Northeasterners Return Home to Poor Public Health Infrastructure

GUWAHATI: Being in the extreme northeast of India, this region of seven states and more than 45 million people has always found itself at a disadvantage because of poor communication with the centres of power. Moreover, the whole region with only 22 members of Parliament has very little power of advocacy.

But in the initial stages of the COVID19 pandemic its relative isolation turned out to be a blessing in disguise, because the virus took a long time to reach the region. Nearly a week into the national lockdown, the Northeast has only two confirmed positive cases: a 23-year-old woman who returned to Manipur from the UK on March 21 after completing her doctoral studies, and a Baptist pastor who returned to Mizoram from the Netherlands two days later.

The real number may be higher than this because testing is low in India. But in the Northeast it is bound to be much lower than in the rest of India. That advantage may disappear in the next few days.

Because of high unemployment in the region a large number of its youth migrate to cities in peninsular India (known here as the Mainland) in search of unskilled or semi-skilled work in the hospitality industry, as security guards or other low-paid jobs. Around 100,000 of them have come back from cities where the pandemic has spread since the enterprises where they work have closed down or have suspended operations because of it.

One will know in the next few days whether they have carried COVID19 with them. Testing which is low in India is to a great extent limited to air travel, especially to foreign travellers entering India. According to a news report on March 29 India had tested only 19 persons per million, the lowest proportion in the world, the next lowest being Japan with 319.

Testing is slowly being extended to train travel as well. But the migrants of the Northeast have reached their villages already without being tested. As a result, one may not know the extent of the spread of COVID19 immediately.

Testing is non-existent and health services are poor in their villages. The lockdown can prevent the spread of the disease where social distance works. Most returnee migrants live in small houses in which it is not easy to enforce social distance. So if they are infected already they may spread it to others. One will know soon.

The danger of the virus spreading is only one aspect of the pandemic. Of equal importance is the economic pandemic. Even if the disease does not reach the region through migrant workers, the returnee migrants and their families face an economic disaster.

Like migrants in the rest of India they too were holding low-paying jobs, and do not have the savings to tide over a crisis of this magnitude. At present they are without work, without social or financial security, so they and their families may face even starvation.

The economic pandemic is not limited to the 100,000 returnees. The region also has lakhs of migrants from other states like Bihar and from Bangladesh. They sustain themselves through daily wage ‘unskilled’ work. The lockdown has deprived them of such work with no alternative and they too face starvation.

To this danger must be added racism linked to the virus.

Together with US President Donald Trump, many people in Mainland India are calling COVID19 the Chinese virus. A relatively large number of migrants from the Northeast have Mongoloid features. In the cities to which they migrate, they are taunted as Chinese or Chinkis and as carriers of the disease.

Recently for example, three students from Nagaland were reportedly denied entry into a shop in Mysuru because of their ‘Chinese’ features. Others from the region have complained of some locals taunting them as ‘Corona’.

On her blog Dr Alana Golmei from Manipur who now resides in Delhi and is general secretary of the Northeast Support Group recounts how on three different occasions staff of the NCERT taunted her and her companion from Meghalaya as “corona virus” when then entered the NCERT campus. They apologised when confronted by Golmei.

Many landlords have asked Northeasterners to vacate their houses although they do not want to return to the Northeast. Thus they are being subjected to a racist pandemic. One has also to be on the lookout to see whether the villages to which they return discriminate against them as possible carriers of the virus.

Civil society organisations in the Northeast must face this challenge. Many civil and church representatives led by the Inter-Agency Group met on March 27 in Guwahati to look at the possibility of coming together to prepare food packets for migrant and other workers who are facing starvation.

They have worked out a plan and have asked for permission from the district authorities. This permission is still in the pipeline at the time of writing. They want to go beyond relief to ensure that the central and state government packages for the poor reach the needy.

This is a major challenge that civil society organisations and church groups must face and on which they should work together. They should also realise that this is only the first step and they need to go far beyond it once the lockdown is lifted.

The health infrastructure is extremely poor in the region. Government health services exist only on paper. The pandemic may spread if a proper infrastructure is not built within the next few weeks. The civil-society-church combine can do it.

Unlike in the South where by and large these bodies run hospitals on a commercial basis, in the Northeast their infrastructure consists mainly of rural dispensaries. In the seven states together they have only four hospitals, all of them run on a charitable basis. But their dispensaries render yeoman service without getting any funds from the state.

This rural infrastructure needs to be activated on a permanent basis. On one side, civil society organisations and church groups can put pressure on state-run health services to function properly. On the other, together they can demand that the state fund their dispensaries in order to ensure that a good public health infrastructure is created.

They cannot run away from this challenge of building a permanent effective health infrastructure in order to prevent future pandemics. They have to accept this challenge as intrinsic to their mission.

Walter Fernandes is director of the North Eastern Social Research Centre, Guwahati