Owing to a month-long effort, on 12 May 2021, among the community of 16,000 persons only 117 positive cases were reported, and only 2 among them had needed hospitalisation. No deaths were reported.
Bhuigaon in the city of Vasai city in the Mumbai Metropolitan Region, houses approximately 16,000 persons. In early April 2021, when the COVID-19 cases were on the rise, people in these areas were struck by fear, as in other parts of the country. The frequent reported shortage of hospital beds and oxygen supplies increased panic levels. Messages and updates via WhatsApp and on news channels fuelled fear and confusion. From 1–11 April 2021, 11 deaths were reported from this locality, including that of 2 youth, and 22 people were hospitalized in total.
Seeing the increasing disarray around them, the locality’s activists, community leaders and volunteers got together. They reached out to the doctors and nurses in their area to get a better sense of the situation in hospitals and health centres, and to deliberate deeply on how they could work together. The interactions helped them create a list of what was needed for community support.
‘We all know that not everyone who tests positive for COVID-19 needs hospitalization, and yet the fear in the community was growing daily. When we listed out all areas that needed to be looked into, we were more prepared for what we did next’, says Mecanzy Dabre, one of the leading members of the community response efforts who hails from the region and is also the Deputy General Secretary of the National Hawker’s Federation.
The group identified 11 areas of support and divided themselves into teams focused on the logistical and procurement requirements, health monitoring and supportive infrastructure needs, delivery of food and medicines to families that needed them, sanitisation of homes of community members post COVID, and more.
To allow for quick testing of all exhibiting COVID symptoms in the community, the team tied up with local government health centres. From 10am–1pm daily, both the RT–PCR and rapid antigen test were available to community members at a nearby school premises. The tie-up also ensured that the RT–PCR test report would be available in 24 hours, and a panel of doctors was available for online consultation thereafter, if a community member wished to consult with them. For those requiring a CT-Scan, the tie-up made with a local health centre ensured that appointments could be made in 30 minutes. The team had kept a local autorickshaw on hire, which was sanitized regularly and available for those who needed it to travel for their tests/consultations and back. For emergency cases too, the team had tied up with a local health centre to streamline the hospital admission process, and access to oxygen/ICU/ventilator beds.
At the 4 hospitals located nearby, the team planned for oxygen cylinders to be supplied and be regularly refilled. An oximeter was mapped to every 100 households in the community, should they require it. To regularly check on people’s blood pressure and blood sugar levels, one nurse was mapped to every 1,000 members in the community. Besides this, sanitisers, PPE kits, vitamins and other basic material was procured for the community needs and for the health workers.
22 nurses committed to participate in the community monitoring efforts. They were organised in shifts, so that they could balance this voluntary support to their community along with their jobs at health centres where they are employed. ‘This way, whenever we received a call, we knew who to direct it to and within 30 minutes they would respond’, says Dabre.
Once the systems were in place, people started feeling more assured of reaching out for support, should they need it. The team focused on constantly spreading more awareness about COVID and its symptoms, so that community members could watch their health better. They kept reinforcing the need for masking, maintaining social distancing and following other COVID-appropriate behaviour. They requested the church leaders to make videos and share, which also reinforced the needed behaviours. If someone tested positive, the team encouraged them to seek medical support, take the prescribed medication and quarantine at home for the entire duration. Positive cases were also tracked by the team continuously, and it helped them better understand the overall community health situation.
With the community members already knowing each other to some extent, it was not necessary for the team to publicise their efforts much. WhatApp was extensively used and the team kept sharing detailed updates on the community situation and the need to keep following all safety protocols.
Another important area was to ensure that those who are infected with COVID do not leave their homes before their quarantine period is over. The team would try to keep an eye on the household, to ensure this did not happen. They would also be in regular touch with the household to check on how the family members were doing. ‘We would keep assuring them that we are with them, and they should not feel alone and try to keep negative thoughts away. Along with fighting the virus, in the second wave we were also fighting fear and panic to a large extent. We really worked to ensure that people did not give in to fear’, says Dabre.
These interventions were also made at a very cost-effective budget. Only Rs 1 lakh was spent by the team in a month. Many people had already bought oximeters, which were then tagged to different household clusters. Some community members had also been so impressed by the collective efforts that they had donated to keep things going.
A month since their efforts, on 12 May 2021 the community only had 117 positive cases, and only two among them had needed hospitalisation. No deaths were reported. Only 6 nurses had needed to volunteer finally, among the 22 who had showed interest.
The efforts by the team in Bhuigaon reveal just how powerful community-based efforts can be, even in tackling the COVID virus at its peak. As committed people came together and set in place a strong system to monitor and manage the disease, people in the community could gain more confidence and adopt measures to keep their health in check and overcome the virus spread.
