We weren’t prepared. We never imagined that COVID-19 would show its ugly head here, in our remote corner of the country. We live and work in a tiny pocket of land in north-west Uttarakhand, sharing a border with Kinnaur district of Himachal Pradesh on one side. On the other, we’re walled-in by great Himalayan peaks.
The rivers Supin and Rupin birth from high-altitude glacial lakes in these peaks and flow through the upper Tons Valley to form the River Tons.
The upper Tons Valley is home to 37 villages situated inside of an animal sanctuary, amiably sharing space with leopards and sloth bears and barking deer. There is no place for a virus here, only vast stretches of mountains and meadows and streams snaking through deep valleys. Idyllic and safe. Not quite.
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From a handful of cases to a COVID death
While the COVID-19 pandemic last year brought economic devastation to these parts that largely depend on scant tourism over the summer months, it didn’t bring us more than a handful of COVID-19 cases, or death.
Till a month ago (early May), while the rest of the country was sending out SOS messages for oxygen and ventilators, we were still largely unaccustomed to wearing masks here.
It was only when a fit 32-year-old father of three lost his life to complications arising of COVID-19 in the first week of May that the first signs of the looming tragedy started to show up. Suddenly, everyone, even toddlers, had a mask on.
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And in less than two weeks after the young man’s death, 16 of 37 villages were declared containment zones and over a 100 new cases were being recorded every single day.
Crumbling healthcare facilities
That healthcare infrastructure in rural India is sorely lacking is well known, but in the last month, the ineptitude has been felt in these parts like never before.
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One primary health centre lying in apathetic disarray, a single MBBS doctor, and none of the equipment required to fight a raging pandemic was all that was available to all of the upper Tons Valley’s 37 villages (and more in neighbouring areas) and its 25,000 people.
Challenges of topography, testing and poverty
Compounding the crisis were three factors, – the challenging topography, a very low rate of testing, and poverty. Only 18 villages in the upper Tons Valley are connected by road. The rest by foot-tracks on which man and mule ply.
If someone is sick in the remote villages, even bringing them down to the main roads poses a problem. It takes more than a few hours, and at least four men to carry one person down in a makeshift chair-stretcher or ‘kursi’.
It is a tough ask for COVID-19 testing teams to travel to the more remote villages. And so, often, there is no testing despite reports of whole villages being sick with a fever.
There is also immense resistance to testing, largely because villagers fear ostracisation and also have fields and cattle to tend to.
We’re talking about an area where 80 per cent of families are below the poverty line, and more have been nudged over this line in the last year with the primary source of income – tourism — coming to a dead standstill.
And where people have the will to take those unwell to the hospital, money acts as a deterrent. This usually means calling for an ambulance and going 200 kilometers away to Dehradun or Rishikesh, where there are functioning ventilators and ICUs in government hospitals. Do the math.
Kalap fundraiser
When we, Kalap Trust, put our COVID-19 Surge Relief Fundraiser out on May 16, 2021, our immediate intent was to address the lack of facilities for COVID-19 positive patients in the upper Tons Valley and to create a centre where patients could be attended to immediately, instead of having to travel far distances.
The key challenge was to arrange for oxygen-concentrators. When we did manage to procure four oxygen-concentrators, our next challenge was to get them from the NCR (National Capital Region) to Dehradun and to the upper Tons Valley in the middle of a strict lockdown.
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We could only do this because we approached our Uttarkashi district administration and offered to collaborate – they had the trained medical staff, a space where we could set up a COVID-care centre, and the authority to grant requisite permissions for transportation, we had the funds (from online fundraising) to procure equipment and install it.
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Within 96 hours we were able to set up a five-bed oxygen-support COVID-care Facility in a classroom at the Intermediate College in Mori, adjacent to the lone Public Health Centre in all of the upper Tons Valley. We brought in oxygen-concentrators, hospital beds, all manner of medicine and medical equipment from the NCR and Dehradun, the state capital.
COVID langars
We recognised that to ensure patients come from far and wide, we had to provide food at the COVID-care Centre, as no eateries were open due to the lockdown.
So our next step was to set up a langar (free kitchen) to serve freshly cooked, nutritious meals to patients, their attendants, and the already-overworked healthcare staff at the centre.
At the same time, we realised that for every one patient admitted at the centre, there were 50 isolating in the villages. We worked with the pradhans of all 37 villages for the ram panchayat langar that would provide cooked meals to those isolating. This also ensured that no chulhas (wood-fire stoves) were lit in homes with COVID-19 patients.
Almost 100 per cent of the homes here cook on woodfire, and the smoke is harmful to virus-affected lungs. Good nutrition and a smokeless home are the two things we have been pushing in the villages to boost the recovery rate of COVID-19 positive patients. This, we feel, has met with reasonable success.
We have sent out pamphlets to every village, hoping to drive home the dos and don’ts, and also encouraging people to bring those unwell to be attended to, at our Covid-care centre.
Why pamphlets? Because lack of a network means phones are useless here. If we sit down and list all our challenges in order of most-challenging to least, this would occupy the top spot.
Shubhra Chatterji is a writer/director who travels around India documenting its culinary culture. She divides her time between Mumbai and the Tons Valley. She is co-founder of www.tonsvalley.shop. Views are personal.
