COVID-19: What Gujarat, Maharashtra Can Learn From The Kerala Model

How did Kerala get its act together in the fight against COVID-19? How did states like Gujarat and Maharashtra lose the plot completely? To be fair to the Western states, population in cities like Mumbai and Ahmedabad is a major tipping point which changes the dimensions of the challenge in the fight against COVID-19. Both have highly congested areas with cheek-by-jowl settlements, Mumbai more so.

On the COVID-19 front, the one big difference is that Kerala's preparedness started very early in the day. As soon as the state Health Minister, K Sailaja came to know of the new virus emanating from Wuhan in China, she ordered officials in the state to gear up for it.

As early as 24 January, the monitoring team set up a control room and District Medical Officers in Kerala's 14 districts were directed to follow suit. When 3 medical students flew in on a plane from Wuhan on 27 January, Kerala had put in place the World Health Organization's (WHO) protocol of test, trace and isolate.

Kerala had placed more than 1,60,000 people in COVID-19 as the pandemic raged. The state has a well-trained army of health workers at the community level who visited those in isolation and monitored their condition. Kerala has now brought the number of those in quarantine to just over 20,000, media reports said.

Nipah-2018

Kerala won laurels for its handling of the virus Nipah, in 2018. This helped the southernmost state in the country to tackle COVID-19 more effectively.

Among the advantages Kerala has is a robust healthcare system down at the village or community level. For example, a motorboat government clinic travels across waterways in the backwaters of Alapuzzha tending to those in need and calling in an ambulance, if required.

Strong PHC network

This decentralised public health system has worked well for the state. In Kerala, one finds that every village has a Primary Health Centre (PHC) and clinics and hospitals down to multiple levels of the community.

Kerala's preparedness, in terms of creating clinics and a registry for respiratory disease well before the coronavirus pandemic, also proved to be immensely helpful. Kerala could thus put together a database on vulnerable segments of the community. Through this registry the state could also look out for COVID-19 cases and also for community transmission.

Gujarat, Maharashtra

What about states like Gujarat and Maharashtra? Both the states in western India are driven by a strong industrial base. Both have the presence of large corporate houses and MNCs. However, neither Gujarat nor Maharashtra has the sort of village or community level healthcare system which Kerala boasts of. Sure, Kerala has the advantage of being a smaller state and has it lower population level as well.

Why are these two states which are the industrial powerhouses of the country reeling from such high COVID-19 figures? Despite the progress accomplished on the industrial front, the public health care system in both states appears to be much more fragile than what one would have wanted to see. A costly lesson which all states including Maharashtra and Gujarat need to learn from Coronavirus is to follow the example of Kerala and set up a robust healthcare system which works down to the grassroots level.

Mumbai has excellent corporate hospitals as presumably does Ahmedabad. Even if one were to concede that the government hospitals in both the cities are just as good, what about the supporting healthcare system in the districts, Tehsils, blocks and villages.

The PHC network has to be revamped on a large scale everywhere, for all states notably Gujarat and Maharashtra, to get their act together in the healthcare sector. COVID-19 has driven home this point with sharp ferocity.