Covid-19 Response and Action Plan

The COVID-19 pandemic has impacted almost every community on earth. Normal life is everywhere upended, security and wellbeing thrown into grave doubt. The crisis has also brought rediscovery and renewal of our feelings of common connection and of care for each other. This is especially so for Bhopal gas survivors, who right now must be counted among the most vulnerable communities on the planet.

Sambhavna Community Health Worker supporting densely populated gas-affected community

The Sars-Cov2 virus is known to be particularly dangerous for those with existing lung problems. Due to the permanent damage wrought by Union Carbide’s gases, Bhopal survivors commonly suffer acute respiratory disorders. Other chronic health conditions include hypertension and muscle weakness, cardiovascular diseases, diabetes, and various forms of cancer, all of which combine to place survivors at a severely elevated risk from Covid-19.

To make matters even worse Bhopal survivors are among the poorest people on the planet. Living in densely overcrowded conditions makes social distancing next to impossible. Lack of clean running water makes maintenance of simple hygieneprocedures equally challenging.

India has been on lockdown since the 24th March. Citizens are unable to venture from their homes, and those fit enough to work are therefore unable to do so. The vast majority of gas survivors earn as daily wage labourers. If they don’t work they don’t get paid, and they are thus unable to buy even the most basic provisions, never mind the medicines needed to cope with chronic health problems.

Sambhavna staff working to prepare Sambhavna’s community outreach, this is the registration room

Our clinics in Bhopal have been working incredibly hard, in exceedingly difficult circumstances, to put measures in place to raise awareness and stem the spread of the coronavirus, while still also providing these communities with the vital everyday medical care they need.

With most major countries on lockdown, with international organisations unable to carry out aid work, with governments still trying to work out strategies to protect the vulnerable, and with the virus likely to invade every town and village the international scientific community is beginning to urge governments to mobilise their citizens in a broad public health effort that is quickly being recognised as essential to winning the fight against Covid-19.

Sambhvana has been steering community health programs in Bhopal for almost a quarter century. Over this time our Clinic has led several initiatives to empower individuals and communities to participate in protecting and improving their own health. Its teams of 7 Community Health Workers (CHW) and 10 Community Research Workers (CRW) have inspired over 100 Community Health Volunteers (CHV) to regularly undertake public health work in their own homes and neighbourhoods, helping to significantly reduce the spread of diseases such as Malaria and TB.

Community Health Workers learning how to construct handwashing stations

In conjunction with local organisers, Sambhavna Clinic staff are currently implementing a finely-detailed action plan to mobilise local communities against Covid-19. Under this plan upwards of 50,000 local people are engaged in rapid virus detection, isolation and contact tracing.

Sambhavna’s approach has perhaps never been more important to communities in Bhopal and, potentially, to every other community across the globe. In fact, we believe that Sambhavna has created a model for tackling Covid-19 outbreaks that could be replicated in any community, anywhere.

Until now all of Sambhavna’s work has been funded by the extraordinary efforts of ordinary people around the world. It is our Clinic’s long-held dream to be able, in return, to give something back. It is no exaggeration to say that we have never been in more need of Sambhavna’s hard-won, practical wisdom.

 

 


Sambhavna’s Action Plan for Protection from and Caring of COVID-19 in 21 Communities (Population 50, 000)  

This Action Plan is in four parts.

1.     Effective communication for raising awareness.

2.     Door to door survey for identifying persons with symptoms indicative of COVID-19

3.     Isolation of persons with symptoms of COVID-19

4.     Treatment and care of persons with COVID-19.

 

1.     Effective communication for raising awareness.

1.1. To reach the information leaflet published by Sambhavna and Chingari to each family in different communities and to organize reading out the leaflet for those with no literacy. Large part of this work will be carried out by children, particularly those who assist the Community Health Workers (CHW).

1.2. To make Whatsapp groups of all families in the community (one member from each family) and post selected and most relevant information.

1.3. To make one hand washing contraption for every four families in the community.

1.4. To get families in the community to make paper masks.

Most of the above work will be carried out by 100 Community Health Volunteers (CHV)  (many of who have been working with the CHWs  for last 5 years) with support and guidance of 7 CHWs from Sambhavna.

CHVs are expected to recruit at least 5 new health volunteers  from among the people they work. Other staff of Sambhavna such as 10 Community Research Workers will join the CHWs in this work.

Coordination of the work will be carried out through three field centres. This part of the work will be completed by April 12, 2020.

A woman reading the information pamphlet created and distributed by Sambhavna and Chingari staff

Children using hand wash stations in the community designed and implemented by staff at Sambhavna and Community Health Volunteers

   

 

 

 

 

 

 

 

 

2. Door to door survey for identifying persons with symptoms indicative of COVID-19

2.1. Collect information on health complaints (including mental health) of every member of every family in the community through door-to-door visits and through phone calls. Administer the Checklist (by NCDC) to score persons with complaints related to COVID 19. Include absence of smell and taste (if only on grounds of familiarity) a condition reported by large numbers following toxic exposure in December 1984. This would be done twice in a week.

2.2. Measure temperature of every person complaining of fever. CHVs will counsel them to stay apart and ask them to seek support of CHVs in charge of Isolation. This will happen on the same day.

2.3. To tally up scores from the check-list and identify those in need of isolation and organize their counselling and isolation. This will also happen on the same day.

2.4. To follow-up on vulnerable members of the community including children, pregnant women, persons above 60 and those with respiratory, cardiovascular, renal problems or are diabetic every other day.

A Community Health Worker giving a thermometer to a Community Health Volunteer and explaining how to use it

Collecting information on health complaints

 

 

 

 

 

 

 

 

3.     Isolation of persons with symptoms of COVID-19

3.1. In houses with 2 or more than 2 rooms, ensure that one room is prepared in advance for isolating a person or persons identified with symptoms of COVID-19.

3.2. Arrange for common isolation facility (a large tent set up in open area a little away from the community) persons identified with symptom of COVID-19.

3.3. Arrange for safety of volunteers and family members looking after persons isolated at home and those in common isolation facility.

3.4. Arrange food and water for those in common isolation facility and volunteers and family members taking care of them.

Advising families on safe isolation practices

Food delivery to the vulnerable

 

 

 

 

 

 

 

 

 

4.     Treatment and care of persons with COVID-19.

4.1. To send information on name, age, sex, history of symptoms and their severity to the Health care system set up by the government and arrange for their testing and treatment through the government health care system.

4.2. Arrange for consultation with volunteer doctors (through video conferencing) regarding treatment of persons identified with symptoms of COVID-19.

 


What is Chingari Doing?

Under government guidelines Chingari has been forced to close and children can no longer attend.  However, the staff here have also been out working in the community to ensure the safety of the vulnerable families that rely on Chingari for the health and wellbeing if their children.

They have worked with the Sambhvana team to develop an information pamphlet and have been distributing to all Chingari families.

There is a team of drivers delivering food and vital medicines to the children in the community in the Chingari vans that are usually used to pick up and drop off children from the Chingari Centre.  Last week they delivered food to 75 impoverished families and medicines to 42 children with neurological disorders who without this vital medicine may suffer from fits and/or seizures.

 

Chingari staff delivering food to families

Chingari staff delivering medicine to a mother

 

 

 

 

 

 

 

 

 


Coronavirus Updates

We will be updating our blog regularly with updates on the clinics and gas-affected community during this outbreak. Please go to https://www.bhopal.org/category/coronavirus/ for the latest news.

We believe Dow must finally accept responsibility for Bhopal. Until then, The Bhopal Medical Appeal funds two award-winning clinics in the city. Both offer free, first-class care to victims of the gas disaster or the ongoing water contamination. The survivors have nowhere else left to turn – please help if you can.