Covid-19 and the invisibilisation of rural India

Two village pradhans (chiefs), in two different states, one in the north, another in the south, one in Uttar Pradesh (UP), the other in Tamil Nadu, pointed me in exactly the same direction to understand the muted tragedy that is unfolding in rural India.

As the government declares the worst of the second wave of the pandemic over in our cities and gets ready to unlock, in our villages, our citizens have been dying. And they have been dying uncounted, and mostly at home, from illnesses that match the exact symptoms of Covid-19, including plummeting oxygen levels.

On the ground, in every hamlet, even the smallest ones across states, residents say, anywhere between 20-40 deaths have taken place in May. Though rural health care infrastructure in our southern states is distinctly better than in the north, the struggle for testing and vaccines is exactly the same in large swathes of rural India, irrespective of geography.

In Tamil Nadu's Chennasandiram panchayat of seven villages, the panchayat president Jayakumar Reddy tells me that the surge in sudden deaths in the last two months has made people even more terrified to make the trek to nearby towns and cities — the only places where they have a hope of getting a vaccine.

Among the dead is 27-year-old Vijay, who was discharged from a private hospital and told he was well enough to go home, only to die the next morning, eight hours later. We also meet Shobha, the sister of Rudresh, a young man who travelled from Bengaluru to Hosur in the hope of finding a hospital closer to his home. He ended up riding in an ambulance for 250 kilometres before dying in the vehicle, unable to find an oxygenated intensive care unit (ICU) bed. "No one cares about the poor," his sister says, barely able to form the words through a cascade of tears.

Children sit at a bus station, as they wait to board a bus to return to their villages, after the Delhi government ordered a six-day lockdown to limit the spread of Covid-19. PHOTO: REUTERS

"We want vaccines," implores Reddy. "We are all farmers. As poor people, are we going to be completely overlooked?" he asks.

The invisibilisation of rural India is the stage of the pandemic we are now at, relegated to the margins of public and policy discourse and attention.

Tragedies abound in our villages where hardly anyone is chronicling them. Not only are their deaths slipping through the official cracks — of deep concern in a week that saw Bihar reconcile its death data in thousands, causing India to breach the 6,000 mark for daily fatalities — the absence of vaccines and testing also means we may not be measuring the trajectory of the second wave accurately. The crests and troughs in Covid-19 cases and the spikes and falls of daily infographics by which we now measure the wellness of our lives have been based mostly on city-driven data.

Reddy reports 20 confirmed Covid deaths in the villages under him in Hosur. He does not think most of them have been certified.

Hundreds of miles away in Ramana village in Varanasi, Prime Minister Narendra Modi's constituency, the village pradhan (headman) reports twice as many deaths, 40 in the last few weeks. Ram Gopal, who lost two family members, an uncle and a grandfather, shows us all the related medical paperwork. In one case, no death certificate has been provided. In another "typical pneumonia", and not Covid-19, is listed as the reason for the fatality.

In UP's Kannauj, at the cremation ground, residents say four or five hearses have left their villages every day in the past few weeks.

The ethical issue with these deaths remaining uncounted and unrecognised is obvious. But from the perspective of framing public policy too, there is a real conundrum.

If sickness and death in India's villages remain on the margins of public and media attention, do we really know for sure if cases are coming down? Is the decision to ease restrictions based on data that is entirely city-centric? And once movement between villages and cities resumes, isn't there a real danger that the virus will also travel up and down, undetected?

In the north especially, primary health care centres (PHCs) I have reported from have been mostly locked or abandoned. Forget Covid vaccines or RT-PCR testing kits, these PHCs don't even have doctors.

In 2020 we saw the poorest Indian citizens suffer as migrant workers, in the hundreds of thousands, fled the cities on foot, sometimes barefoot, to return to the villages.

In 2021, the virus came home for the wealthy and upper-middle-class Indians. Of course, low-income households suffered the most, financial penury compounding their grief and loss.

But as the situation in the metropolises slowly comes under tenuous control, the Delta variant's damage has once again exposed the great class divide of the virus and our response to it.

Barkha Dutt is an award-winning journalist and author