Kerala Model On Healthcare Archives - Lokmarg

Politics, it seems, is one part of national life that does not go into lockdown. Beneath the appearance of the whole country united in dealing with the Covid-19 pandemic, the undercurrents of State-Centre relations continue.

These are testing times for Prime Minister Narendra Modi who hopes to come out of this with national as well as international compliments on his handling of the crises.

But it is the chief ministers who are actually doing all the heavy lifting in tackling the Covid-19 pandemic in their respective states. And they are not all getting the equal recognitions or complete support they deserve.

Faced with a serious public health emergency and a looming economic crisis, the chief ministers have a lot at stake and are, therefore, putting their best foot forward in managing the deadly coronavirus outbreak. They know they will be judged by their handling of the crises.

Kerala chief minister Pinarayi Vijayan and Rajasthan’s Ashok Gehlot have come in for praise for their quick and deft management of the pandemic. Kerala was a step ahead of other states as a proactive chief minister lost no time in announcing a slew of social welfare measures and initiated steps for setting up quarantine centres and testing facilities. Kerala has an advantage over other states as successive governments have invested heavily in health infrastructure. Gehlot also displayed similar alacrity in ordering an immediate shutdown, door-to-door surveys, testing and monitoring in Bhilwara when it was hit by a rush of infections. The Bhilwara model has since been replicated in other states.

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Among the other chief ministers – Bihar’s Nitish Kumar and West Bengal’s Mamata Banerjee – face a big challenge as Assembly elections are due in both the states. Bihar goes to polls later this year while elections in West Bengal are due next year.

Of the two, Nitish Kumar has to be on top of his game because the Bihar Assembly elections are to be held this November which gives him a small window of opportunity to contain the pandemic. The chief minister’s handling of the corona crisis will predictably be a major issue in these polls and have a huge bearing on Nitish Kumar’s electoral prospects. Though his government is making all-out efforts to procure testing kits and protective equipment for the medical staff, the chief minister has a tough task on hand as Bihar does not boast of a strong health infrastructure.

Then there is the troubling issue of migrant workers from Bihar who have been working in other states but now wish to return home as they have no jobs or money. Nitish Kumar was initially reluctant to facilitate their return as there was a fear that the infection could spread to the rural areas with the influx of such a large population. He first transferred a sum of Rs. 1,000 each to the one lakh-plus stranded migrant workers but later agreed to ferry them back after the Centre made necessary arrangements for their journey home by train. Nitish Kumar was forced to give in because migrant workers are an important vote bank as most of them invariably come home to cast their vote.

As BJP’s alliance partner, Nitish Kumar has been fortunate to get special treatment from the Centre which is more than willing to bail him out. The saffron party also has a big stake in the coming assembly election in Bihar. Nitish Kumar is further lucky as the opposition in Bihar is leaderless and hopelessly divided.

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Mamata Banerjee, on the other hand, has a match on her hand as she has to contend with a strong and powerful rival in the BJP. There is simmering tension between the Modi government and Mamata Banerjee with the Centre accusing her of withholding accurate figures of the corona cases and for not providing adequate quarantine centres and further lagging behind in testing. She has also received a lot of flak for indulging in minority appeasement by not enforcing the lockdown too strictly in the minority-dominated areas during Ramzan. To make matters worse, West Bengal governor Jagdeep Dhankar has shot off a series of letters to Banerjee charging that she had committed “monumental blunders” in handling the pandemic.

Desperate and working hard to expand its footprint in West Bengal, the Centre has been particularly critical of the Trinamool Congress chief as the BJP believes this is an opportunity to show Mamata Banerjee in poor light.

Although West Bengal had ordered a lockdown before the Centre’s announcement and took necessary measures to manage Covid-19 cases, the Modi government chose to send an inter-ministerial team to the state for an on-the-ground assessment of the situation. This led to a war of words between the BJP and the Trinamool Congress with Mamata Banerjee accusing New Delhi of playing politics by singling out West Bengal for this treatment. Banerjee further alleged that the Centre had deprived West Bengal of its share of taxes and ignored her requests for additional funds required by the state to manage the pandemic.

While the Centre has not missed this opportunity to discredit Mamata Banerjee, it has been more generous towards BJP chief ministers. Madhya Pradesh’s Shivraj Singh Chouhan, Gujarat’s Vijay Rupani and Uttar Pradesh’s Yogi Adityanath are struggling to contain the rising number of infections in their state but not too many questions are being asked of them by New Delhi.

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Chouhan has a convenient explanation that he did not have sufficient time to make the necessary arrangements to deal with a crisis of this magnitude since he had taken over as chief minister when the pandemic had already gained a foothold in the state. However, Chouhan has no explanation for the fact that he had failed to appoint a health minister for nearly a month after he was appointed CM.

Unlike Chouhan, Vijay Rupani ought to have done far better as he inherited the famed Gujarat model of development, put in place by Narendra Modi when he was chief minister. This was expected to serve him well in the current situation. As it happens, the rate of infections in Gujarat is high and is continuing to climb.

Rupani’s lacklustre performance in managing the pandemic is matched by his poor handling of the large number of the restless migrant workers who were housed in makeshift camps in Surat and Vadodara. There have been several instances of violent clashes between the police and the migrants who wanted to go back home, giving the distinct impression that no one was in charge.

Similarly, Yogi Adityanath’s efforts in dealing with the pandemic have also been found wanting. He is not helped by the fact that Uttar Pradesh’s health care infrastructure is shoddy to say the least. But, in his trademark style, Yogi Adityanath has conveniently added a communal tinge to Covid-19 pandemic and blamed the minorities for spreading the virus after a number of infections were traced to the Tablighi Jamaat assembly in Delhi. This has been exploited as a timely distraction from his government’s incompetence.

Though Modi is being heaped with praise for his decisive leadership in this hour of crisis, the fact is that it is the chief ministers who have led from the front in this battle. There have been some signs of tension between the Centre and the states over the lack of funds and centralisation of powers by New Delhi but, for a change, the Modi government has chosen to listen to the chief ministers. It agreed to lift the ban on the sale of alcohol, as demanded by the chief ministers, as it had deprived the state governments of a huge source of revenue which, it was pointed out, could have been used to ramp up their health infrastructure.

It is now to be seen if the Centre will put aside politics, be a uniting force, go a step further and release the pending share of taxes to the states and provide them with the monetary assistance they have demanded to help them deal with the corona crisis, whether they are pro or anti BJP.

State-Centre politics has not gone into lockdown, but it will be wise for Modi’s BJP to suspend it at least until the nation gets through the crises.

Fighting an epidemic like Corona requires scientific temper, humanism and a spirit for inquiry and reform. I strictly follow scientists and experts than those who eulogise on the imagined benefits of cow dung and cow urine.
–KK Shailaja, Health Minister of Kerala

As early as late March this year, impossible things were happening in Kerala. An old couple, aged 93 and 88, were admitted to the Kottayam Medical College. Their son and his family, upon return from Italy during the last week of February, had infected the elderly.

Placed in the high-risk category by international standards, considering the high mortality rate of older people globally due to the pandemic, they were already inflicted with multiple ailments, typical of old age. The man had heart and breathing problems, which deteriorated into a heart attack in the hospital; he was put under a ventilator.

Indeed, when the entire health system in the country and world over had put their hands up on old patients, especially those above 60, the medical staff and doctors at the Kottayam Medical College successfully saved the lives of the husband and wife. Kerala Health Minister KK Shailaja ‘Teacher’ was directly in touch with the hospital staff, assuring total support of the government, and successfully implementing the policy of decentralized micro-management. Almost a month later, a warm farewell was given to the couple by the hospital staff as the two left for their destination to Pathanamthitta.

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Indeed, India’s first three positive cases were reported from Kerala, in just about two days in early February this year. The three patients were discharged, totally cared, after 15 days.

Why Kerala has become a model state has many outstanding reasons of current and long-term achievements. For instance, the same health minister led from the front in 2018 and 2019, to combat the Nipah virus outbreak.

During the devastating floods in 2018 and 2019, the entire Kerala, the state, its citizens in the rest of India, and those working in the Gulf, pooled in resources even as the central government gave a pittance as relief. The state machinery worked from the grassroots onwards, one step forward and two steps back, and painstakingly managed to resurrect the ravaged landscape into a new and pulsating entity. Even secularism was strengthened when religious places opened their compounds for prayers, shelter and food for all concerned, even while the waters of the flood roared outside.

This is an era of the information, and we are so proud of the global village. That America is a democracy is proved every day when US President Donald Trump, who hates the hostile free press in his country, holds a press conference on the dot, and answers the most difficult questions. He does not always indulge in a monologue, like the rare ‘speeches’ of the president for life in China, Xi Jin Ping, of what is clearly a totalitarian advanced capitalist nation-state.

At home, Prime Minister Narendra Modi has not addressed a single press conference since May 2014. And in the current bleak scenario, both his home minister and health minister seem to be decisively missing.

Even an otherwise accessible ‘aam aadmi’ chief minister like Arvind Kejriwal, ground reporters crib, is refusing to answer questions, not even on Whatsapp or in a digital press meet. He diverts questions, and reportedly indulges in a one-way discourse, thereby consolidating what is a total information clampdown, on good or bad news, or what is in store for the people in Delhi and elsewhere.

Not so in Kerala. Chief Minister Pinarayi Vijayan has spoken to the media almost every day with regular updates, good and bad, about the state health scenario. Mostly, it is good news, and future projects. The state government, indeed, had agreed to ease local transport for workers, open book shops and restaurants, but the Union home ministry reportedly shot it down, for reasons only they know.

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Indeed, it will be worthwhile to give credit to the low profile, hard-working, straight-talking, simple and stoic chemistry teacher-turned-politician called KK Shailaja ‘Teacher’. A hands-on minister, she is at the frontlines with her resilient mantra of ‘science over superstition’ in the most highly literate state in India. In that sense, once can draw parallels the ‘woman of science’ – Germany’s Angela Merkel.

According to reports, as early as in the month of January, when the first ominous signs were emerging from distant Wuhan in China, the health minister noticed the ‘alarm calls’. Her first reaction was that there were students from Kerala out there, perhaps trapped. “I sat together with the health secretary and discussed what to do because we knew a lot of Malayalee medical students were in Wuhan. We had the experience of Nipah, whereby we could not identify the first patient before he transmitted it to four family members.”

Hence, emergency measures were taken from the beginning even as help was reached out to the students. The airports in the state were kept on high alert from the beginning; this reporter was stopped for enquiry at the Kochi airport in early March. What is the origin of your destination, I was asked. When told that it was Delhi, they let me pass, even as foreigners were quarantined in comfort.

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In top international tourist destinations like at the Kovalam beach resort near Thiruvantharam, or at the bustling Fort Kochi with its exquisite sunsets, old churches, Chinese fishing nets and huge ships sailing into the horizon across the Arabian Sea, there was a heightened state of awareness about the epidemic. Social distancing was being practiced without any overt formality, and the foreigners were treated with utmost respect and friendliness, with the local administration going out of their way to make them comfortable. Indeed, most foreigners have reportedly chosen to stay back.

Kerala’s discharge rate is very high. The mortality rate too is low. Said Minister Shailja: “Coronavirus mortality rate in Kerala is below 0.5 per cent, but in the world it is more than 5 per cent. In some places, it is even more than 10 per cent. Most of the people who are in isolation in the hospitals are stable and very few are in critical stage. We are treating them with utmost care. The discharging or cure rate is also very high in Kerala because of our systematic work. We evaluate everything every day.”

Sources in Thrissur inform that the virus has been declared almost totally controlled in Thrissur, Kottayam and Idukki. This is no mean achievement when the entire world is reeling under the pandemic.

The latest is the robot, as in China. Now ‘Nightingale-19’, designed by young innovators with the solid backing of the health department, is being used to provide food and medicines at the health centres in Ancharakandi in Kannur district. This is also a first in a ‘model’ state, where atleast 4 lakh migrant workers, designated with dignity as ‘guest workers’, have been given rations for three months, comfortable shelters and health care and counseling. In that case, there was no crisis in Kerala, when it came to the ‘guest workers’. So much so, ‘Opposition’ MPs, Mohua Mitra and Shashi Tharoor, joined in to speak to the Bengali workers directly through video, in Bengali, asking them to feel comfortable and not to worry at all.

Indeed, this can only happen in Kerala.

Tag: Kerala Model On Healthcare

Statism In Time Of Pandemic