The COVID-19 pandemic has had a devastating effect in India, but has taken an especially heavy toll on the urban poor – who have a higher risk of both infection and economic disruption. Despite the best efforts by the government, social vulnerabilities and inequalities have intensified in the wake of COVID-19.
A recent survey by the Indian Council of Medical Research estimated the transmission risk in urban areas to be 1.09 times higher than in rural areas and 1.89 times higher in urban slums due to density and congested living conditions of the population. Within already vulnerable urban poor communities, women and girls are at greater risk. India’s current under-5mortality rate is higher for girls than boys and disrupted essential services will widen this gap.
Save the Children, with funding from Rural India Supporting Trust (RIST), is working to assist the most vulnerable and marginalized children and families in the slums of Mumbai and Delhi, with the goal of addressing the disruptions in essential health services, particularly for children and expectant mothers, brought on by the pandemic.
Supporting Maternal Health Services
We are doing this by re-initiating the delivery of essential Maternal, Newborn, Child Health and Nutrition (MNCHN) services in N Ward in Mumbai and South East District in Delhi. We’re training Community Organizers to identify women and children in need of care and connect them with local healthcare centers.
Heena, 23, from Ghatkopar East, was recently reached through the program. Heena’s 18-month-old daughter was due for her vaccinations. Local public health workers had repeatedly contacted her about the immunization program at the local clinic – one even visited her at her home. However, Heena was reluctant to immunize her daughter. In India, a patriarchal culture sometimes prevents women from making health decisions, and fear of COVID-19 has made people even more reluctant to venture from their homes to seek care.
Finally, through the RIST supported project a Save the Children Community Organizer contacted Heena. She discovered that Heena’s husband was not in favor of vaccinations. He was concerned about the side effects. The Community Organizer explained the benefits to Heena’s husband and managed to convince him. The baby is now up to date on her vaccinations.
Community organizers have come across several cases where parents have been reluctant to immunize their children due to a lack of awareness of the benefits. COVID-19 has added additional challenges as people are fearful of exposure. In response, Save the Children is distributing leaflets with COVID-19 “Dos and Don’ts” to households with pregnant or nursing mothers and is supporting door-to-door vaccinations as part of their community mobilization activities.
Increasing Awareness of Services
Many pregnant women in India are unable access public health services – many are simply unaware of them. This highlights the importance of the role of organizations like Save the Children in raising awareness about MNCHN services and helping women to access them, as we did with Pooja, 19, an expectant mom who recently moved to Ghatkopar.
New to the area, Pooja was unaware of the health facilities in her new town and did not complete early registration for her delivery. One of Save the Children’s Community Organizers supported by the RIST grant reached out to Pooja provided her with information on antenatal visits, sonography and the optimal diet for pregnant women. She also explained the early registration process at the local health center. Still, Pooja was hesitant to take advantage of the services. The hospital she had in mind was far from her home and she wasn’t confident she could travel such a distance. In India, many women are dependent on their husbands and are discouraged from traveling alone. The Community Organizer suggested that she register at nearby Rajawadi Hospital instead. After repeated reminders, Pooja and her husband completed the registration at Rajawadi hospital. Pooja also had check-ups related to her pregnancy.
Emergency Relief Distributions
With funding from RIST, Save the Children is also supporting vulnerable and marginalized children, their families and health service providers with immediate food, hygiene and Personal Protection Equipment (PPE)at a time when cases of COVID-19 are surging in India.
In the last two weeks of April, there were around 25,000 new cases of the virus per day in Delhi alone. The government tightened restrictions on all establishments, public gatherings and activities and instituted an evening curfew and weekend lockdown. This situation is extremely dire, as one Save the Children staff member on the ground recently reported. “There is a lack of basic health facilities and personnel. Test results take more than a week to come. With the lack of oxygen, lack of ICU beds, the brittle supply chains that all people are facing, one can sense a storm, even from a distance. People are dying in large numbers and the virus is spreading fast,” she said.
Thanks to RIST, Save the Children has been able to help battle the virus by delivering immediate humanitarian assistance to the most vulnerable and marginalized children and their families in Delhi. The agency has already reached 127 families in need, with plans to reach many more. These families have received food baskets that include flour, sugar, chickpeas, soybeans and cooking oil.
Families also received hygiene kits that include soap, toothpaste, toothbrushes, shampoo, razors and shaving cream, among other toiletries, and dignity kits that include soap, sanitary products, underwear ,antiseptic, cotton wool, a flashlight and batteries and sewing kits. To support the frontlines in the battle against COVID-19, Save the Children has provided two health dispensaries and 25 Anganwadi workers in Delhi with 1,000 PPE kits consisting of N95 masks, gloves and bottles of sanitizer. Distributions will begin in Mumbai too as soon as restrictions are lifted.
“By virtue of our presence in the field, we have been the first witnesses and responders to the crisis on the ground and supported many children and their families,” a Save the Children staff member recounted.