ICARE workshop on community engagement in Covid prevention

Syllad | The Rising MeghalayaDecember 20, 2021

ICARE a civil society organisation organized the first of its kind consultative workshop on community engagement in Covid prevention where a free and  candid discussion between Government officials, heads of traditional institutions and concerned individuals was facilitated. The workshop which was organized in collaboration with the Indian Council for Social Science Research(ICSSR) North Eastern Regional Centre. NEHU was organized in a hybrid mode owing to Covid protocols.

ICSSR Hon Director, ICSSR, NERC, Prof B Panda while initiating the discussion said he was happy that such a meaningful debate on a live issue is being organized at the Centre. The ICSSR he said provides financial support to colleges and universities for carrying out social science research. “We believe in collaboration with the market, government, community and civil society in facilitating discourses and expanding the development space. We believe every research should have social outcomes,” Prof Panda said and expressed happiness at the collaboration with ICARE.   

Prof Sumarbin Umdor, Economics Department, NEHU and member ICARE while laying out the background for the workshop said he realized about two decades ago when he was part of the IFAD project facilitating a training for health workers, the importance of coproduction which means engaging the community. He explained how the word coproduction was first coined by Prof Elinor Ostrom of the University of Indiana in the 1970s to explain to the Chicago Police why crime went up the moment police stopped relying on community policing and started getting into their patrol cars. Umdor emphasized on the distinct advantage of working with the community in furthering government efforts.

Prof Nanda Kishore Kannuri of the Public Health Foundation of India, Hyderabad made a presentation on the importance of consultation and participatory planning when dealing with a pandemic like Covid. He said information sharing by Government agencies is crucial and health communication should be culturally sensitive and contextualized. Trust building is essentially in trying to bring about  behavioral change such as wearing masks, maintaining social distance and hand washing etc., as part of Covid prevention.  Prof Kannuri pointed to the Kerala model of addressing pandemics such as the Nipa virus through the engagement of the panchayats and various other community stakeholders and the government as a positive social mobilisation strategy. He also spoke of the constant need to check and challenge misinformation.  

Principal Secretary Health, Govt of Meghalaya, Sampath Kumar recalled how difficult the first phases of the pandemic were when stigmatisation prevented patients dying of Covid from even getting a burial space. But with time and the coming together of the Dorbar Shnong and various community leaders and when the fear psychosis was addressed then the Dorbar Shnong of Pomlakrai village asserted that they would take responsibility of the person testing Covid positive from the village and look after her quarantine needs. This was the beginning of the end of stigmatization of people who tested Covid positive, Kumar said.

Sampath Kumar also spoke of adaptative leadership where all stakeholders in society and not just the Government would be part of the solution. “When there is a crisis people look for solutions and they think all solutions will come from the Government. When Covid first struck there was no data and no way of knowing how to address it except through normal medical intervention. However, the Government quickly adapted by setting up a State Level Medical Expert team comprising doctors from government and private institutions to try and find solutions. This team contributed significantly.

 “We had to do a lot of data mining and mapping to break the transmission and the Indian Institute of Public Health (IIPH) Shillong was of great help in putting together that data. We had to build the health system to prepare for the Covid crisis and started with four ventilators and also trained medical personnel in Covid interventions. We also ventured into capacity building of communities and created 7000 Community Covid Management Teams (CCMT) and 2000 community run quarantine centres.” Sampath Kumar said adding their biggest challenge was to dispel the fear psychosis, rumours and misinformation around Covid.

Speaking of vaccine hesitancy, Sampath Kumar said the design for public health communication could have been better managed. In the second phase of Covid it was felt that building the capacity of the community so that they better understand the knowledge of medicine and health care and take responsibility instead of relying too heavily on the administration. The Government is now formulating a health policy where community engagement vide Village Health Councils can be institutionalized. Kumar underlined that in Meghalaya, malaria used to be the number one killer but after the ASHAs were trained to test malaria patients and to give them the required medication the number of malarial deaths have come down significantly. Hence a similar training for tackling Covid is in the pipeline.  

Mission Director, National Health Mission, Mr Ram Kumar while addressing the meeting said that across India there was no community engagement in the initial phases of the pandemic. People thought it was to be managed by the government.  “unless the community owns the initiatives, no pandemic can be contained. However when Government engages with the community it should be ready to speak to all kinds of people and not only those they are comfortable with. Government should answer questions even when it does not like the questions or the person asking the question. Transparency is important.

Ram Kumar also stressed on the importance of the data and said that all the data that has been mined should be institutionalised. “There was no oxygen crisis in Meghalaya because we were in a better position to predict the oxygen requirement thanks to the data. It is important to build a credible and objective data team,” Ram Kumar said adding, “Use data to respond, not react.”  

Mr RL Blah, President of Synjuk Ki Nongsynshar Shnong ka Bri U Hynniewtrep (SNSBH) who has been in the forefront of mobilizing community engagement particularly during the first Covid phase explained how this body had put their lives on the line to help address the crisis. “During the first Covid wave there was complete lockdown so we could handpick the best professionals as members of the CCMT and use their services. We set up quarantine centres for the returnees comprising students and workers from outside the state. Apart from providing them sleeping facilities we also provide them with WiFi knowing how lonely they would feel. For all of this we used the Dorbar funds and contributions from well wishers. We never expected any payment from the government,” Blah informed adding that they set up 40 quarantine centres.

At the personal level Blah said he was so involved that he had to be tested 17 times and quarantined on four occasions. He also understood then that stigmatization was real when people started to avoid him.      

Blah rued the fact that the state government was dragging its feet over giving due recognition and empowerment to the traditional institutions when they are most connected to the people at the grassroots and they are institutions that are still recognized as the best social mobilisers as they have the trust of the community.  

Blah admitted that during the second wave things fell apart because the professionals had to attend to their duties and could no longer volunteer for Covid duties.

Blah also pointed out at the sincerity of the Shillong Municipal workers who went beyond the call of duty to cremate people who died of Covid even including those beyond Municipal limits. He felt that the Government should have recognized these selfless souls.

Blah also informed he gathering that after Christmas the SNSBH would be going to Mawkynrew and Jongksha to meet the 65 Dorbar Shnong along with the Shillong All Faith Forum to dispel the myths against vaccination and explain to people that now with the Omicron threat, vaccination is the only answer.