By Gratia E Dkhar & Naphishisha Nongsiej
Meghalaya has managed to avert high casualties in the first Covid wave. But the state that maintained low positivity rate soon saw a rapid surge in cases and by April 29, 2021 the state had registered a caseload of 16,617. The steep rise in infection and deaths revealed that the second Covid wave would be more severe than the first. This time around, the disease began spreading into the hinterland where medical infrastructure is scarce. Of the many villages that had to bear the brunt of the second wave was Khweng, in Bhoirymbong block, Ri Bhoi District.
The residents of Khweng were coming to terms with the loss of two of their elderly knowledge holders, when on April 29 they received news of an attendee at one of the funerals having tested Covid positive. In about 14 days over 130 active cases were registered, an alarming surge for a village that has only about 114 households, indicating community transmission. The Deputy Commissioner, Ri Bhoi had then declared Khweng and the adjacent village of Liarsluid as a containment zone. With many of the members of the village Covid Committee also testing positive, the two villages immediately formed a 10-member Joint Committee to tackle the virus.
With the high possibility of community transmission, the Committee working closely with the Community Health Centre (CHC) in Bhoirymbong requested all households to self-isolate themselves for a period as determined by the health department. The Committee made sure that correct information related to the virus, signs and symptoms, precautions and management were disseminated to people. To avoid any panic, the Committee urged its residents to dispel myths and rumours received from unvalidated sources. Daily public announcements and making regular rounds of the village also came handy in treating those showing Covid symptoms.
Since widespread testing was essential to monitor and reduce viral transmission the Covid Committee, together with the CHC, organised a point-of-care testing in an open field in Liarsluid. The high turn-out of villagers from Khweng and Liarsluid for the voluntary screening helped in early identification of the infected households. Over 1000 community members including adolescents and children were part of the screening. With frequent testing and contact tracing, identification of infected individuals, secondary contacts and isolation was made possible. Secondary exposed individuals were quarantined before they could infect others, thereby preventing further onward transmission of the virus.
The Covid infected individuals were advised home quarantine due to lack of designated care centres and quarantine centre in Bhoirymbong cluster. The community hall was used as a quarantine centre during the first wave but was discontinued as it lacked basic facilities and inadequate financial support to maintain the centres. In some cases, individual homes were turned into quarantine rooms and the unaffected members were shifted to homes of close relatives who had tested negative. Home quarantine proved to be the biggest challenge as most families lived in shared accommodation with limited rooms, using a common kitchen, bathroom and toilet, making it impossible to maintain social distance. Though home quarantine has helped in halting the spread to other households in the community, it also saw rapid spread within households, where in some cases all family members of primary contacts contracted the virus within days.
To contain the spread, a review meeting of North East Slow Food and Agrobiodiversity Society (NESFAS) was held with the Covid Committee where it was agreed that setting up a quarantine facility was imperative. NESFAS-REC (Rural Electrification Corporation) Foundation with CHC supported the setting up of quarantine centres at the Khweng Community Hall, Khweng Lower and Primary School and the Liarsluid LP School with a total capacity of 40 beds. Basic facilities like lighting, beds, mosquito nets, water, sanitation and food were arranged for the facility. NESFAS provided the Committee with Personal Protective Equipment (PPEs). Four portable oxygen concentrators were donated to the CHC to address medical emergencies. Random testing was conducted where 18 new cases were reported and were subsequently shifted to the quarantine facility in the presence Dr. T. Sutnga, Medical and Health Officer, CHC, Bhoirymbong. The rate of positivity drastically dropped once the patients were isolated in the quarantine centre.
Declaring the area as a containment zone coincided with the sowing month, leaving the residents anxious as they were dependent on farming. Livelihood activities were hampered and food security was at risk. Villagers were worried about making ends meet. To tackle this problem, the Committee identified families likely to be deeply affected by the pandemic. Households in the community came forward to support those vulnerable families who have lost their sources of income. The MLA, Mr George B Lyngdoh (Umroi Constituency), the MDC, neighbouring villages, well wishers and organisations like World Vision also extended support to the communities with essential commodities that helped house-holds tide over the period of confinement. The MLA was part of several meetings of the Covid team and the Health Department that took key decisions for managing the spread of the pandemic.
All these efforts bore fruit and the village was restored to a green zone with zero active case by June 8, 2021. The village recorded a total of 137 cases and a single casualty. Mr Anestar Diengdoh, secretary of Khweng and member of the Covid Committee said that the initial rise in number of cases overwhelmed them but the Covid Committee was determined to win over the virus and some of the key decisions and measures taken proved effective.
Recognising that the third wave is looming the Covid Committee whose efforts were widely acknowledged by the Deputy Commissioner has recommended aggressive awareness campaigns on vaccination to dispel misinformation and rumours which are the main cause of vaccine hesitancy among rural communities. Half of the elderly population (above 45 years) in Khweng had received the vaccination prior to the incident. It was found that those who had received the dose recovered faster and displayed milder symptoms. The Committee also urged that every village should be supported to maintain a quarantine centre as home isolation in many households would be challenging and would contribute to uncontrollable surge in COVID-19 cases.
Apart from efforts to ramp up infrastructure at the grassroots level the experiences have demonstrated the vulnerabilities of communities to access adequate food. This calls for households and communities to reflect and rethink measures to strengthen their food security. This can begin with inculcating the age old habit of saving resources for emergencies and to strengthen the indigenous food system for increased productivity.
(Gratia E Dkhar is a Lead Associate, Agroecology, NESFAS and can be reached at [email protected])
(Naphishisha Nongsiej is Field Coordinator, NESFAS and can be reached at [email protected] )