Open House: What steps administration must take to protect people living in congested places?

Set up make-shift hospitals in vicinity

Viktor Frankl had said, “For the world is in a bad state, but everything will become still worse unless each of us does his best.” The present crisis wrought by the pandemic is quite monumental and the administration and the Health Department cannot tackle it alone. An accountable and responsible approach of the administration and the Health Department, ably supported by people, is desperately needed to alleviate the miserable plight of the people living in congested places and quarters. The inhabitants of such areas should be inoculated on priority. Doctors, nurses, police personnel, sanitation workers and all other frontline workers should be deputed at such places to take care of the people residing there. Their houses, toilets and surroundings should be disinfected on daily basis and the residents should be told to wash their hands frequently and always wear masks when around other people. Oxygen concentrators, cylinders, electric syringe pumps etc. should be kept ready to deal with any emergency situation at these places. Technical staff from various programmes should be redeployed to assist health authorities to respond to any emergency condition at these areas. The administration should make use of all means and measures to reduce the transmission. No one should be left in the lurch. The condition of congested places should be regularly monitored to take stock of the situation so that it does not go out of hand. Make-shift hospitals and Covid care centres should be set up in the vicinity of such localities to protect the people from contracting the virus that is causing havoc across the world. The people in congested areas are like sitting ducks that can be protected from getting infected by the coordinated, concerted and strenuous efforts of the administration and the Health Department. The authorities need to act swiftly, expand hospital capacities and equip them with sufficient medical supplies. It looks to be a tall order but without doing so it will be naive to leave them fend for themselves.

Tarsem S Bumrah

Hygiene should be ensured

As of now, the government’s vaccination drive is being rolled out on the basis of certain age groups, whereas the local administration and the Health Department should inoculate rickshaw-pullers, auto-rickshaw drivers, street vendors and daily wagers etc. living in congested areas, on priority. The move will also help in containing the virus as people from these areas interact with a large number of people due to the services that they offer. A more stringent cleanliness drive should also be started in such areas to ensure hygienic conditions in the city.

Harsh N Johar

Vaccinate slum-dwellers, people living in congested areas on priority

• To solve the said problem, long-term and short-term steps need to be taken. In colonial times, civic body and Railways' employees of the lower grade used to be provided with residential accommodation in quarters. But now, urban areas are left with limited space and such quarters should be replaced with well-ventilated multi-storey flats for accommodating more families under hygienic conditions.
• Every city in our country is dotted with such slums and we feel proud in claiming that the Dharavi area in Mumbai is the largest slum in Asia, which we should rather be ashamed of. Such black spots should be replaced with multi-storey flats with financial assistance from the Centre.
• With each passing day, urban areas are getting congested due to migration from rural areas and the government at Centre and state levels should launch employment schemes for rural India to discourage this migration. For short-term steps to resolve the problem, it has been observed across the world that Covid proved to be more fatal among people who already are suffering with some disease. So, the local municipal corporation should start a cleanliness drive in each ward, paying special attention to congested areas.
• Problems like over-flowing sewerage and accumulation of water at roadside should be solved on priority basis. Senior officers in all government departments should occasionally come out of their offices and check the public utilities at the ground level. Has anyone ever seen a senior government officer using public toilet? The filthy condition of public toilets does need improvement because they are in pathetic state.
• Also, the local civic body in Amritsar should start the work of fogging at war-footing to make sure vector-borne diseases such as malaria and dengue do not add to the woes of the already burdened health sector. Though, the government has started vaccination drive at large scale, they should give it on priority to people living in congested or slum areas.

Naresh Johar

Rope in asha workers for the drive

The administration and the Health Department should rope in Asha workers for personal prevention awareness campaigns among such communities for spreading the message of practicing physical distancing, wearing a mask, keeping rooms well ventilated, avoiding crowds, washing hands regularly with soap, coughing into bent elbow and cleaning surfaces which are touched by large number of people with household cleaners which contain detergent to decrease the risk of infection through infected surfaces. The administration and Health Department should make a roster of the nursing staff which should include nursing students and also hire volunteers from the ‘Rozgaar’ offices and who should be given training and deployed into field job at congested areas to boost up testing and vaccination of people above the age of 45. The administration must also be proactive and assign targets to volunteers to run a campaign of doing maximum testing and vaccination as being done to curb polio and leprosy for the past few years. It should also be ensured that exhaust fans are functional and operating in restrooms when the space is occupied and also clean drinking water, sanitisation and hygienic conditions are there at toilets which are running under the campaign of the Swachh Bharat mission since 2014 and make every state free of open defection. The administration must also utilise the funds assigned under the mission to make public toilets clean and well sanitised. An initiative must be taken to educate the residents of such congested areas by displaying relevant signs and messages that promote everyday safe and healthy practices and describe how to stop the spread of contaminants while communicating with other residents, workers, volunteers and visitors.

Ankur Gupta

Ensure vaccination of slum-dwellers

Amid the second wave, every person is likely to be affected, particularly people living in slums with limited toilets and congested living conditions where maintenance of physical distance not possible. To protect these slum dwellers, the administration and Health Department must ensure that these people be tested and vaccinated invariably along with other measures under the respected guidelines.

TS BHATTI

Spread awareness to contain Pandemic

The main issue in these areas is overcrowding. Asking the residents to shift or make new quarters is impossible, awareness regarding sanitisation and following of norms like social distancing and mask is first and foremost. This pandemic can only be controlled by awareness among masses. The administration should ensure availability of masks at cheaper rates near these quarters. Make sure the public toilets are clean and sanitised. The Health Department should ensure free vaccination of all as soon as possible. Also, the occupants should be made aware of initial symptoms of Covid and each family provided with at least one pulse oxymeter for early detection of respiratory symptoms.

Jaspreet Grover

QUESTION

Complaints against private hospitals fleecing Covid patients have increased and the patients are preferring home isolation. Do you think the trust and belief in the health system has shaken?

Suggestions in not more than 200 words can be sent to amritsardesk@tribunemail.com by Thursday (May 20).

Win with Will, don’t give in that easy

There is always a scope for improvement. With confidence and strong will and unruffled attitude of ‘I shall win, no matter what’, with right application of mind and inviting the services of the experts on the subject, is crucial to such avoidable tragedy. Slums and congested areas, is a common feature in developing countries like that of ours, where unhygienic conditions can be improved with extensive and regular sanitisation. The paramedical teams under the charge of senior medical officers can begin with educating people on preventive and safety measures and strict follow-up actions. Aware more residents and add incentives for this job. Polio eradication efforts first met with some roadblocks due to illiteracy, but soon, it picked up and did splendid job in eradicating polio worldwide. Social organisations and politicians of the areas should come forward to make it a mass movement to save lives and sufferings of masses.

BM Singh

Myths, doubts of public need to be dealt with

A complete synergy between people and the administration can bring desired results in eradication of Covid-19. People living in congested places and having toilets in small areas need to take extra care in tackling the virus. Sanitising the seat and taps frequently and flushing with lid closed after every use should be made a norm. All the people should wear double masks and in addition to frequently sanitising hands, work tops, door knobs and door bolts etc, should use transparent plastic shields and partitions where it is not possible to maintain a social distance of six feet. All the windows, ventilators and doors should be kept open where possible to allow outside air in the house for maximum ventilation and exhaust fans put on in toilets to expel air carrying the virus. Use of air conditioners should be avoided to prevent aerosols containing the virus and hand dryers and hairdryers, steam inhalation, etc should not be resorted to by a patient quarantined at home as it could spread the virus via aerosols. Administration and the Health Department in tandem should arrange interactions with the public on TV channels, answering queries of the people live, in frequent bulletins broadcasted on tackling the virus. Trusted health experts and head of the administration should answer the questions and remove doubts and myths of the people face to face.

Anil Khanna

Plan or perish, it’s time to choose one

In one of his speeches, Jawaharlal Nehru remarked that the day we learnt to use public toilets properly, democracy will have arrived in India. He assumed that there were enough public toilets around us or at least direction markers indicating the nearest facility. The reality is starkly different. The situation is compounded by our hypocritical attitude to the Animal Welfare Act. The bitter fact is that the real India that elects a government, good or not so good, resides along rail tracks, highways or city ghettos and living in tight quarters like a mud house measuring less than 25 square yards. Any epidemic invading a family there soon spreads to the whole colony. Would that our city planners had provided high rise small flats than vast 1,000 square yards mansions could have saved a lot of open space. In such colonies, it is easier to control a pandemic like the now ubiquitous coronavirus. Even door-to-door vaccination is easier like in row houses provided there is political will. But in the existing scenario with 40 per cent population living in congested homes, it is not possible to follow the virus protocols except perhaps wearing a mask. Even now, let us not assume that this is the last pandemic to face mankind.

Prof Mohan Singh

Good governance need of the hour

The number of Covid cases is increasing at an alarming rate in the community and it is hitting all sections of the society hard. Slums have emerged as hotspots for the virus transmission. The urban slums are highly susceptible to Covid-19 infection due to unavailability of adequate water, toilets, drainage, waste management systems, housing and other basic amenities. During this pandemic, the challenges of slum communities demand urgent solutions for containing the spread of the virus. Efficient and effective governance is an essential component of a well-planned pandemic control response. The state government has to act swiftly and coordinate effectively from the state headquarters. Public health teams and technical experts should be deployed for continuous monitoring by the state government leadership, including the Chief Minister, the Health Minister and other senior bureaucrats. A multi-sectoral approach towards pandemic preparedness emphasises the significant roles played not only by the health sector but also by all other sectors, individuals, families, communities, NGOs, and private healthcare workers in mitigating the effects of the pandemic, the outbreak response of which requires coordination at all levels. The municipal administration should collaborate with other departments for various activities to contain the virus, especially door-to-door screening, risk communication, disinfection of public toilets and supply of essential groceries. Round the clock war room should be established for monitoring every aspect of tracing, testing, quarantine, and lockdown in containment zones. In Dharavi, Mumbai, the municipal administration contained the virus by adopting “chasing the virus” approach rather than waiting for people to report it. Undoubtedly, lockdown is an effective strategy for containing the transmission of the infection. However, this is very challenging as it impacts the livelihoods of masses and adds to the woes of weaker sections of the society, where a daily wager can feed his family only if he goes out to work. Most of them, with little or no savings, have to step out daily amid the lockdown. Practising social distancing is also difficult in slum areas due to congested accommodations. For effective implementation of lockdown and reducing the discomfort to the public due to the restrictions, the administration has to ensure door-to-door regular supplies of food and other essentials and also set up control room of several departments for the public’s convenience. As we wait for the vaccine to be available widely, immediate measures such as strengthening the health system should be taken by the authorities.

Dr KS Manchanda

Build more bio-green public toilets

The most dreadful spots of virus spread are the congested places of human inhabitation. People living in urban areas with high population density are more prone to contracting the virus than with thinly populated areas. Tracing transmission through common toilets as the cause of spread in humans is being reported in recent studies. To protect this contact transmission of virus through this mode is to minimise the use of common toilets at these locations. The administration should build more bio-green public toilets near congested places of living like housing board quarters , inner city areas, galis, mohalla, etc. These should be regularly sanitised and hygienically-maintained to keep them free of virus penetration. Residents living in congested locations be subjected to frequent Rapid Antigen Tests, preferably twice a month for timely detection of the inflected persons. No home isolation facility should be offered for treatment, only designated Covid isolation centres should be provided for patients from congested places of living.

Anil Vinayak

Consider toilets also as hotspots

Covid-19 is a mysterious virus which has confused everybody from politicians to doctors, from scientists to statisticians. In 2020, it engulfed the most neat and clean countries living in closed circuit air conditioned environments and in 2021 it has spread its wings to the open fields of villages. It has been proved that the catching the virus is more likely in toilets and bathrooms. Public is more likely to get infected inside public toilets. Congestion definitely facilitates its spread.

At individual level, use of masks, frequent hand washing, no spitting, no gargling, not touching the surfaces, handles etc. While government can pitch in by constructing more toilets, sanitising bathroom floors and walls more frequently, proper ventilation, providing bathrooms with soaps and hand sanitisers, fogging entire area at night and above all mass immunisation to the earliest.

Dr PS Grover

Awareness drive must be launched

People living in congested places and quarters can be protected from contracting virus by creating awareness among them about the signs and symptoms of the disease. Early detection and separation of suspected patients by arranging screening camps and motivating them for timely testing if symptomatic or been in close contact of an infected patient. Infected person living in congested area should be motivated to get isolated at government isolation facility to avoid further risk of contamination to others. Areas where positivity rate for Covid cases is high should be identified and declared as micro-containment zones. The administration should take appropriate steps via verbal and visual platforms to educate people about proper hygiene and cleanliness. Regular washing of hands, maintaining social distancing, hygienic toilets which are cleaned regularly and disinfected, proper ventilation in rooms and avoiding ACs in congested areas can reduce the risk of contracting the virus. With the government prioritising construction works in the third phase of the vaccination drive, it needs to be made sure that proper awareness is created amongst them for motivating them to get themselves vaccinated by avoiding any misconceptions about vaccine. We, the Doctors are working tirelessly for our society and together we shall win the war against Covid.

Dr Harsimarpreet Singh

More things to look after than ventilators

Amidst this pandemic, it’s of global concern to break the chain of infection and curb down the mass transmission and thereby to reduce the load on healthcare delivery. People living in congested places and quarters are at high risk of transmission, because breathing in a single room with the aerosols may make them susceptible to the virus and the administration must focus on primordial prevention. The government is focusing just on oxygen and ventilators , rather suggestion is to provide a place where there’s enough ventilation and provide protein rich diet through pulses etc, to below poverty line people so as to enhance the immunity and reduce the transmission rates. Moreover, if supply of mask and sanitiser vending machines are set up it would reduce the risk to great extent. Studies, though not approved by the WHO, suggest that wearing double mask may reduce the risk to almost nil. The government can take measures to introduce cartoon type videos for awareness and involve medical personnel in health education and using them to dispel the ignorance, myths and misconceptions regarding the virus. This virus is preventable only if caution is taken.

Sparsh Athwal