Healthcare Personnel, Public Health Activists Pen Letter for All Indians on COVID-19

New Delhi:  A number of healthcare workers and public health activists have expressed concern over super-speciality government hospitals being converted to “COVID hospitals”. 

In an open letter written to all Indians, reminding them of their role in community participation to tame the spread of the coronavirus, the signatories stated that such an action by the government is “leading to distress of many other patients such as those with tuberculosis, HIV, cancer, non-communicable diseases, as well as emergencies.”

The letter has among signatories, Karnataka public health doctor Syliva Karpagam, AIIMS professor Shah Alam Khan and Kerala state planning board member B. Ekbal.

“Planning for COVID should not be at the cost of other patients,” they wrote. 

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Calling community participation a “key” in controlling the spread of COVID-19 and “an important measure to keep our vulnerable communities safe,” the signatories particularly called on the MLAs, MPs, corporators, police, media and religious leaders to play a crucial role in strengthening it by highlighting certain issues, including the need for essential public transport, mainly in remote areas, and better food security. 

“With an already poor state of nutrition and high rates of non-communicable diseases like diabetes, hypertension, heart disease, etc., this lockdown will cause even more health issues.” 

“We are particularly concerned about those in remote areas who many not be able to access healthcare in the absence of public transport,” it added.

Requesting the government to identify a broad based group of public health experts with “wide representation from all other sectors, particularly the marginalised communities to plan for the pandemic in a scientific manner”, they also suggested that people should highlight “lack of PPE (personal protection kit) for the (medical) staff, the need for decentralised public healthcare, availability of affordable lab services across the country, especially in remote and inaccessible areas.”

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Calling all Indians to maintain physical distancing with social consciousness, the signatories of the open letter also expressed “extreme concern” about “reports of social distancing being used to legitimise caste-based discrimination by denying rations and other essentials”. 

The letter points out too “communalisation of the pandemic, particularly targeting Muslims”, which it said, “will prevent us from using this opportunity to identify gaps in our public health system and put pressure on the government to plug these gaps so that we are much more prepared for any future outbreak”.  

Condemning such an attitude, they said:

“Blaming one community while not holding the government accountable serves no purpose”. 

The signatories also pointed out that several people who in spite of being role models for social distancing protocols have “themselves organised parties, religious events, celebrations and public gatherings”.  

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The full text of the letter, along with its signatories, is below:

We are healthcare workers and public health activists who strongly feel that this crisis is a time for all Indians, irrespective of gender, caste, religion, class, sexual orientation, ability etc. to come together, extend support, help and empathise with each other, even as we urge the government to strengthen health systems.

Community participation is key in controlling the spread of a pandemic and an important measure to keep our vulnerable communities safe.

We feel that the ministers, MLAs, corporators, MPs, religious leaders, police and media have a crucial role to play in the following.

1. 1. Being role models in following safe distance protocols– It is of great concern when the people who should be role models in society themselves organize parties, religious events, celebrations and public gatherings inspite of this becoming an easy route to aggravate the pandemic
   2. Non discriminatory behavior – Overty communalising the pandemic using abusive, communal slurs, calling for economic and social boycotts, hate speech, misrepresentation and stigmatization is shocking. It is of deep concern that even volunteers distributing food to poor patients in hospitals have been targeted leading to distress for patients and their families. There is also covert targeting, such as denial of rations, healthcare etc. This is of deep concern to us and we condemn it in the strongest way. There have been several public events which could have created a cluster of positive cases. There is no rational basis for states or the centre to put out data specifically highlighting one event or giving a religious angle. This only serves to aggravate the already volatile communal situation in the country and doesn’t add to our epidemiologic understanding or planning in any significant way. Even if does, this need only be available to those planning interventions. It need not be flashed everyday by media as a form of public discrimination. This communalization of the pandemic, particularly targeting Muslims will prevent us from using this opportunity to identify gaps in our public health system and put pressure on the government to plug these gaps so that we are much more prepared for any future outbreak. Blaming one community while not holding the government accountable serves no purpose.
   3. Physical distancing with social consciousness – In India, discrimination is already present in several spheres. We are extremely concerned about reports of ‘Social distancing’ being used to legitimise caste based discrimination by denying rations and other essentials.
   4. Strengthening public healthcare – We request all Indians, both in India and abroad to highlight the lack of PPE for the staff, the need for decentralized public health care, availability of affordable lab services across the country, especially in remote and inaccessible areas – overall a comprehensive, affordable and accessible healthcare for all our people. We are also particularly concerned that super-specialty government hospitals are being converted to Covid hospitals and leading to distress of many other patients such as those with tuberculosis, HIV, cancer, non communicable diseases, as well as emergencies. Planning for Covid should not be at the cost of other patients.
   5. Demand better food security – With relief work being less than satisfactory, large scale distress of the poor across the country should be the concern of everyone of us. With already poor state of nutrition and high rates of non communicable diseases like diabetes, hypertension, heart disease etc. this lockdown will cause even further health issues.
   6. Essential public transport – The lockdown has to be implemented with the least inconvenience to people. We are particularly concerned about those in remote areas who may not be able to access healthcare in the absence of public transport. We, the undersigned, request the government to identify a broad based group of public health experts with wide representation from all other sectors, particularly marginalized communities, to plan for the pandemic in a scientific manner. We also request Indians to use their platforms to demand better healthcare and not target anyone. Together we can beat the pandemic and also be better equipped in future for similar situations.

1. 1. Dr. Suhas Kohlekar, Virologist and social activist for health rights
   2. Dr. Shakeel, Consultant Physician and Convenor, Jan Swasthya Abhiyan, Bihar
   3. Dr. Monica Chandy, Consultant Neurologist, New Delhi
   4. Dr.Mohan Rao, former professor at the Centre of Social Medicine and Community Health, JNU, New Delhi.
   5. Deepika, Researcher , Chhattisgarh
   6. Dr. Amar Jesani, Independent researcher, Mumbai
   7. Dr. Sylvia Karpagam, Public Health doctor, Karnataka
   8. Dr. Nafis Faizi, People’s Health Movement
   9. Dr. Christopher Roy, Surgeon
   10. Dr. Prabir KC, Public Health Consultant
   11. Dr, Mira Shiva  (Public Health Physician )
   12. Dr. Vikas Bajpai, Assistant Professor, Centre for Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi
   13. Dr. Peehu Pardeshi, Assistant Professor, Jamsetji Tata School of Disaster Studies, Tata Institute of Social Sciences, Mumbai
   14. Dr. Bijoya Roy, Public Health Researcher, New Delhi
   15. Dr.K.R.Antony, Consultant Public Health, Child Survival and Development. Kochi
   16. Nachiket Udupa, Public health
   17. Dr. Nidhin Joseph, Public Health Physician, Mumbai
   18. Dr. Indira Chakravarthy, public health researcher
   19. Dr. B. Ekbal, Member Kerala State Planning Board
   20.  Dr. Shah Alam Khan, Professor of Orthopaedics, All India Institute of Medical Sciences, New Delhi
   21. Dr. Sulakshana Nandi, Public Health Researcher, Chhattisgarh
   22. Dewal, Public Health Worker Chhattisgarh
   23. Rajiv Choudhrie, MedSup Padhar hospital, Betul MP
   24. Dr Jammi N Rao, FRCP, Retired Public Health Consultant, United Kingdom
   25. Dr Sushrut Jadhav, Psychiatrist and Medical Anthropologist, University College London, UK
   26. Dr Kaaren Mathias, Public health physician, Uttarakhand
   27. Dr Bittu KR, Public health activist
   28. Brinelle Dsouza, TISS and Convenor JSA Mumbai