COVID19 Lockdown: An indefinite Season of No Work

The plight of the migrant workers in Kerala during the time of COVID-19 outbreak.

Internal migration is a key feature of Indian social life, and it sway over the economic prospects of the major industrial cities of the country. Migrants usually occupy poorer quarters, live in despicable environments, and often face discrimination at their place of work. Being a marginalised community on economic grounds, the woes of the migrant workers, by and large, go unnoticed by the authorities,who treat them as second class citizens and exclude them from all walks of the society. In the wake of COVID-19, the lives of the migrant workers have turned out to be even more difficult as the state has no definite plan for their survival.

The declaration of national lockdown in the light of COVID-19 struck in the ears of the migrant population in major industrial towns in the country as a death knell. It left them with confusion, uncertainty and fear. So, they began their homeward journey in the belief that they would at least have something there for sustenance.

Accompanying the announcement, the Central government directed all the state/UT governments to ensure the safety of the people within their boundaries irrespective of their nationality or state of domicile till the end of the lockdown. It also mandated to curb their movement via any means and continue in the places where they are now. States, hence, all of a sudden, became responsible for accommodating a large mass of people following the WHO guidelines.

It seems the BJP led central government was least prepared and had no clear strategy to combat the pandemic. This insensitive act may have an adverse impact not only on the health of people, but it can also lead to a total paralysis of the economy.

Migration and Health during a Pandemic

Migrant workers account for the lion’s share of India’s workforce, especially in the informal sector and buttress the Indian economy to a great extent. According to the Census 2011, there are around 139 million (accounting for inter- and intra-state movement) migrant workers, and the yearly average of inter-state migration for jobs stands at nine million. This trend has increased exponentially over the years. Also, the Employment-Unemployment Survey (2015-16) reports that 80% of the total workforce in India takes a job in the informal sector and, therefore, falls out of the ambits of social security endowments.

Internal migration in India is the result of uneven wealth and development distribution. The mass movement in search of profitable occupation is a symptom of a waning rural economy. The decision to abandon traditional jobs such as agriculture or animal husbandry comes from the adverse conditions prevailing in rural India. In essence there are poverty, resource depletion, recurrent environmental hazards, financial liabilities and population pressure Also, the rapid expansion of the cities to the rural regions takes over the land and livelihood of many, and leaves them homeless and jobless. Hence, to attain economic stability, people are forced to move into cities in large numbers.

For decades, the agriculture sector in India has been crying out for help to stand upright. Its prolonged distress has arisen from the continuous instances of crop failures, debt, dropping product prices, and increasing expenditure. Natural calamities like drought, low monsoon, and water shortage have added to the crisis and put the livelihood of 40% of the population in peril. States like Andhra Pradesh, Bihar, Gujarat, Maharashtra, and Rajasthan face the adverse impacts of climate fluctuation. According to a 2018 CSDS study, people abandoning agriculture and moving to cities stands at 71% and 69%, respectively. The main attractions in the cities are better jobs, education facilities, and the healthcare system.

A city does not accept the migrants as its people as soon as they settle there. For the native city dwellers, migrant people belong to ‘cattle class’ . They face discrimination in almost everything, including wages, living standards, job security, accessibility to services such as schooling and healthcare, working environment. The inhuman treatment by the locals, employers and authorities, and poor life conditions lead them to a state of acute stress and insecurity. Gradually, they become increasingly vulnerable to hazardous health issues. Given the poor living environments of the migrants, they can become potent carriers of infectious diseases. This grim reality implies the gravity of the situation when they are left uncared for at the time of the COVID-19 outbreak in all major Indian cities.

Migration and health are inseparably connected. Migration in most circumstances may entail higher health risks. The International Organisation for Migration lists three aspects of migration. They are; the comparison of health conditions of the migrant population at the origin and destination, the effect of migration on the public health in general and concerning systems that respond to the migration and health.

Several factors ranging from safe transportation, living standards to access to a quality healthcare system affect a migrant’s health. These factors constitute the social determinants of health. These factors play a vital role in the maintenance of a healthy migrant society and lack of measures to ensure them may bring about severe negative impacts.

Migration has to be dealt with adequate caution because it can flare up social disasters and crises in the form of epidemics. Authorities should provide necessary healthcare facilities to accommodate the growing migrant population. The possible issues like spread of communicable diseases have to be addressed. Mostly migrant communities live in crammed, filthy environments offered to them by agents who recruited them and have no access to quality life conditions. Declaration of lockdown has brought them unemployment and loss of wages. This forced them to search for alternate means of sustenance. The Government’s failure to ensure the needs of migrant workers made the situation calamitous by forcing them to march back to their homes. This mass inverse migration might facilitate the diffusion of the virus into Indian villages and may end up an increased number of infected cases in uncontrollable levels. The result of this will be a dangerous phase of community transmission.

To combat the pandemic, India needs an efficient health system equipped with the workforce as well as machinery, such as ventilators, in proportion with the population to combat the pandemic. Despite the claims to have free and affordable public health care services across the country, the government health systems prove to be inadequate and ill-furnished to cater to the rising demand during emergencies like the COVID-19 outbreak. The only recourse then is private institutions, which, as everyone knows, are out of reach for the poor.

A study published in BMJ Open pinpoints the acute shortage of health staff as basis of the falling standards and poor accessibility of the healthcare sector in India. According to the study, the total number of health workers in India is 2.5 million, which means there are 20.9 health personnel for each 10000 people. But in states like Rajasthan, Uttar Pradesh, Madhya Pradesh, Bihar, Jharkhand, Chhattisgarh, Assam and Meghalaya, the density falls below the national average at 10-16 workers per 10,000 population. These are mostly sites of origin of migration into which the migrant people return in large numbers as potent carriers of COVID-19. The either undeveloped or mismanaged health care services in the rural areas in India present a bleak picture of India’s fight against the pandemic. Only 36% of the total health workforce is available for the 71% of Indian population living in rural areas. The proportion of health staff in private and public enterprises too signals a grievous situation. More than 4/5th of the doctors along with 7/10 of the nurses and midwives are concentrated in private hospitals. The given data reflect how health services are inaccessible to the daily wagers in the time of unemployment.

It is urgent to take an account of facilities available in the limited number of health centres. National Health Profile - 2019 reveals that there are 7,13,986 total government hospital beds available in India. In other words, there are 0.55 beds for every 1000 people. In the case of senior citizens, it is 5.18 beds per 1000 people. Much to our dismay, twelve states including Bihar, Jharkhand, Gujarat, Uttar Pradesh, Andra Pradesh, Chhattisgarh, Madhya Pradesh, Haryana, Maharashtra, Odisha, Assam and Manipur, which house 70% of the total population, lag significantly behind the national average in the number of hospital beds.

The deficiency in the number of beds may add to the escalating danger. Besides, the ventilator facility is also indispensable as 5-10% of affected people require it. Given the current estimation of the potential of total public healthcare services, it has become increasingly doubtful whether India can contain the outbreak before it progresses to the next phase: the social transmission.

State crisis and Deficiency of Political Will

The state’s incapability and lack of political will to rise to the expectation on the first alert and act discreetly is matter of concern in the time of COVID-19. China began its fight against the Virus within two days of the official announcement of the outbreak on 21 January 2020 by imposing a complete lock down of its epicenter Hubei and other provinces. WHO issued a warning on 10 January 2020 regarding the possible pandemic and reiterated with a more serious note on its destructive power. On 13 March 2020, WHO signaled Europe becoming the new epicenter of the pandemic. As the Virus spread progressed globally and reached almost all world nations, The Indian seemed to move rather sluggishly towards a holistic plan to combat its threat. Except the blanket stoppage of international travels, it appeared to have failed in calculating the civic crisis it could bring to the marginalised.

The Prime Minister Narendra Modi and his government took the matter seriously only on 19 March 2020 and immediately gave a call for a nation-wide curfew called Janta Curfew, as the first step. Death toll in Italy stood at 3,405 on the day. This clearly states how unmindful a regime can be of its people and country.

The next move was the imposition of a lock down a few hours after the end of Janta Curfew, understanding the gravity of the situation. Lock down could not be as irresponsible as this; with no thought on the labour-lost daily wagers and movement of essential goods and services and severe lack of communication with states with regard to arrangements. The worst affected are migrants who have no one to feed them in such an insecure time.

With the total blockade, the migrants and daily wagers are left at the mercy of the state governments. As Prime Minister, Modi should have emphasised and put in place a mode of operation to protect the crores of people suddenly from starvation and lack of safe shelter. Migrant workers suffer more in the heat of the lockdown since they cannot claim the benefits of National Rural Employment Guarantee Act or the Public Distribution system, boons for many a local daily wager. The state should have envisioned a special plan for them as well, which it did not. Amidst the economy taking unpleasant directions and a period of unemployment rate at its high, India may also fall victim to an unprecedented economic crisis and ensuing problems unless the government acts responsibly.

Modi in his address to the nation hailed National Lock Down as the principal weapon to win the battle against the COVID-19, and regretted the inconvenience his subjects were made to suffer due to it. By the time he pronounced his apology note, at least twenty two migrant workers had become victims of the Virus; the actual number seemed to be higher. It awakened the centre from passivity and order was immediately sent out to the states to ensure food and shelter for the migrant workers and keep them locked in the respective states they work. The honourable Supreme Court also sought details of measures taken by the Centre to check the outbreak.

The directions to the state gave the permission for the State Governments to utilise the money in the State Disaster Response Fund (SDRF) to cater to the needs of the migrant workers. In stark contrast to other states that awaited directions from the Centre, Kerala had already begun its fight against COVID-19 and taken steps to hold the ‘Guest Workers’ on to it.

Guest Workers not Migrant Workers for Kerala

Kerala has always been a model to the other states especially in the matters of equity and social inclusion and has won international acclaim for its social indices, comparable to developed nations.

Kerala being one of the states with higher influx of Migration workers,is actually progressing in constructing a comprehensive and accommodative approach towards the workers coming in.The state will probably have a migrant population of more than thirty lakhs as per different reports. The migrant workers in the state enjoy the privilege of being the 'guests' of the state,as the term 'guest worker' which is widely used here denotes. They have better access to Health, Education and housing compared to any state in the country.

Many measures have been implemented to ensure the welfare of the Guest labourers in the state. Aawas, Apna Ghar, Changathi etc are few programs in this regard.

Immediately after the left government under the leadership of the Chief Minister Pinarayi Vijayan, came into power in 2016, it pronounced the launch of an ambitious insurance plan named 'Aawas' for the migrant workers. Currently, the plan takes measures to enroll all migrant workers in the states and entitles them with free healthcare.

The government now moots for "The Kerala Migrant Workers Social Security Bill" to address various issues faced by the Guest workers in the state. It became the first state in the country to introduce a welfare scheme like this. More than 4 lakh labourers have registered for this scheme so far.

On the other hand, ‘Apna Ghar’ is an initiative for safe and clean hostels for the migrant workers. This may be one of the first of its kinds to be implemented in the country. The government opened one in the Palakkad district on a pilot basis, which can house 1500 workers. Apart from that, the state has already set up labour camps for them and extending the camps to all districts is under way. In addition, to understand the grievances of the migrant directly, there is a plan on the pipeline to establish kiosks and call centres manned with people well-versed in Hindi.

The effort to teach the migrant labourers Malayalam and Hindi languages through Literacy Mission is another commendable step from the part of the Kerala government. For it, the government publishes textbooks like 'Hamari Malayalam' textbooks and 'Changathi' and offers classes in most unlikely places such as factories and auditorium apart from anganwadis and union offices, libraries and shelters. The inclusive policy adopted by the Kerala government has been working out well in the time of crisis as it helps to rope in the migrant workers too in the battle against COVID-19.

According to the data disclosed by the state, the Kerala government has undertaken the shelter, food and medical attention for 2.83 lakh guest workers in 14,308 temporary labour camps set up across the state. Community kitchens are established under the control of local self governments to ensure food for the members in each camp three-times a day. Provisions such as Atta, Dal and vegetables are supplied to those who have food preferences. Medical support is also taken care of by the government and options like health screening and Mobile Clinic are sought for populated camps. 

On the day one itself, the Kerala government rose to full swing and began working out a plan for containing the spread of the Virus. ‘Disha’ an helpline for information regarding COVID-19 was launched immediately to enable communication between the patient and the health workers. Then, state-wide awareness campaigns were conducted to apprise the people of the impending danger and the need to maintain hygiene and physical distancing. ‘Break the Chain’ is such a campaign that has gone into each nook and corner of the state and beyond. To a great extent, campaigns helped raise the alert among the people by plugging the communication gap that could have subverted all the plans. In the meanwhile, stringent measures have also been against hoax messages and unscientific practices to prevent the misinformation from circulating. Unlike in other states, the Chief Minister himself comes live on Media every evening to update the COVID-19 status in Kerala and the decisions of the state governments are also detailed on a daily basis.

To increase the awareness among the migrant workers, brochures, leaflets and short videos were prepared in Hindi, Odia and Bengali, and circulated among them. Health workers who could communicate in Hindi were deployed to interact with them and make them understand the gravity of the situation. GoK Direct, Kerala government’s official app for real time updates related to COVID-19, has the information of the number of infected cases and route maps of the patients posted in languages such as Malayalam, English, Bengali, Hindi, Tamil and Kannada. This enables everyone in the state to have direct information and prevents misinformation and hoax messages.There is also a dedicated helpline introduced which enables the Guest workers to raise their queries and redress their grievances.

Amidst the government and state walking the tightrope, there have been attempts to backstab from some anti social elements for mean political gains. Migrant labourers have in a few places taken themselves to streets stirred by local political interventions. They are found to be fed with misinformation that scared them outright. But in reality, best possible arrangements are put in practice by the state government through the network of the revenue department, labour departments and local self governments. Also, the state requested the interventions of heads and leaders of all religious and political groups to give a call to everyone for a joint effort to fight the disastrous situation, which they whole-heartedly agreed and lent their support for the cause. 

As of now, assessing the interventions from any government body in the country, Kerala is a long way ahead in the calculation, planning, and implementation of various strategies to contain the pandemic, with unswerving from its duties to the general public on all matters. When India has opted for suppression as a measure, Kerala has gone for more social investments and taken care of the needs of people irrespective of where they come from and their status. To repeat the tweet of the eminent journalist Rajdeep Sardesai “What Kerala thinks today India must think tomorrow”.

Sreekumar NC is a research scholar at the Center of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi.

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