Chasing the virus in India’s Dharavi

THE dark clouds of the deadly Covid19 continue to hover over us.

But an occasional bright spot gives hope that our combined wisdom and ingenuity can defeat the deadly virus, even in the most challenging circumstances.

Recently, Dharavi was singled out for praise by the World Health Organization, along with South Korea, New Zealand, Vietnam and Spain, among others, for its efforts in containing the spread of Covid-19 over the past 3 months.

Dharavi is a densely populated, poor locality in the megacity of Mumbai with an area of 2.5km2. Within those confines live more than 700 000 people.

After the first Covid-19 case was reported in Dharavi in April, many feared that it would become an epicentre of the virus because physical distancing was mostly impractical, given the concentration of the population.

By the end of April, Dharavi had 500 cases and in May the number of cases crossed 1 000. The situation threatened to become alarming.

But the people of Dharavi fought back. The community joined hands with the municipal authorities, healthcare services, non-governmental organisations and volunteers. They put in place a robust mechanism of testing, contact tracing, isolation and quarantining measures. About 2 500 health workers were assigned to Dharavi, who identified five zones that were potential high-risk areas due to the spread of the initial infections. These areas were strictly contained.

Authorities distributed tens of thousands of grocery kits and food packets to reduce the need for people in these containment zones to venture out. Health workers and volunteers sanitised community toilets many times a day.

Private doctors of the locality who were the main health-care providers in Dharavi rose to the occasion. They were provided with protective equipment and were entrusted with the task of attending to all the residents who needed testing.

Every day, officials and doctors navigated the crowded lanes of Dharavi for door-to-door testing. They tested thousands of people daily while confronting the fear, anxiety and stigma surrounding the disease.

Close to 50 000 people in the highrisk zones were tested as a first step. But as temperatures began to soar in hot, humid Mumbai, door-to-door testing by health-care workers in elaborate protective clothing became difficult.

With the co-operation of the community, “fever camps” were set up. Eventually, the doctors and community leaders of Dharavi managed to break the stigma attached to the virus and people came voluntarily in large numbers for testing.

Reports said even those who had come in contact with people who had coughed in front of them started visiting the camps. Soon, a good majority of the population was screened for the virus.

Among the residents who reported symptoms, 20% were found to be positive and were immediately quarantined. Home quarantine was not an option in Dharavi, so local officials put in a huge effort to convert schools, marriage halls and community centres into quarantine facilities.

Eventually, the situation in Dharavi stabilised. Mission Dharavi was successful according to officials, because the public health strategy focused on the known basics – tracing, tracking, testing and treatment. But, the real difference was the community engagement and exemplary teamwork and co-operation among the many stakeholders involved in battling the virus.

In spite of the results, the officials and the residents of Dharavi know that the war against Covid-19 is not over yet.

But having won their first battle, the people of Dharavi are confident that they have a strategy in place to fight Covid-19.

Their efforts inspire us and hold lessons on how underprivileged communities living in densely populated areas can contain the pandemic.