Aid workers in rural India warn of 'unnoticed disaster' as Covid spreads

A doctor measures a patient's oxygen levels

A volunteer checks a Covid-19 patient's oxygen levels in Delhi. In rural areas, even pulse oximeters like this are scarce. Image: Vijay Pandey/DEC

The devastating impact of Covid-19 in rural India is becoming apparent as DEC charities are highlighting shortages of simple devices and tests that we take for granted in the UK. 

Here it is not only oxygen and ventilators that are in short supply – even pulse oximeters to measure oxygen saturation levels and thermometers are commonly unavailable, according to HelpAge India.  

The health facilities in rural districts in states like Bihar are far less prepared for this wave of Covid-19 than those in the capital Delhi, where a lack of beds, supplies and oxygen have led to people dying while waiting for treatment. The real rates of Covid-19 in rural areas are thought to be three times higher than reported due to lack of testing.  

The country director for DEC charity Tearfund said what’s happening in rural areas is an “unnoticed disaster”.  Prince David said: “The biggest concern I have at the moment is the growing numbers of new cases and increasing infection rates. While lots is being done to bring relief to people in the cities, most villages in rural India simply do not have the infrastructure to allow people to travel to access medical treatment. 

Save the Children’s Madhura Kapdi, Director of Campaigns and Communications, said the media reports suggested that the cities and larger towns are far more affected, but she believes it's spreading fast into rural India, away from the best medical care and health services. “We’re really concerned about that right now and the needs of the communities we work with.   

“For example, we work in Nashik city in Maharashtra, which has seen a very high Covid caseloads. In fact, until last week it had the highest caseload in India. So, we are working there to make sure that the health centres are better equipped to handle the pandemic. The focus is entirely right now on saving lives.” 

Bihar, which neighbours Nepal in the east of the country, has only one third of the doctors and nurses needed, with many suffering from Covid themselves, says Girish Mishra, Programme Coordinator at HelpAge India, local partner of Age International.

Even so, health workers are seeing 100-200 patients a day. Mishra adds: “there is a huge lack of health workers to provide the services needed.  People are very nervous and agitated about the situation.” 

Save lives

Help DEC charities scale up their work in rural India.

Locally sourced aid 

DEC charities are working hard to source simple medical equipment, cleaning packs for hospitals and health centres, and PPE to protect health workers and frontline aid workers, as well as hygiene kits and food for the most vulnerable families. 

These are locally or regionally sourced within India – not flown in from other countries. 

While there has been evidence of bottlenecks at airports of medical equipment and supplies, this is from bilateral aid – given directly from other governments to the Indian government – and not DEC-funded aid. Madara Hettiarachchi, Director of Humanitarian Programmes and Accountability at the DEC, said DEC charities are providing intensive support to India in the same manner that they have been throughout last year, moving supplies and equipment across, not into, India.  

She said: “DEC charities are equipping frontline medics with basic equipment to keep them going – gowns, gloves, masks, hospital cleaning kits – and providing individuals and families with food, personal hygiene kits and sanitiser all sourced locally. For logistical reasons that’s easier to deliver than flying in aid supplies, with the added bonus of stimulating the local economy that has been affected by Covid-19 lockdowns.” 

Rather than aid not getting through, DEC charities are much more concerned about the Covid-19 risk to their local aid workers. “The one thing that our member charities have repeatedly told us, is they're concerned about the safety and well-being of their staff,” Hettiarachchi said. “These aid workers have got the weight of the world on them as they're trying to look after vulnerable communities in a country that's ravaged by Covid.”

Vulnerable communities at risk 

HelpAge’s Mishra believes the Covid rates are much higher than is being officially reported because people are hesitating to visit the testing centres. Even when they are convinced, Covid-19 tests take five or seven days to get a result and people are unknowingly infecting others during this time. 

She explains: “They feel they will be treated badly in their families and communities if they test positive for Covid. In Bihar, for example, the real rates are possibly double or triple the reported rates.”   

The virus itself is not the only issue for rural families. Many young people who had migrated to cities have returned and are now a ‘burden’ to families. Mishra says: “People in Bihar are already poor, especially those affecting by floods; now they are struggling to survive.” 

Prince David from Tearfund said the most pressing issue is the impact of the pandemic on rural communities’ livelihoods and their ability to meet the immediate needs of daily life. He said: “For many, managing the daily nutrition of themselves and their families is the primary concern. These are people who were already living in disaster situations – with little income and high levels of deprivation.  

“While Covid strikes both the rich and poor, for the rural poor already living in cramped conditions, with poor nutrition and limited access to medical services, their susceptibility to falling seriously ill is much more pronounced.” 

Tearfund is providing cash and vouchers so that people can feed themselves and buy other essentials, as well as introducing cash-for-work programmes, connecting people to labour projects that create livelihoods and helping build infrastructure benefiting the community.   

With more funds they would scale up these initiatives. 

David adds: “My message to the world would be that India is not standing alone in this. What happens to us, affects the rest of the world. We’re incredibly grateful for the international community’s support and would encourage them to continue standing firm with us to ensure that this crisis can be contained and doesn’t impact the rest of the world.”