbackexcelsior@gmail.com
Follow our WhatsApp channel
