Accounts from Mumbai's Dharavi on efforts to chase away the virus

The first reports of Covid-19 from Dharavi’s snaking lanes — which house more than 850,000 people in crowded tenements as small as 100 sq ft — conjured up a potential tinderbox
By all accounts, physical distancing is impossible in Dharavi, which, at 2.5 sq km, is one of Asia’s largest informal settlements. The first reports of Covid-19 from Dharavi’s snaking lanes — which house more than 850,000 people in crowded tenements as small as 100 sq ft — conjured up a potential tinderbox. In about two months, that threat has seemingly diminished through the inspired efforts of civic administration, volunteers and residents. From the high 90s in early May, the number of positive cases reported daily has dropped to the low-20s and even 10s in June. The mortality rate and the rate at which cases are doubling too have slowed. Next, many in the sprawling slum are hoping for recovery from a loss of income. 

Anil Pachnekar and Avni Raut 

General physicians

Initially, people were not always willing to share accurate medical and travel history during screening. To most the prospect of quarantine felt like jail. That fear reduced considerably if the figures who came clad in blue had familiar voices. So about 25 general physicians whom the residents of Dharavi know well helped in surveying severely affected pockets such as Mukund Nagar, Kalyanwadi, Muslim Nagar and Social Nagar. Leading them was Anil Pachnekar, of the Mahim Dharavi Medical Practitioners Association. He has run a clinic in the area for 35 years.

 

The initial weeks were horrifying, he says. At least eight doctors in his team tested positive but came out unharmed. He worried particularly for the safety of his two sons, both doctors who have kidney conditions, and took hour-long baths each day after reaching home and peeling off the oppressive protective gear.

Also among the volunteering doctors was Avni Raut, who has worked in Shastri Nagar for 15 years. She recommended about 40 patients for hospitalisation, of whom nine unfortunately succumbed to the disease. The rest came back and thanked her. After the recent improvement in numbers, Raut, who has not taken a single day off, now examines 50 patients a day versus 200 patients earlier. As many as 350 local doctors have since joined these efforts.

Shaikh Mobinuddin

Dharavi-based entrepreneur

The chirping of sewing machines, which is the background score of Shaikh Mobinuddin’s life, has become muted. The fourth-generation entrepreneur has made fortunes in the scrap recycling and bag-making businesses, and rents out workshops to several smaller firms in Dharavi. But the lockdown cut short bag production for June’s back-to-school season and work is unlikely to resume soon. Of the roughly 10,000 workers from Jharkhand, Bihar and West Bengal who laboured in his neighbouring compounds, only 50-100 have stayed back. As many as 250,000 migrant workers reportedly left Dharavi after relaxations in the lockdown late last month. No one is being asked to return just yet.

 

The global aspect of the recycling business in Dharavi, which took in scrap from West Asia and sent out finished products to the United States, is also in peril. “The blood flow of the economy has stopped,” says Mobinuddin. By some estimates, the slum’s informal industries are worth $1 billion.  

‘I stand with Dharavi’

 

Local volunteers

 

The road to recovery in the slum has not been without painful errors. A death in Dharavi Main Road prompted local youths to start “I Stand with Dharavi”, a movement for Covid-19 relief. Sunny Gadre’s mother was refused tests for three days late in April, until her symptoms worsened and she died shortly after admission to Sion Hospital where the infrastructure was in a shambles. Even after this, Gadre himself was refused a test and had to find a bed for isolation without help.

 

 

 

Ever since, his friend and insurance agent Prashant Sadaphule has been enlisting volunteers for a range of tasks: enquiring about beds, sourcing medicines, spraying sanitisers, seeking accountability from civic administration, and gathering rations for families in the innermost chawls. Their next big effort is to create a database of locals left unemployed by the pandemic. “There is a new stigma attached to the slum now. Companies are calling employees who stay as far as Panvel and Ulhasnagar back to work, but not those living in Dharavi,” he says. 

Kiran Dighavkar

Assistant municipal commissioner, G North ward

“Crisis doesn’t create character. It reveals it,” reads Kiran Dighavkar’s profile image on WhatsApp. For three months now, his work days have started early with a call and ended near midnight. The assistant commissioner of Brihanmumbai Municipal Corporation’s (BMC) G North ward had the formidable task of driving Covid-19 out of Dharavi, Mahim and Dadar. “When the pandemic entered Dharavi on April 1, it brought death,” says Dighavkar, referring to a 56-year-old from Baliga Nagar who tested positive and died the same day. “I had to look calm and not show I was worried.”

 

Until then, only those who had travelled in prior weeks were being screened and stamped. These scattered and unhurried steps had to be gathered into an urgent strategy. A team of 2,550 workers was raised. Medical staff — doctors, nurses, ward attendants — are now screening people door-to-door, running fever clinics and monitoring patients in quarantine centres. To isolate the infected, engineers have set up 12 facilities including inside a sports complex, college and a nature park. BMC’s gardening staff distributes food packets. Solid waste managers clear the garbage and sanitise the quarter.

Dighavkar’s emphasis was on early detection and isolation, which is why cases were higher at the outset. Rather than bringing down numbers, he focused on improving treatment. Careful not to celebrate prematurely, Dighavkar maintains that the situation is dynamic, given factors like the monsoon, which brings its own diseases, and the reopening of the economy, which will free up movement. There are, however, signs of hope. One of the schools his team took over for quarantining people has been sanitised and will be handed back to the education department. “With only 10-25 new cases a day, we don’t need as many quarantine centres.”

Manjula Katakdhond

Community health worker

Of all those involved, the quietest contributions have been by ASHA volunteers, who have been on Covid-19 duty long after their usual shifts for an extra Rs 300 a day. From putting up posters and demonstrating precautionary measures in the period before the disease grew teeth, their responsibilities expanded to coaxing out contacts of positive patients for surveying.

 

On the field, they have been chased away by angry residents, and back home their neighbours have looked at them suspiciously. With little infrastructure in the early weeks, Manjula Katakdhond, a community health worker, made masks out of saree ends.

Katakdhond and her 17 colleagues in the Shastri Nagar area now have masks, hand gloves and budding public cooperation. The sight of the women with navy blue lanyards makes some locals obediently reach for face covers and stand slightly apart.

TM Jagdish

Local corporator

Relatives of the afflicted and BMC staff alike have come to rely on T M Jagdish to quickly match patients with spare hospital beds. The Shiv Sena corporator, known locally as “Jagdish bhai”, has been spotted a few times sanitising the streets and toilets of Ward No. 185 himself in his trademark white shirt and Ray-Bans. But with the recent dip he is back to overseeing monsoon repairs including de-silting.

 

His Kumbharwada office has also become a venue where people from his and neighbouring wards line up in the hundreds for cooked meals. The pandemic has pushed his electorate — mostly domestic workers, cab drivers and lift operators — deeper into poverty. Despite government-led initiatives and donations by NGOs, the need for rations is nowhere close to being met, he points out. Even as the threat of disease declines, the problem of food security looms large.


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