Covid-19: The Five Lessons of the Bhilwara Model – Analysis
On Tuesday, Prime Minister Narendra Modi extended the blockade for another 19 days, until May 3. But there was a nuanced political move that the prime minister introduced in his speech. He spoke about the critical points, which represent groups where a large number of cases have been identified and which can become sites of community transmission. These hot spots, he emphasized, had to be contained; the administration had to ensure that vulnerable areas were strictly monitored; and the general objective had to be maintained to avoid the appearance of new critical points. States, districts and subregions that can do so will see a relaxation of the restrictions after April 20.
Through this approach, the Prime Minister attempts to balance the dual, often conflicting, goals that the country must meet. On the one hand, it must soften the blow of the pandemic in a country of 1.3 billion people whose lives and livelihoods were forced to stop. On the other hand, you must spend time, money and resources in the containment of the disease and, finally, in its eradication.
To do the latter, the Prime Minister’s reference to critical points is crucial. It comes from several states in the country that declare certain areas as containment zones. In these areas, blocking is applied more strictly; even essential supplies are delivered to houses; there is aggressive screening; the test has increased; insulation is applied; patients are treated; And the effort is first to flatten the curve and then ensure that the area is free of disease.
This model assumed national prominence due to measures taken in the textile city of Bhilwara in Rajasthan, which became known as “ruthless containment,” a phrase coined by the state’s additional secretary (health), Rohit Kumar Singh. The measurements deserve close examination because the model is now serving a broader template.
Once it was discovered that the disease had arrived and spread to the city, the Rajasthan state government, led by Prime Minister Ashok Gehlot and Singh, along with a determined and competent local district administration, with the help of health professionals and police personnel, He worked tirelessly on two fronts: precaution and treatment. The Bhilwara model proved to be a difficult but necessary method. It was difficult because the model caused large-scale public inconvenience: it is not easy for any regime, especially democratic regimes, to alter the lives of citizens. But this was already done. Bhilwara’s first lesson, therefore, is that state governments must remain vigilant, have a constant feedback mechanism from the field, respond promptly, and be ready to make decisions, simply because of the spread of the disease and the contribution of experts.
When the first case was reported on March 19, the administration did not hesitate to implement a curfew from the inside out. Remember this was before the national blockade was imposed. Restrictions, though lenient, were put in place and essential services were allowed during this time. However, fearing further spread, the administration gradually expanded the geographic reach of the curfew by creating buffer zones, which eventually covered the entire district. Then he began adjusting essential supplies. This was a Herculean and multiple approach that required agencies to go door to door to deliver the essentials. This, then, is the second lesson: adapt according to the circumstances, implement even stricter measures when necessary, but do it in a sensitive manner and with a human face to ensure that the needs of citizens are met. This was then supplemented by aggressive screening of all residents and continued testing of symptomatic individuals. This is particularly commendable as the closest test center is in Jaipur, about 250 kilometers from Bhilwara. Over time, government agencies established dedicated Covid-19 hospitals and organized vehicles to transport people from rural areas to be tested. Thousands of hotel rooms and beds in other institutions and hostels were established as quarantine centers to keep symptomatic patients in isolation. This, then, is the third lesson. Hard measures are not an end in themselves. They are the means to guarantee better health results. And, therefore, the strict lockout period should be used to augment health infrastructure, test, isolate, and treat.
To keep local officials motivated, special and specific responsibilities were assigned to teams of elected village representatives, including subdivisional magistrates. This is the fourth lesson. India has strong institutions on the ground; it has leaders with roots in the community who have legitimacy with the people; It is important to make the whole process participatory by using these institutions and leaders. That will ensure popular acceptance.
There is, however, problematic compensation involved in the Bhilwara model, as in other containment areas. Pandemics trigger health emergencies that require coercive measures and the reduction of some civil liberties that are not often found in democracies. These include restrictions on freedom of movement – through curfew, quarantine, border sealing, etc. – and rationing of supplies. But perhaps, in times of unprecedented crisis, this is the only way to go. And that, then, is the final lesson. There will be short-term restrictions on rights, but it is for the broader public good and is conditional on the restoration of rights when public health improves.
Chandrachur Singh teaches at Hindu College, Delhi University.
The opinions expressed are personal.