Imphal Review of Arts and Politics

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The Need Now is for Private and Public Health Facilities to Work in Close Partnership

When the first confirmed Covid-19 case of Manipur was detected in a foreign returned student heading back home; the immediate chorus then was a social media mob that dragged out personal photos of the girl, questioned why she had to head back and risk infecting others and then went around fuelling rumours of how the said person had been a part of social functions, thereby making room for how she could infect others. Manipur and its people have come a long way in the Covid-19 journey since them but even as some things have changed, some remain the same: from the first panic button moment to a not so serious attitude fuelled by the fact that infection was still confined to people heading back home and at quarantine centres, to the current standoff where there is the beginning of a mad scramble for general health care made problematic by the growing numbers of transmission happening amongst the general public. The nature of the Covid-19 situation in Manipur has changed and for the worse, even as the reactions from the public and the unruly social media response remains mostly problematic and which in the long run may further complicate things in the long run.
It is important to state that no health care setting or institution can be allowed to turn away any patient in need. The allegations that an urgent medical case of a patient was unaddressed on the grounds that he was from a district that was showing a spike in Covid-19 cases, leading to delay and then to a tragic death is morally, ethically and for the medical profession, a sorry state of affairs. Unfortunately, all of this was avoidable with the Government taking up due strategic intervention and putting in a system of ensuring a functional health care system that would look into general health concerns of the public and Covid-19 care and treatment for those infected. This has not happened. What makes it worse is that unlike other parts of the country where the private health care system bore the brunt of Covid-19 infection in terms of taking in positive patients or their staff becoming positive for Covid-19 only after the Government hospitals had been exhausted; in Manipur private health care facilities are battling Covid-19 infections amongst its staff or patients and hence, becoming containment zones. This means that unlike other states where private health care has been roped in to aid Government health systems to address Covid-19 with their resources of staff and medical equipment, the same cannot be done in Manipur at least till the entire list of staff and their family members and all of the contacts of their contacts are tested till the chain of any likely transmission is broken.
It is here that the response and role of the community comes into the picture. When local clubs and community elders barricade lanes and roads ‘to ward off Covid-19 infection’, they have failed to consider the fact that any medical emergency in the neighbourhood that needs to be addressed is going to lose time while trying to reach a health care facility. Any group, any person who curtails health workers from reporting for their duty in the fear that they run the risk of being infected and in turn getting infected from them need to calm down and see the logic that general health issues and medical emergencies still need to be tackled and addressed. The more level headed approach for community leaders at the local level to do would be to take the onus of educating people about safety protocols, to forge support systems for families in case anyone has tested positive and to press Government mechanisms to test general health care providers now that the transmission has truly spread on to the larger community. Another helpful measure would be for community leaders to work out how neighbourhood infrastructure like the Leikai club or community hall can be used as temporary quarantine centres for doctors and nurses who have to report for duty.
One area that the Manipur government has to address without fail and at outmost speed would be to ensure two critical things are in place given the nature of the Covid-19 transmission right now: the first, is to test health care workers at PHCs and CHCs regularly and the second would be to set up a dash board or any technologically backed initiative that would link the public to their general and emergency health care that are of a non Covid-19 nature. The first measure would need other supportive measures like ensuring adequate PPE suits and other protection materials while the second measure assumes significance in light of genuine cases of medical discrimination and those that are being portrayed as one sided. In most parts of the country, there are partnerships between the Government, the health department, volunteers and tech firms to put on public domain the latest information about bed slots, ambulance numbers/doctors and nurses, their availability and their locations in order to help people use the one nearest to them, units of blood available, testing facilities and their charges as well. This would need to be backed by a robust helpline service with adequate staffing that would facilitate a smooth flow of referring the patient after taking his/her medical as well as any exposure or risk to Covid-19 infection, in which case the referral can be made to Covid-19 treatment centres.
The Manipur Government needs to pull up its sock now or be prepared for the current situation to turn worse still: one where the infection is spiking along unimaginable lines with the public losing faith in the medical system. It needs to outpace and outrun the virus while fostering and building trust with the community. This would have to start by instilling confidence building measures, something that is missing in the manner that the updates on the Covid-19 situation is limited to mere statistics and from an official. There is a drastic need now, more than ever to make the Covid-19 crisis in Manipur, a humane experience where everyone needs to be connected to one another in spirit while ensuring physical distance. There is an imperative need for the public too to realize that each one, each person has a stake and a role in how Covid-19 plays it out in Manipur. Question is: is the Government up to it? Are the people up to it?

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