By Doctor George Jacob
Kochi, July 12, 2020: The sprawling megapolis of Mumbai has become one of the viral hotspots in India, as COVID-19 has decidedly refused to let go of its grip on the world’s second most populous nation. This hasn’t surprised anybody.
Mumbai, like New York is tailor made for SARS-CoV2 to wreak disaster. A population of 12.4 million, always on the move, and living in cramped conditions has been sitting duck for the rampaging virus. That is why of the 84,524 Mumbaikars infected,4,899 have succumbed. Mumbai’s healthcare facilities have been overwhelmed. Patients are being turned away from facilities which have run out of beds and equipment.
But, inside Mumbai where the viral pandemic seems monstrous in sheer form and dimensions, is a place which takes up one-square mile of the city. This place is called Dharavi.
It is one of world’s most densely populated areas (with 360,000 people/square km). Families comprising of those who survive on daily wages sleep in 8/8-foot rooms. Toilets are shared between families. People squeeze past one another in alleys. Social distancing, one of the basics in staving off the pandemic, remains just a dream in Asia’s largest slum, which formed the setting for Oscar-winning movie ‘Slumdog millionaire.’ Epidemiologists feared Dharavi sat on the heap of a keg powder of viral onslaught. It did.
For starters, a 56-year old garment shop owner became Dharavi’s first case of Covid-19 on April 1. He died the same day. A surgeon working in Wokhardt Hospital was Dharavi’s second case. Later his wife too tested positive. Since then, Dharavi’s viral graph seemed poised to go through the roof.
But that was not to be. Dharavi’s local population, with selfless intervention and on-the- ground involvement of selfless healthcare providers and civic authorities displayed tremendous resolve to produce a miracle – to flatten the Corona viral curve. Contacts of cases were meticulously traced and quarantined. Home quarantine in homes with rooms not much larger than matchboxes, in which 8-10 people squeezed themselves in, seemed unviable option.
But that did not deter a people determined to fight the virus. They created 3,000 quarantine beds out of a sports complex, a nature park, schools, marriage halls, hotels and guest houses. Once ready, 66 percent of positive cases were quarantined in these facilities. Food packets were served within Dharavi. People were denied reason to venture outside Dharavi for food.
That wasn’t all. Dharavi had a unique predicament- that of common toilets. Dharavi has 275 municipal toilet blocks, and 125 Maharashtra Housing and Area Development Authority toilet blocks. Each block consists of an average of 10 toilet seats. With reports of viral spread from toilets doing rounds, citizens and sanitary workers sanitized these potential ‘viral machines’ at hourly intervals.
Besides, Dharavi, a stroll through which resembled a mela gradually came to represent a ghost town. Entry and exit points were barricaded and manned. Bridges connecting areas with positive viral cases of vast difference were closed down. Unnecessary venturing out, spreading the virus in the process was a big NO!
These measures came at a price. Stocks of medicines and essential commodities ran out. Yet, citizens persisted with newfound discipline with determination and resolve.
House-to-house screening for cases and checking oxygen levels, especially among the elderly were untaken. Those with critically low oxygen levels were sent to hospitals outside Dharavi for specialized supportive care.
Till date, Dharavi has quarantined 2,480 in various institutions. Only 2,400 has tested positive in Asia’s largest slum- a miracle in medical terms, undoubtedly.
The ‘Dharavi Miracle’ did not tell the world about complicated treatment modalities or novel preventive strategies. No cry for a vaccine was heard from within Dharavi. No unsubstantiated jargon, half-truths and scary medical ‘studies’ were entertained by citizens who were manual laborers, who lived in overcrowded dwelling places.
The Dharavi miracle told the world that, having come thus far, in the global fight against a viral pandemic, basics remain the cornerstone. Still. Quarantining, strict avoidance of roaming around without valid reason, personal hygiene, liberal testing, tracing and isolating are good enough. Vaccine can wait. It will emerge when its gestation period ends, as vaccines have, historically.
That is exactly why the WHO Director General in a virtual press conference on June 17 included Dharavi in the list of places which successfully contained the virus, along with South Korea, Italy and Spain.