India's rural areas devastated by COVID-19
Daily death toll hits 4,000 as poorly equipped health facilities overwhelmed by people seeking help
BANAIL, India — The illness travelled silently through the narrow lanes of this prosperous village in Uttar Pradesh, infecting both young and old. People complained of fevers, cough and breathlessness. Then they began to die.
Vipin Kumar, a farmer in his 40s, was one of them. Last week, a feverish Kumar lay in pain on a cot in the courtyard of his family's modest home, which abuts a maize field.
On the fifth day, his breathing became laboured, and the family was advised by a local doctor to rush him to a big city 40 kilometres away — a formidable task the family could not manage, according to his son, Devendra. That evening, on May 10, his body began to shake violently and he died soon after.
More than 20 people with coronavirus symptoms have died in the village over the past two weeks, according to locals, a significant increase over the three or four deaths per month the village saw before the pandemic. Most of them, like Kumar, were never tested.
“Not a day goes by when there are no deaths,” said Hariom Raghav, a farmer and businessman who had just returned from a cremation. “If things continue like this, the village will empty out soon.”
The story of Banail has been playing out in hundreds of villages across India as the virus continues its deadly surge: Rural areas, where over 65 per cent of India's 1.3 billion people live, had been spared in the first wave of the pandemic but are now facing devastating numbers of infections.
Three quarters of all districts in India are reporting a positivity rate of more than 10 per cent, a health official said last week, an indication of how widely the virus had spread.
With more than 23 million reported cases, India is the global epicentre of the pandemic. The country is recording more than 4,000 deaths a day, which experts say is a vast undercount. Last week the World Health Organization classified the variant first found in India as a variant of “concern” and said initial studies suggested it spreads more easily.
Health-care infrastructure in villages — deficient at best or missing altogether before the pandemic — is illequipped to service the current needs. India's rural health-care system has far fewer specialist doctors than needed. Low levels of awareness among villagers about coronavirus prevention and a slow rollout of vaccines has added to worries.
At the centre of this crisis in the hinterland is the state of Uttar Pradesh — home to 230 million people, more than the population of Brazil. It is also one of the poorest and least-developed states.
In April, local elections were held in villages across the state, which officials say led to the surge in rural areas. According to a teachers' organization, more than 700 government teachers who were assigned to poll duty died after the elections, many after testing positive for the coronavirus.
At the start of the month, the state was recording just over 2,500 cases. By the end of the month, as the elections wrapped up, cases surged to nearly 35,000.
Last week, dozens of bodies suspected to be coronavirus patients were found floating in India's holy Ganges River in areas of Uttar Pradesh and its adjoining state, raising fears that corpses are being cast into the river because crematoriums are overwhelmed.
Activist and farmer leader Yogendra Yadav wrote that “sheer political callousness” has made the state the epicentre of “one of the worst” disasters in 21st century India. Recently, legislators from the ruling Bharatiya Janata Party wrote to the state chief minister to raise an alarm over the situation in rural areas.
In Banail, the village seeing a spurt of deaths, the primary health centre is a rundown pink building with broken windows and a motorbike parked in one of the treatment rooms. The doctor had been away for more than a month — first for a government training program, and then in quarantine after working in a COVID hospital in the district. A pharmacist on duty said he told villagers to call COVID helpline numbers for assistance.
“The government has made no arrangements. They have left us at the mercy of God,” said Rakesh Sisodiya, a villager. “Where should people go?”
Manpal Singh, a local doctor, said about 20 people turn up at his clinic every day with flu-like symptoms.
On a recent afternoon, a government team arrived in the village to conduct screening and testing. Outside a temple guest house, under the shade of a neem tree, the team checked the temperature and oxygen level of the villagers who gathered. The team had brought 25 rapid antigen test kits for a village with more than 10,000 people.
About five kilometres away in a nearby town is a larger government health centre. Just before 2 p.m., Hemendra Kumar, the solo technician conducting tests, had run out of kits and began to turn people away. He said the district authorities send 100-120 rapid antigen kits and 50 RT-PCR kits each day that are used quickly. RT-PCR results can take up to five days because they are sent to a city hospital 60 kilometres away.
At district headquarters in Bulandshahr, Ravindra Kumar, a high-ranking official, said he works late into the night these days. “You have visited one village out of 951,” he said. “We are sending teams in villages for screening, testing and with medicine kits. The situation is completely under control.”
Unlike earlier, he said, a majority of the cases in the past weeks have been reported from rural areas.
In Ghazipur district, at the other end of the state, the situation is just as grim. In the village of Sauram, the village head recently wrote to officials about 17 COVID-like deaths in the past two weeks, prompting them to organize screening camps. Most died at home without ever making it to a health-care facility.
The government has made no arrangements. They have left us at the mercy of God.”
Rakesh Sisodiya