A Rapid Assessment of the Preparedness of Institutional Quarantine Facilities in Ganjam by YSD

By Bibhu Prasad Sahu, Berhampur: Berhampur, approximately 5 lakh people living outside Odisha are expected to come back to the state after the completion of the lockdown period on May 3, 2020. A large proportion of these migrants would be returning to Ganjam district from states such as Maharashtra and Gujarat, which have been one of the major hotspots of positive cases of Coronavirus in the country. In anticipation of the large number of incoming migrants, the Government of Odisha has issued a set of guidelines to the Sarpanchs’ of all Gram Panchayats in the state to effectively deal with the situation. The measures include registering of all returned people at the concerned Gram Panchayat; mandatory stay of all people who have returned in a Panchayat level Quarantine facility for 14 days along with necessary provisions of food, water, and sanitation; health checkup of quarantined persons including screening of COVID-19; and provision of an incentive of Rs. 2000 (Rupees Two Thousand) after successfully completing the quarantine period, among others.
Keeping these guidelines in mind, Youth for Social Development (YSD), a grass roots not for profit development organization based in Ganjam district has conducted a rapid assessment of quarantine centers with an aim of understanding the preparation of institutional quarantine facilities in Ganjam district as mandated by the Government of Odisha. The assessment evaluated the capacity of the Gram Panchayats in the preparation of handling the incoming migrants after the lockdown period, and observed the existing infrastructure available for the setting up of the quarantine center facilities. The rapid assessment of panchayat level quarantine facilities was conducted across 18 Gram Panchayats (GPs) in three blocks of Ganjam District – Purusottampur, Khallikote, and Kabisuryanagar.
The assessment was through observation of quarantine facilities and semi structured interviews with the Sarpanch (PRI) members over telephonic interviews. The interview questionnaire had a mix of qualitative and quantitative questions aimed to cover various aspects to understand the nature of facilities necessary for effective registration and isolation of migrants in quarantine centers set by the Gram Panchayats. The questions covered multiple themes which aimed to explore the demographic details of the 18 case study panchayats, physical facilities available at the established quarantine centers, availability of health infrastructure and healthcare officials at the center, administrative capacity of the Gram Panchayats in the handling of the quarantine center, and anticipated issues by the Sarpanchs and their prospective solutions.
The findings of the survey informed us that the
a. Gram Panchayats seemed to be grossly unprepared with respect to the number of migrants expected to return. The total number of beds in the 120 existing quarantine centers across the 18 Gram Panchayats were 6950 which would not be enough for the already registered 10914 migrants as on 28 April, 2020. The number is bound to increase as the sarpanchs expect approximately 18500 people to return based on their assessment.
b. It was observed that majority of the quarantine centers did not have any special arrangements for pregnant women, children, and the elderly .While majority of the quarantine centers had access to functional toilets, water supply, bathing facilities, and electricity connections, many centers were still in the process of construction of toilets and bathing facilities in their premises.
c. Most of the GPs had the presence of healthcare officials in their quarantine centers in the form of doctors, anganwadi and ANM workers. However, it was surprising that very few panchayats till date had procured gloves and masks, which too were limited for use.
d. Many sarpanchs expressed their fear of the existing quarantine facilities not being enough to cater the large number of migrants who would visit after the completion of the lockdown, thus hoping for additional financial support from the state governments for the running of the centers.
e. Officials in Gram Panchayats also hoped for additional security in anticipation of possible disturbances in the centers, and an additional support of ambulance services and healthcare officials. The officials themselves were also worried about the possibility in a spiraling increase of positive COVID-19 cases in the region once people living in other states start coming back and the officials would have to be directly exposed.
With respect to policy suggestions,
a. Our study findings clearly indicate that the state and the district administration need to closely monitor the functioning of the quarantine centers and the provision of all facilities. The government needs to ensure that funds are released in a time bound manner so that the quarantine centers can function effectively in the provision of sufficient beds; basic infrastructure facilities such as toilets, bathrooms, drinking water; healthy meals for the quarantined people; and medical facilities such as availability of healthcare officials, testing equipment, ambulance support, and availability of sufficient masks, gloves, PPE kits, etc.
b. The GPs also need to be transparent and accountable in the provision of all adequate facilities which could be done by listing of all the entitlement information (such as details of facilities and the incentives provided) in the quarantine center for everyone to be aware of.
c. Our discussions with sarpanchs from the 18 gram-panchayats made us aware of how a majority of them were concerned about managing the security in the quarantine centers. There are possibilities of indiscipline to occur when a large number of unknown people would be cooped up in a room for two weeks. People might protest or even attempt to run away from the centers as it has been occasionally observed in other states. Therefore, presence of police personnel deployed at the quarantine centers would help in controlling the unruly crowds in case of such situations.
d. At the same time, such situations of indiscipline can also be negated with the provision of recreation activities at the center to keep the people engaged. Entertainment facilities such as television and radios could be kept for people to spend time. Activities such as painting of the walls, repairing of the school building (or any structure acting as a quarantine center), and other similar tasks can be told to be addressed based on the skills of the people living. Such activities would not only keep the people engrossed through the day, but would also keep them mentally active instead for them to be sitting idle. The government could also incentivize such activities by paying people in engaging themselves for such tasks.
e. It would be a matter of utmost importance to take note of the mental health of the people in the quarantine centers. Not only they were stuck for a couple of months in other state, but they also would have had harrowing experiences just to be able to come back. And then they would be told to spend the next 14 days in the quarantine center instead of immediately joining back with their family members which they would be longing for. Therefore, it would be beneficial for the administration to arrange mental health counsellors in each GPs for arranging sessions with the people.
f. At the same time, the government should ensure provision of special arrangements for children and adolescents to keep them active and engrossed through the 14-day period for them to play and learn. Similar such arrangements need to be made only for people with disability and senior citizens in the quarantine centers.
g. The state government firstly needs to ensure that the stranded and distressed migrants receive free travel. While workers and their families are going through severe panic and anxiety on a total lack of clarity about their return plans, the prospect of paying large amounts of money just to come back does not help their cause.
h. Secondly, the state government has to ensure that Aadhar based registration is not made mandatory for the registration of the migrants who are willing to come back to their homes. Experts have suggested adequate testing to be jointly carried by both states to reduce the burden on the quarantine centers in the state.
i. And finally, the state and the district administration needs to closely monitor the functioning of the quarantine centers and the provision of all facilities. It needs to ensure that funds are released in a time bound manner so that the quarantine centers can function effectively. It is only the implementation of all of these factors in unison that can soften the impact on the migrants, and help the states negate the spread of COVID-19.
j. Finally, there have been multiple cases that have come recently about the stigmatization of the people who are infected with COVID-19. This includes frontline warriors such as doctors, nurses, paramedics, sanitation workers and police who are in the frontline to contain the spread of the disease. With the rampant spread of misinformation on social media, it becomes the responsibility of the government to negate the atmosphere of fear and suspicion towards certain communities and migrant workers. Therefore, the government needs to take action through awareness programs among communities for maintenance of social harmony and compassion among people in these testing times.