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The 'Dharavi Model' in the fight against the COVID-19 pandemic has often been considered a people's movement that has inspired the world. When the world was struggling to fight the deadly virus, Mumbai's Dharavi managed to heal its wounds the fastest and set an example.
Dharavi was one of the worst-affected areas in the first COVID wave, but managed to stay almost unaffected in the recent second surge. In just a month, new COVID cases dropped to almost zero from more than 1,000. On 14 and 15 June 2021, Dharavi recorded zero new infections for two days in a row.
How was this possible? What is this much-appreciated 'Dharavi Model'? The Quint's Ritvick Bhalekar spoke to ground-level health experts, health workers, and locals to find out how this model kept the area in Mumbai safe in the face of the second COVID wave.
Dharavi Model: The Four Ts
Challenge
Dharavi, a locality in Mumbai, is considered to be one of Asia's largest slums. With an area of close to 2.4 square kilometres and a population of nearly 7.5 lakh, Dharavi is one of the most densely populated areas in the world.
Contact tracing, social distancing, and checking the spread of infection was, naturally, the biggest challenge. When lockdown was announced, implementing the restrictions and at the same time, providing health check-ups, providing ration, medicines, and other essentials were the obstacles.
“The population posed a big challenge. People from across the nation come and settle here. To pass critical information on COVID to the diverse population here was a big challenge. To impose lockdown as per government regulations here, to curb the speedy spread of infection was an obstacle.”Dr Virendra Mohite, Medical Health Officer
Solution
The solution to the dense population was to extensively follow the four Ts – trace, track, test and treat. BMC, local health experts and health workers, and private doctors played a key role.
“At the start of the pandemic, our first chain of action was to block the entry and exit of areas where a person or persons were infected, contact-tracing, and testing contacts who showed symptoms. Symptomatic people were taken to quarantine centres, those who tested positive were shifted to isolation centres. Plus, if you are blocking an area, you must take care of the daily needs of the people of the area.”Dr Virendra Mohite, Medical Health Officer
Reality Check
When The Quint spoke to residents of Dharavi, they said that there were regular health camps, extensive check-ups, and door-to-door campaigns organised by BMC officials.
“BMC officials would come for regular check-ups. Doctors and healthcare workers did door-to-door campaigns. People who had cough, cold, fever were given medicines.”Rameeza Sheikh, Resident, Dharavi
Dharavi Model: Debunking Myths
Challenge
BMC officials ensured that symptomatic patients were immediately taken to quarantine centres and tested and those who tested positive were either shifted to hospitals or taken to isolation centres, based on the severity of the infection. But, various myths and rumours around the condition of these centres posed a big challenge before them.
“People here are anyway exposed to other infections like hepatitis, typhoid, swine flu, and tuberculosis. Initially, people were apprehensive about the state of government isolation centres.”Dr Virendra Mohite, Medical Health Officer
Solution
Given the dense population in Dharavi, ground-level workers had to isolate symptomatic residents and those who tested positive to these centres to break the chain of the virus. So, the only option was to debunk the myths and put an end to all rumours.
“We had to debunk the myth that people die of hunger in these centres. We started making people aware of the facilities here. Gradually, their hesitancy to come to isolation centres reduced and people started appreciating our initiatives.”Dr Virendra Mohite, Medical Health Officer
Reality Check
Admitting that many of them were hesitant in the beginning, the residents told The Quint that soon they realised the important of these centres and appreciated the efforts of the healthcare and other service providers.
“They (BMC officials) made sure all infected persons were taken to hospitals, treated for 14 days and then brought back home. We were given food and other supplies. We got all necessary facilities.”Shanu Tengle, Resident, Dharavi
Dharavi Model: Ground-Level Surveillance
Challenge
Given that Dharavi is one of Asia's largest slums, with a huge population, contact tracing and breaking the chain was the next big challenge ahead of the BMC and the local healthcare workers.
Solution
Multiple teams of healthcare providers and community workers were deployed for the job. The BMC created a WhatsApp group of all doctors who could be consulted. Beside door-to-door campaigning, testing and isolation were initiated. People who were staying in the hotspots were provide essential items so they didn't have to step out.
“Five health posts are functional in Dharavi. Each health post has a team of 11 members. Each member has a team of three community health workers under them. We get a list of infected persons from wards. We then call them individually to gather all information, then our teams visit their homes.”Dr Vishal Kolte, Health Post Officer
Reality Check
Praising the BMC and ground-level workers for their efficiency, Dharavi's most vulnerable – the elderly residents – told The Quint that regular check-ups and tests in the locality safeguarded them against the virus.
“We used to be very scared of the COVID pandemic. But BMC officials come for regular check-ups. They have handled the COVID situation very efficiently.”Ashok Katke, Resident, Dharavi
Dharavi Model: Vaccinate All and Soon
Challenge
Like many people across the country, several residents of Dharavi, too, were hesitant about taking the corona vaccine. Getting all eligible residents to take the vaccine shots at the earliest was another challenge.
“Initially, very few people would come to take vaccines. Out of the target of 100, only 35 to 40 people would turn up.”Dr Amrita Suple, Nodal Officer, Vaccine Centre, Dharavi
Solution
Ground-level teams conducted door-to-door campaigns to spread awareness and even helped all adults with registrations for doses.
“To end this vaccine hesitancy in Dharavi, we conducted door-to-door campaigns, helped with registrations, and debunked myths. Gradually, more people started coming for the jabs.”Dr Amrita Suple, Nodal Officer, Vaccine Centre, Dharavi
Reality Check
The residents of Dharavi said that the healthcare workers and BMC officials helped reduce vaccine hesitancy among people and initiated a fast-paced vaccination drive in the area.
“They have initiated a very pacey vaccination drive. People’s response to it is very positive. High vaccination rate has helped reduce COVID cases here.”Sanjay Bansod, Resident, Dharavi
Dharavi Model: Unity in Diversity
Challenge
Given the diverse groups of people who stay in Mumbai's biggest slum, spreading awareness, conducting campaigns, and debunking myths for individuals groups was a big obstacle.
Solution
BMC officials and ground-level teams ensured awareness drives and campaigns were conducted in multiple languages.
“People from different parts of the country, speaking different languages reside here. So, we started awareness drives in multiple languages – Telugu, Tamil, Urdu, Hindi, Marathi, among others. It’s easier to make people feel at ease and spread awareness in their languages.”Dr Virendra Mohite, Medical Health Officer
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