By Toki Blah
Corona or Covid 19 status of the state continues to dominate Meghalaya news channels and sad to say the news grows grimmer and gloomier by the day. The irony is that people thirst and long for news of Covid negativity but all they get is the ever increase of Covid positive cases. Various factors may be responsible for this increase but the real point of worry is a question that hangs heavy in the monsoon air – are we heading towards a community transmission of the disease? Government or the authorities concerned stoutly maintain that we have yet to reach that stage. The administration still continues to depend on the strategy of testing; contact tracing and quarantine, either at home or in pre-designated centres. There is still the belief that the plague can be contained with this approach. Lockdown of the entire city is seen as the answer to enable such tracing to be successfully conducted and to manage the disease. It is not the intention of this write-up to quibble over such a Covid approach. A question however continues to linger unanswered – what do we do if community transmission does happen or has already started? Are we prepared? The focus of this essay therefore is directed towards such an eventuality and its management and is not meant to criticise or demean the good work that the Government has done and achieved so far. Instead it is an attempt to peer into portends of the future and of things to come.
So far, from the official side it is the Government as an institution and the District Administration that have taken a head on confrontation with the disease. In this struggle the Govt has also been ably partnered and assisted by our grass root establishments of governance, the Dorbar Shnong in the Khasi Jaintia Hills and the Nokma and his A’king in the Garo hills. One can say that it is these three institutions, their officers, doctors, health workers, office bearers and voluntary workers that have been in the forefront in Meghalaya’s war against the Corona virus. So far the strategy employed has been home and community quarantine for those contact traced. In the process three lockdowns have also been resorted to. Lockdowns however are not people friendly and neither are they business or economically responsive; certainly not for business nor for livelihoods of the poor and daily wage earners. We can’t afford to disturb the normal flow of life too frequently or for too long a period. The health of the economy is as important as our physical wellbeing. Yet lockdowns seem to be the only response we can think of when Covid 19 appears to be getting the better of us. So, is there a possibility of a change of strategy or of a paradigm change from overall lockdowns to something else less devastating?
Let us, at this point. accept a hard fact of life and acknowledge the possibility that in the near future, the likelihood of the disease assuming community transmission status cannot be discounted. Do we then resort to another lockdown and more extended lockdowns? Are the current containment practices adequate or can they be improved upon? Can the Government continue with the belief that it and it alone, on its own, manage and contain the plague? Covid 19 is contagious. It spreads in the community and Governments all over are having an uphill struggle to contain this spread. That is its greatest threat and the biggest challenge confronting humanity. The whole world recognises this and the worldwide search right now, together with the hunt for a vaccine, is for a paradigm that can introduce community management and control of the disease. Community management of the disease will actually entail behavioural change in individuals of the society and the society as a whole. In a society like ours it will mean everyone wearing a mask 24×7; keeping social distance; staying at home and desisting from the usual habit of neighbourly visits for a chat and a gossip; discontinuing our usual community habit of gatherings at deaths, weddings and other social events. Question is can the above be enforced and how?
For containment and prevention of spread of the disease, Government had come up with directives on a set of preventive protocols. Unfortunately these are honoured more in the breach than in observance. It happens because people usually take the institution of Government and what it says with a pinch of salt. There is a belief that Government is alien; something foreign; far removed from the day to day concerns of the common man. For community management of Covid to happen in our state, communities need institutions they have faith and confidence in. Institutions they pay heed to. Institutions they can participate in. Institutions that people believe they own and they manage themselves. Community institutions that people can depend on to interact on their behalf on issues that influence their day to day lives. We have them in the form of our traditional grassroots institutions of governance. Government has already recognised the validity of micro management of the disease through containment zones. Incidentally each zone is co-terminous with the jurisdiction of its respective Dorbar. The micro-management of Covid can now be handled at the zone or shnong level instead of an overall lockdown for the entire city, district or state. We have an alternate Covid management paradigm. It can be micro-managed at the Dorbar level.
Dorbars however have a complaint that Government recognises them only when it requires their services. In the fight against Covid 19 the services of the Dorbars are of course crucial but meetings between Government and Dorbars should no longer be ad-hoc in nature but based on a predetermined Covid Management Plan of Action (CoMPA)? CoMPA will specifically focus on the empowerment of our Dorbars to make them better and more effective allies in the Government’s tussle with Covid 19. The micro- management concept will greatly depend on CoMPA’s ability to predetermine the specific roles for both Dorbars and Government. Firstly the Dorbars come on board with the public respect they enjoy and this asset can be used to enforce the social protocols so desperately needed in the prevention of the spread of the disease. Secondly, not every Covid case needs hospitalisation. Crucial hospital space can be reserved only for critically ill or severe case Covid patients while the less severe can make do with home or community quarantine. Such intermediary Covid aspects can be managed by the Village Covid Management Teams already in place with each shnong, if ably supported by the administration.
In such a scenario the Government reverses its role from an active implementer of Covid Management to that of facilitator of such management, which now will be more community and participatory centric. Government can concentrate on creating or providing infrastructure which is so inadequately lacking or missing. Perhaps a cluster of shnongs (or synjuks where they already exist) can be facilitated through the provisions of doctors for better health care prospects for each synjuk. Government can also start thinking of facilitating the setting up of community Covid quarantine centres for synjuks who do not enjoy such centres. Government can also start thinking on designating a Covid specific hospital for only Covid patients. The present practice of Covid wards in every hospital is causing apprehension, havoc and inconvenience to non-Covid patients and runs the risk of shutdowns of crucial hospital facilities in case of a community outbreak. Nazareth and NEIGRIHMS can be still used as testing centres but let’s free them from Covid treatment so as to allow their services, especially the super specialist assets of NEIGRIHMS, for other types of patients. There has to be an overall Plan of action in the fight against Covid. These are some passing thoughts towards less lockdowns for our state. There could be more relevant issues that can be highlighted and more learned and experienced persons could also contribute their thoughts towards this debate.