COVID-19: The Unfolding Predicament In Villages Of Thar Desert Of Rajasthan

by | May 15, 2019

The Thar Desert expands to 2,00,000 square kilometres and Bikaner district covers over 27,244 square kilometres. The climate and terrain makes it the most inhospitable and forbidding place in the country with temperatures reaching below freezing in winters and in excess of 48℃ in summers. Rains are infrequent and do not exceed 27 centimetres. Depending on rain and yield season, families here live moving between the village and their Dhanis (hamlets). This makes even basic facilities in health, education and governance difficult to, both, access and deliver. The public infrastructure remains very limited and mostly defunct. The distances between villages and Dhanis make availability of appropriate medical care a logistical difficulty, especially, in case of an emergency. Sometimes the average travel distance to access the most basic health service could be at a minimum distance of 50 kilometres. Reaching out to a specialised doctor might be over 150 kilometres travel, at times.

Appropriate medical facilities are only available at the block level while any specialised diagnosis and treatment can be made only at the district headquarter level. In spite of the implementation of multiple government schemes, the system continues to lack in its reach and capacity. The number of PHC and CHCs are also very limited. Infrastructural constraints are further intensified by lack of substantive knowledge, awareness and behavioural limitations about health.

The situation has been aggravated as COVID-19, a “once-in-a-century pandemic”, has gravely hit the invisible sections of rural desert communities this time. Migrant labourers, farmers, artisans, pastoralists and daily wage earners are among these worst affected sections. The soaring number of cases, fatality and the continued restriction in movement has intersected with their pre-existing disadvantages, bringing to the fore income insecurity, inequalities, discrimination, anxieties and misinformation.

As tragedies stemming from the current wave of COVID-19 pandemic roar in Indian metropolises, less visible ones are rampantly emerging in the villages. Rural areas of the Thar desert in Rajasthan are no longer just a receptor for returning migrants but already a site where resources and coping mechanisms have been stretched or non-existent. In contrast with last year when around 70 people had tested positive between April 2020- March 2021 in Bajju Tehsil, this year the number of positive cases has crossed 200 in less than a month.

“Situation is worsening by the day. Everyday people from Bajju and surrounding villages of Bangadsar, Bhaloori, Mithadiya, Charanwala are flocking to the OPD and nearly 50 patients are showing active symptoms on a daily basis. Limited information amongst the village communities and scanty resources in the Community Health Centres is now burdening the already overwhelmed healthcare facility.” says Dr. Yadav of Bajju village CHC in Bikaner district. Over 204 residents in this village with a population of around 8000 have tested positive between April and May. However, hundreds have not gotten tested either because of lack of testing kits or unawareness!

The steep surge in the number of COVID-19 positive patients in these remote villages is a matter of grave concern given the limited health infrastructure, overworked staff, abysmally low awareness and lack of basic facilities. The Kolayat block of Bikaner, comprising 209 villages, has 3 CHCs in which only 2 have COVID-19 facility wards. These 2 wards are running with a capacity of 10 beds each, all of which are currently occupied. In lack of the supporting ecosystem, patients are being referred to PBM Hospital, Bikaner. Such accounts coming in from the field, point that the times of distress will quickly turn into a catastrophe of unimaginable scale, if not addressed immediately.

The pandemic has caught the rural population unguarded and unaware. The underprepared system is finding itself handicapped in reaching out to the distant hamlets in the Thar desert for provision of services as well as information dissemination. “16 people in our village had tested positive of which one patient, Admana Ram, died of the virus. He was a truck driver and had travelled from Delhi when he first started showing symptoms. We are more vigilant of the situation ever since but now even the ASHA’s are hesitant in going to the infected households for checkups and distribution of medicines”, Savitri Bishnoi, Sarpanch, Mithadiya village.

What’s worse is that the actual spread is still not known owing to a very small fraction of people getting tested because of lack of access, availability and awareness. The Bajju CHC receives a total of 100 testing kits in one batch with no definitive frequency of the next round of supply. These are being utilised in a single day.

This is further exacerbated as there is no access to instant information channels. In a survey conducted by Urmul Seemant Samiti, with 126 Camel Herding households in Bikaner and Jodhpur districts of Rajasthan, over 82% people in the 45-60 age group did not take the vaccine. They owed this to their doubt on efficacy of vaccines, low digital literacy and lack of availability and know-how of processes. 15 of these 126 households have COVID-19 positive patients in them. Jaswant Singh from Gokul village while sitting outside the COVID facility centre in Bajju, attending to his father Swaroop Singh who was admitted there, shared with a heavy heart, “I think the doctors here gave my father COVID. He was completely fine at home. Only his oxygen level was low as told by ASHA didi, but how could he have COVID?” On further introspection he said, “We had attended my cousin’s wedding in Barmer. 12 of us went there and upon return 4 people had fever. But all of them are fine now, how come only my father contracted the virus? I am sure the doctors here gave him COVID”. Swaroop Singh was admitted in a critical condition. He was tested COVID positive and is also diagnosed with acute diabetes and is currently on continuous oxygen support fighting for life.

The response has to be rapid, deep and coordinated, given the fact that the virus is spreading like wildfire. In the absence of timely action there will be no light at the end of this tunnel.