COVID-19 in Rural India: Converting Spaces

By: Laura Elias Casas
Photos By: Aina Valldaura

Until the last week of March the teaching activity at the Professional School of Languages in Anantapur (Andhra Pradesh, India) was developing as usual. However, in front of the sudden threat of the COVID-19 world pandemic, the space has been reconverted in order to take in the unit of obstetrics and gynecology of the nearby Bathalapalli Hospital.

Both the school and the hospital are run by the non-profit organization Rural Development Trust (also known as RDT), created by Vicente Ferrer in 1969 with the aim of helping people from some of the most remote spots in India to get out of poverty. The service area of the organization are the states of Telangana and Andhra Pradesh, where most of the population live from agriculture in a rural and disadvantaged context. RDT has several projects going on at the time devoted to helping on different areas such as community health, habitat, education, labour insertion, ecology, culture, and women empowerment.

The Professional School of Languages is part of the Women Empowerment project, a center for graduate women from disadvantaged backgrounds who have little chance to enter the job market. After a selection process, those women who are given a place at the Professional School (all aged 21 to 25) stay for an academic year at the Bukkaraya Campus. There they develop various skills such as English language, communication, and IT, which will be useful for them in the near future in order to find a job and become economically independent. Apart from potentiating the students’ level of English, teachers at the Professional School help the students to learn another language, that can be French, German, or Spanish. Then, after eleven months of training, they start applying for jobs in cities such as Bangalore or Chennai, where the range of opportunities is vast and they can fill a vacancy in a big company.

Unfortunately, the academic activity at the school has had to change abruptly due to the coronavirus crisis. “The project has had to become virtual, but it hasn’t stopped. It has shown its non-visible part, its essence, its soul. It’s made of a wish to learn and to share, that’s why it’s immune and no virus can stop it,” explains José Antonio Hoyos, the coordinator in charge of the Professional School.

After having to close all the educational centers of the organization on  March 19th, the teaching team reacted rapidly to organize the project online, as there were still four months ahead to finish the course. “We realized that we had plenty of resources close by, as the smartphone is a device that has penetrated into the rural parts where our students live,” says José Antonio.

With the new situation, phones have become indispensable for the students of the Professional School. Twice a week, teachers call the students’ families to check on their health and send them homework. With the new situation, they have had to follow the lessons from their hometowns, as the organization took the decision that they should go back home to prevent further infections.

Today, in the classroom where four months ago there was a Spanish language lesson, a gynecology consultation is taking place. The District Collector has appointed Bathalapalli hospital as an exclusive COVID-19 centre, and the medical staff are already working flat out to try to stop the rising curve. Meanwhile, all the consultations not related to the virus have been relocated, in order to prevent the number of infected people from growing. Now, the maternity unit is at the Professional School.

The reconversion of the space was pretty easy due to the fact that the building had been a family planning center before. In only three days, the new gynecology facilities were ready. The RDT’s fast response to the crisis comes from their will to keep mothers and babies safe and sound. There have been already more than one hundred deliveries conducted in the readapted hospital the last few days, all of them successfully. Nevertheless, the medical staff are worried about the blood reserves, as people cannot move freely due to the lockdown, and they are more reluctant to go to medical centers for fear of getting infected. There are around one hundred children with thalassemia who need blood transfusions once or twice a month, and depend on these reserves.

Bathalapalli Children Hospital is taken as a medical unit of reference in the area, as there are not many hospitals which offer the same conditions. Thus, it is a highly specialized point in neonatology and pediatrics. Now, all those women who come from afar in need of the obstetrics and gynecology services will have the opportunity to be properly assisted at the educational campus. The rearrangement, however, is entailing some problems due to the lockdown. The Indian Prime Minister Narendra Modi decreed on March 24th a first lockdown period of twenty-one days, which was later extended until the curve flattens. Anantapur was declared a hotspot, meaning people cannot leave their homes except to buy essential needs or in case they work “on duty COVID-19.” For this reason, one of the main challenges that families looking for gynecological services have encountered is the lack of transportation, as mothers come from remote areas of the region to the hospital to deliver or make their consultations. Due to the lockdown, getting around has become more difficult, as accesses to the city have been cut to help to prevent the situation from getting worse. In order to drive around the city, a special permission is needed. This permission is only given to those vehicles carrying out essential services. RDT has obtained the permission to use the organization’s vehicles to distribute food, make face masks and help medical staff move around.

The hospital is located in a medical complex. Apart from the pediatrics unit, RDT provides other services dedicated to improving access to health for the disadvantaged rural communities. An example is as a specialized centre for infectious diseases, in this case for HIV and tuberculosis. This unit is still working, although with a lower influence than usual. Thanks to outreach workers, they are being able to provide with medications all those patients who need them and cannot reach the hospital.

Regarding the attention of patients suffering COVID-19, Bathalapalli didn’t receive patients in a critical state until May. At first, most of the people who attended the place were asymptomatic or had mild symptoms.  But lately, the increase of more serious cases has been sharp. Among the facilities, they are provided with beds in an intensive care unit, as well as numerous beds with oxygen supply.

RDT has been collaborating with local authorities since the first case was reported in March. Luckily, Anantapur citizens’ response has been highly positive. “People rapidly took the initiative: they made face masks with fabrics they had at home, marked the distances with white chalk in local shops, and collaborated with the authorities to identify who had come from abroad and had to be self-isolated,” reports Aina Valldaura, RDT communication manager.

The new hospital is providing regular training to all the medical staff, so that they stay updated regarding treatments and equipment. Apart from fighting at the frontline against the virus, all health professionals working at Bathalapalli Hospital have to face the stigma of being healthcare workers. Some neighbors living in the surrounding villages threatened nurses and doctors for fear of becoming infected. RDT has provided accommodation for those workers whose will is to stay at the complex instead of going back home after their shift.

In a country of 1300 million inhabitants, a “stay at home” slogan is not enough. And definitely, not easy to accomplish at all. Around 70% of the country’s population works in the informal sector and do not have any savings nor pension. Since lockdown was decreed, hundreds of thousands of people found themselves with no money overnight, and with no way of going back home as public transportation was cancelled. RDT has been distributing food rations and basic hygiene provisions for more than 115,000 people. Aina outlines the solidarity shown in general these days, as RDT central campus has been receiving daily donations from peasants, disabled people assembly leaders and other individuals.  These donations will permit the food distribution program for migrant people and day laborers who now have been left with nothing.

These proofs of community feeling and solidarity are another sign of the adaptability with which people are reacting to this completely new situation. The way the Professional School has been rearranged to hold the maternity unit of the hospital is a great example of the capacity of reinvention and adaptability of the volunteers working at the frontline. India is going through a pandemic crisis just like the rest of the world, but meanwhile, life continues blooming and growing.

Laura Elias Casas is a secondary education teacher and writer based in Barcelona. She has done several workshops and talks for RDT, and has taken part in two volunteering projects at the Professional School of Women in Anantapur, India. She is deeply interested in women empowerment, travelling and literature.

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