WHY RURAL POPULATION IS AFFECTED MOST BY THE SECOND WAVE?

Infections are shooting up in the Indian countryside in comparison to big towns, this wave of the corona has not left any section of the society, everyone is affected everywhere by the second wave of COVID-19, but unlike the first wave of COVID-19 this time rural areas are affected the most which were left untouched in the 1st wave, due to which a mindset has been created in the mind of the rural population that it is an urban disease and it cannot reach villages and cannot affect them. The deadlier, highly infectious second wave of the Covid-19 erupted in February to inundate hospitals and medical staff and crematoriums and mortuaries, is now fast spreading to rural districts, with almost half of the new cases are coming from rural areas.

The rural areas are seeing a deluge in cases without the necessary health infrastructure, as the major problem in rural areas is that they lack medical facilities or hospitals; hardly there might be small government hospitals, which hardly would have any medical facilities, or any oxygen concentrators or enough beds for treatment. most of the medical infrastructure facilities are especially concentrated in the cities, where people of rural areas visit when there are patients who are very serious in the hope of finding treatment, but getting treatment in city hospitals is very hard as Covid cases are on a surge, and the hospitals already full were almost four patients are waiting to get a bed in any hospital.

Lack of medical faculties have not only affected rural districts but has even brought cities like Delhi, which boast a medical infrastructure, to their heels. Also, a major reason for the spreading of this infection is migrants who have traveled from Maharashtra and other states to their home towns, and it is estimated by the government that About 57 lakh migrants have been shifted to various destinations across the country by special trains and about 4.1 million through roadways.

The increase in the rural case is a worrying trend, as the share of rural districts in new cases increased to 45.5 % in April and 48.5% in May, as compared to approximately 37% in March. the main reason for the surge in the cases in these areas are lack of awareness and reluctance to submit to testing and treatment are taking their lives, who are ignoring the Covid symptoms and considering it the basic flu, and the second major reason for these devastating surge of cases is due to myths and fear of vaccines in rural people, which is restricting them to get jabbed.

Also, the rural people even after having symptoms for Covid, they are resisting to get an RTPCR test, and instead, they are considering it the normal flu, or typhoid, and people in villages are going for treatment of MIYADI to Babas, and this treatment restricts you to have necessary food for about 3-4 days and after this duration when people are not cured and have breathing issues there oxygen is around 40-60, and when they realize that this is not MIYADI but corona, they head towards treatment in cities, which are fully packed, and because of lack of knowledge and their superstiousness many lives are gone.

SBI estimated that among the top 15 worst-hit rural districts, six are from Maharashtra, five from Andhra Pradesh, two from Kerala, and one from Karnataka and Rajasthan where the cases in rural areas have shown rapid growth.

In Maharashtra, Rural areas of Maharashtra are worst hit by the 2nd wave and are contributing more cases to the state’s total tally in comparison to urban areas. According to the state health department, it goes off in Amravati around the last week of February when 4,000-odd weddings took place, but then data suggests it originated in Akola and Thane.

In Uttar Pradesh, the Panchayat polls have turned into a Corona spreader from April 15 to 29. During the campaigning took no notice of Covid protocols, coupled with the arrival of migrants from other states to vote, which has led to a spike in cases in the state.

Health department data shows that about 29% of the 170,059 active cases on April 17 were reported from the 18 districts that voted in the first phase on 15th April. On 13th April, 716 new cases emerged in Kanpur, which voted in the first phase. On 19th April, 1,365 cases were reported during the second voting phase. New cases in Hardoi rose from 56 to 265 from 13th April 19th April, and in Gautam Buddh Nagar from 402 to 970 from 17th April to 24th April.

In Rajasthan, Siddharth Mahajan, secretary of medical health and family welfare has reported that about 40 percent of the total cases are being reported from the rural areas, and now districts are reporting a higher number of cases than last year, while 30 of the 33 districts have been reporting over 100 cases each day. On 26th April, Jaipur district has reported 2,878 cases, while Jodhpur, Kota, Udaipur, and Ajmer recorded 1,711, 955,668,660 respectively.

Also, geographically Rajasthan is India’s largest state, which creates a hurdle of supplying medical help, like oxygen and prominent drugs like Remdesivir, to the remote areas.

In Madhya Pradesh nearly 1.5 lakh people have been identified since 5th April, with influenza-like symptoms in the rural parts of Madhya Pradesh, around 26,000 have tested Covid positive, representing a positivity rate of 17.3%. These rural patients constitute about 14% of the total 189,055 new cases reported in MP between 5th April and 25th April.

The major reason for the spread in the state is the inadequate medical facilities in the rural areas; villages are as good as on their own in the fight against Covid. Out of 819 Covid treatment centres, only 69 are located in the rural areas, and out of the total 21,637 isolation beds in the state, only 3,039 beds are available in rural areas. And there are only 338 oxygen and 51 ICU beds available in the rural belt. Moreover, many migrant workers returned to their villages in MP from Maharashtra around Holi, which has also become a reason for spreading the infection.

Jharkhand has about 1,500 confirmed cases, and only 117 are from urban centres, while the remaining are from rural areas, which witnessed a surge following the arrival of people from outside the state.

Hesitancy and myths of Vaccination in Rural Population

Like an infection, misinformation is now trickling into rural areas, just the way Covid has reached the rural population, the misinformation regarding Covid vaccines have reached faster, now whatever health workers and administrators tell them, people will believe what they want to believe, and make these authorities feel helpless.

the village population have full of myths and rumours for vaccines like vaccines can cause impotence or the vaccines are a ploy by the government to kill people and some just don’t need vaccination, on the television that the vaccine's side-effects will show up two to three years from now, some people heard on the television that the vaccine's side-effects will show up two to three years from now, and what not and all of this is making it harder for them to convince people.

There is a catena of cases regarding myths of vaccination like, Nirmala Gadri from Aurangabad's Soygaon was asked to assure them if she can guarantee that they will not suffer any side effects of vaccines will and if something happens people will catch hold of her. She added people in villages fear that they will die of the vaccine, and mock her for visiting homes and say that she has no other work; she just goes around carrying the gun (infrared thermometer).

Also, at the same place, an elderly woman in her 80s died within 15 days of getting the vaccine, as she had a fever and high blood pressure and died of a heart attack, adding that public health authorities told that the death was not because of the vaccine. But now, people do not even allow Gadri to check them for fever, saying, you will mark us COVID positive for no reason.

Aarti Korgaokar, an Anganwadi worker from Sawantwadi taluka in Sindhudurg district, shared her battle with conspiracy theories and a belief that villagers do not need vaccines, as the vaccine kills and Anjali will get money from the government if any villager died.

Venu Vare, of Trimbakeshwar, told people about her own experience of getting vaccinated but people would tell her that they would be given a poor quality vaccine and not the one that she got. Also, the vaccination centre is about 30 km from the two villages but even if the vaccination centre were closer to them, not many of them would agree to get a vaccination.

Namrata Thakur, from Tawa PHC in Palghar district, told that people believe that working on farms gave them stronger immunity against COVID-19, and vaccines lead to fever, which hampers those who depend on a daily wage.

Also, at Vavi village (PHC) in Nashik district in a vaccination drive in April 2021, only 20-25 people above the age of 45 years turned up, even though the centre was only 4 km from the village.

Hesitancy and myths of vaccination are not only limited to Maharashtra but also in other states like Nuh One of India's most backward districts of Haryana had vaccinated less than 1% of its targeted population.

A bizarre case of the hesitancy of vaccination has come forward, where Villagers in Uttar Pradesh's Barabanki jumped into a river to escape getting vaccinated against Covid-19. The villagers said they jumped into the river because they were told that this was not a vaccine, but a poisonous injection.

Hence, there is an urgent need for a vaccination awareness campaign by the Doctors, administrators or educated local people who can create awareness and clear all the myths concerning vaccination of the rural population. The rural people need door-to-door counselling and transport services to reach vaccination centres, especially in remote villages.

~Authored by Sunayna Jain