Shahid Akhter, editor, ETHealthworld, spoke to Santanu Mishra, Co-Founder and Executive Trustee, Smile Foundation, to know more about the participation of civil society organizations in the wake of the second / third wave of Covid-19 pandemic.

How is the Indian civil society preparing for the third wave of Covid-19 which experts say is imminent?

Covid-19 is a black swan event. The ferocity of the second wave has warranted coordinated action on a large scale. From the very beginning of the pandemic in India, civil society organizations have helped ease the shock of Covid-19 for millions of Indians. Their relentless efforts have ensured the delivery of essential services to people at the end of the line. Our countrymen need a healing touch, which civil society organizations have strived to provide.

As the country approaches the third wave of Covid-19, there is a need for all stakeholders – the government, civil society organizations and corporates to mobilize resources, build greater trust and work closer than ever to help people cope with the pandemic.

We must all work in unison to help India navigate this trying phase, chipping in wherever possible and in any capacity. We must proceed with the firm belief that we can and will be able to make a profound difference. There are inherent strengths in each of the sets of stakeholders – corporates have capital, the government has reach and NGOs have ground connect and know-how. The effort should be for stakeholders to fill in wherever they see room for greater efficiency.

The pandemic has led to overburdening of Primary Health Centers across the country. What impact do you see should the pandemic start peaking in rural India?

It is true that India’s public healthcare infrastructure is currently overburdened. But it is important for us to realize that this pandemic has stretched the health infrastructure of even the most advanced countries, which are thought to have the best healthcare facilities. The sheer size of India’s population and the highly contagious nature of the infection has put immense pressure on health infrastructure. Our healthcare workers are putting up an exceptionally brave fight.

The pandemic has so far not impacted rural populations in a big way, but our administrators are cognizant that the situation can change, and quickly at that. The need for India to strengthen its Primary Healthcare Centers (PHCs) has been voiced for long. The pandemic has put this capacity expansion on top of the priority list as the Indian government has mobilized a very high quantum of resources towards fighting the spread of Covid-19.

As per data from the Union Ministry of Health and Family Welfare, as on March 2019, there were 24,855 rural PHCs and 5,190 urban PHCs functional across the country. This translates to one center per 30,000 population in general areas and one center per 20,000 population in difficult/tribal and hilly areas. Although the numbers appear alright, the functional status of these centers needs to be studied carefully in terms of the physical infrastructure, manpower, equipment, drugs, and other logistical supplies at the disposal of these centers. One then arrives at the conclusion that there is a great need for quality infrastructure and manpower to ensure these centers can deliver high quality healthcare services and meet the challenge ahead. There is no doubt that we must urgently work to iron out deficiencies in our vast network of Primary Healthcare Centers, especially and particularly in view of the third wave of the pandemic.

Considering reports of parts of rural India getting left out in the vaccination drive, how should India ensure equity in vaccine distribution?

As part of the decentralized vaccination strategy, the government has mandated Co-Win registration which can be tough to navigate for users in rural India, both in terms of access to the app and an English-only user interface. So, changes will have to be made for ease of access and use by a large chunk of the population.

Mandatory registration on CoWin portal, as part of the Liberalized and Accelerated Phase 3 Strategy of Covid-19 Vaccination deters the rural populace as rural tele-density in India stands at below 60%. Further, as per data from the Telecom Regulatory Authority of India (TRAI), India has 58 internet subscribers for every 100 people, which means a significant chunk of our population does not have access to the internet. Our vaccination rollout strategy must, going ahead, address this reality. The digital divide is clear and present, and administrators should take it into account in the interest of fair and equitable distribution of vaccines.

Having said that, even as vaccine distribution is ironed out, the union government has laid down a clear roadmap for the supply of vaccines, as it has been assured supplies by vaccine manufacturers. Over 2 billion doses could become available for India between August and December 2021. Additionally, the government is in talks with global vaccine manufacturers for augmented supply.

What is Smile Foundation’s role in easing the burden on the nation’s healthcare infrastructure?

The second wave of Covid-19 has shaken the country. Fighting the new, more infectious variant of the virus, frontline health workers are working round the clock even as hospitals run out of beds and oxygen supply, and thousands succumb to preventable deaths.

As the situation worsens with each passing day, the need of the hour is to provide urgent necessities like PPE kits to health workers, strengthening the existing public health infrastructure through supply of oxygen and medicines, reducing the load of primary healthcare facilities, providing hygiene kits to masses, and spreading awareness to contain the spread of the viral infection.

We are of the firm belief that health cannot wait. Health cannot wait for people who are suffering at the hands of the pandemic, and for people struggling to see their loved ones survive, for people working tirelessly to help save lives. These people need your support now, and the whole country should come forward to help. Smile Foundation has launched the Health Cannot Wait campaign to address all these needs on a massive scale. As part of the campaign we are soliciting donations for ensuring uninterrupted healthcare services at people’s doorstep. The aim is to benefit 2 million people with mobile hospital and telemedicine projects in the ongoing financial year.

Through the Health Cannot Wait campaign, there is a target to provide 1 million protective gear kits to frontline healthcare workers. These kits include PPE Kits, N95 masks and sanitizer. We would also provide 500,000 hygiene kits (soap, sanitizer, mask) to underprivileged families.

Vaccine hesitancy among people continues to hinder the country’s progress towards recovery. The vaccine provides protection against the virus to a high extent and is our best bet to curb the spread of the virus. However, doubts and fears prevent people from getting vaccinated. We are sensitizing people about the benefits of vaccination through tele-counseling and spreading awareness on prevention against the virus. So far, we have sensitized more than 100,000 people through tele-counseling, and our target is to reach out to 500,000 people.

We are striving provide oxygen cylinders, oxygen concentrators, BiPAP machines, PPE Kits, sanitizers, oximeters, thermal scanners & masks to 100 Covid Care centres & government health institutions with support from corporates and institutions.

Additionally, Smile Foundation aims to create 100 oxygen banks in the country. On the ration relief front, we aim to provide three square meals to more than 2,50,000 families by supplying dry ration kits. The effort is also to mobilize resources and provide 50,000 home isolation kits for COVID patients.

We must all stand and be counted in this hour of dire need and serve the millions who are looking for assistance so they can barely survive.

There is a sense of vaccine hesitancy among sections of the population. How can this be overcome?

Vaccine hesitancy among people is an issue that must be addressed. People must realize that the vaccines protect us from the viral infection to a great degree.

Tele-counselling is one of the most impactful ways of approaching this problem. People must be educated – one-on-one – about the benefits of getting vaccinated. The personal benefits of getting vaccinated, rather than the collective ones, must be clearly spelt out.

Individual tele-counselling has the potential to work wonders as people are more receptive when addressed intimately.