An inexplicable spurt of colds, coughs and fevers in villages of Uttar Pradesh is causing ripples of unease. PHCs, pharmacies, doctors and ASHA workers in rural parts of the state are worried, more so in light of the spiralling COVID 19 cases in the state.
Barabanki and Unnao, Uttar Pradesh
Lallan Chauhan was at the nearest medical store to pick up paracetamol tablets. “I have a fever. So do my two sons and wife,” Chauhan, a farmer who cultivates watermelon and vegetables, told Gaon Connection.
Chauhan hails from Gandhipur, a small village of about 250 people, in Fatehpur block of Barabanki. “Of the twenty odd families who live in my village, fifteen or sixteen of them have a member or two sick with cold, cough and fever. In some households, the entire family is down,” he said.
At Belhara, also in Fatehpur block, health worker and lab technician Shadab Alam sounded worried. “The situation is worsening day by day. Lots of people are complaining of fever, coughs and colds. No one is taking the pandemic seriously,” he told Gaon Connection.
As COVID-19 cases continue to rise in India’s most populous state, Uttar Pradesh, a ‘mysterious’ viral fever is stalking its villages, claim the local people. Patients are dying too.
The state reported 34,372 fresh cases of COVID19 and 332 deaths due to the virus in the past 24 hours. Has the virus made inroads into India’s villages? There is no definite answer as COVID-19 testing is poor in rural India with an even poorer health infrastructure. Coupled with it, villagers are reluctant to get themselves tested for the coronavirus due to the stigma attached to the disease.
“Our health workers are keeping an eye out, and in case anyone displays the Coronavirus symptoms, we recommend home quarantine and give them medicines,” Santosh Singh a doctor at the primary health centre (PHC) in Chheda, Suratganj block of Barabanki, told Gaon Connection. He was confident that the COVID-19 cases were not as bad in villages as they were in the cities. He attributed most of the fever cases to a ‘seasonal change’.
But the fevers are rising in number. So much so that at a medical store not too far off from Chheda in Barabanki, the pharmacist has been busy all day, for several days. “There has been an increased demand for paracetamol tablets. And I have stock only left for another day or two,” he said. According to him, even the supply of medicines is erratic. “I ordered ten boxes of paracetamol, but got only two,” he said.
In the nearby village of Ghaghsi in Barabanki, ASHA worker Sangeeta Devi also confirmed that many villagers were suffering from severe coughs, colds and often fever.
Hundred kilometres away from Barabanki, a fever is spreading rapidly in the villages of Unnao district too. “Every family seems to be affected by the viral fever,” Sanjay Yadav, gram pradhan (village head) of Badarka village, told Gaon Connection. On an average, in a family of four at least two or three of the family members are afflicted, and clinics of the local doctors are crowded all the time, he said.
“The population of Badraka is approximately 2,000. Yet, nothing has been done so far to sanitise the village. We are doing all we can with the help of the cleaners in the village,” Sanjay Yadav said. “It would not be wrong to say that nine out of ten families in the village have fever,” he worriedly added.
Not very far from Badraka village, at the Dhanvantri clinic in Korarikala village of Sadar tehsil, people wait their turn to meet RP Chaurasiya, the local doctor. “The number of fever patients I am seeing is threefold this year. While last year in April and May I would have no more than forty patients coming to my clinic a day, this year the number is nothing less than hundred and thirty daily,” Chaurasiya told Gaon Connection. “Eighty per cent of them have viral fever and a cough,” he said.
ASHA worker Renu Yadav, a frontline health worker, claimed she had never seen anything like this before. “Almost every family is struck down with fever. The viral fever is spreading rapidly,” Renu Yadav from Katri Alhuapur Sarosa village in Sikandarpur Karan block of Unnao, told Gaon Connection.
“People have stopped meeting each other. They are scared of getting infected and are therefore staying home,” she said. The health workers are going door-to-door counselling the people about hygiene, drinking boiled water, and so on. “We are also distributing medication wherever required. But the situation is grim,” Renu Yadav reiterated.
In Ramachara Mau village of Unnao, 56-year-old Om Prakash died of a fever on April 28. “In just a couple of days, what we thought was a normal fever became serious enough for us to take him to a hospital,” his 48-year-old brother Satish Kumar told Gaon Connection. He described the harrowing time the family had trying to find a hospital that would admit Om Prakash. After running from pillar to post, a nursing home in Kanpur took him in. But after spending two days in the Intensive Care Unit, Om Prakash passed away.
In the same village, 36-year-old Virendra Yadav was campaigning hard for his gram pradhan mother Medha Devi who was standing for the recently concluded gram panchayat elections. Today, he is lying in a COVID-19 hospital at Nawabganj in Unnao, 30 kms away.
“On April 25, Virendra had slight fever. We put it down to his exertions of visiting several villages a day to campaign for his mother,” said Ramkumar Yadav, his father. According to him, the fever increased the following day, but Virendra just took some paracetamol tablets and did not bother too much. “Only when the fever continued to rise unabated, we took him to a doctor nearby who took one look at him and recommended we admit him into a hospital,” he said.
On April 29, the fourth phase of UP panchayat elections, a silent bunch of people, their mouths and noses covered with gamcha, walked towards Itauriya village in Shahjahanpur. They were returning from the cremation grounds after attending the last rites of a fellow villager, who, they said, was a suspected COVID case. “He was a labourer and had returned from Delhi a few days ago. He developed a fever, complained of breathlessness and before he could go to the doctor’s, he died,” an inhabitant of Itauriya told Gaon Connection.
According to health worker and lab technician Alam, even though fever cases have registered a sharp increase in villages, there was still great reluctance amongst the people to come forward and get tested for COVID-19.
“We are afraid. What if we test positive and we are sent to a COVID19 hospital,” asked Vishambhar from Maikua village in Unnao. He said that was one reason why people were reluctant to even get tested. They avoided it and if at all someone got fever, they isolated themselves. “We have heard that the prevailing conditions in the hospitals are not good,” Vishambhar said pointing towards the constant visuals on TV of patients gasping for breath at hospitals that have run short of medical-grade oxygen and crucial drugs.
Meanwhile, many villagers are dismissing the fevers and colds as a seasonal affair. “Yeh corona phorona kuch nahin hai (there is no Corona here),” phoo phooed Moolchand Varma from Pipri Shadipur in Sitapur district. “We work in the fields during the day under the hot sun and sleep out at night when it is chill,” he pointed out. “Obviously, we will catch a cold and cough,” he scoffed.
What is ailing the villages of Uttar Pradesh is difficult to say as district level testing for the coronavirus is limited. Take the case of Barabanki district, which has a population of 3,260,699 as per the decade old 2011 census. On an average, about 2,000 tests are being conducted a day. For instance, yesterday on April 30, of the total 2,128 test reports received, 262 were found COVID19 positive. This means over 12 per cent samples were coronavirus positive.
On April 11, Barabanki district reported 71 positive cases. On April 15, this jumped to 307 positive cases. Five days later, on April 20, 384 people were found to be corona positive. But, as of April 30, 262 positive cases were identified in the district.
Similarly, in Mirzapur district (2,496,970 population as per 2011 census), on April 20, 1,485 samples were tested and 290 were found positive. That’s about 20 per cent positive samples, which means every fifth person tested in the district was found COVID19 positive. But, within 10 days, the official record shows that daily sampling jumped to 5,868 on April 30 with 210 people testing positive that day.
Meanwhile, in Unnao district (3,108,367 population as per 2011 census), 2,034 samples were tested on April 30 and 288 were found to be positive.
With many of the hospitals not entertaining patients with other health issues, there is a lot of self medication going on, said a local doctor at a small clinic, in a town about 30 kms away from Barabanki.
According to him, every day around 150 people come with fever symptoms. “They come with fever, cold and cough. We check their oxygen levels. If it is below ninety four, we ask them to go to a bigger hospital where they have a facility to treat them. Otherwise, we recommend home isolation and give them paracetamol,” he said on condition of anonymity.
“There is so much information on the mobile phone, and everyone knows to take a paracetamol tablet if they get a fever,” he went on to add. “One woman came in with nosebleeds. It turned out that she had read that steaming would keep COVID19 at bay and had ended up steaming so frequently that her nasal passage had dried up and begun to bleed,” the local doctor said.
While most villages have no access to proper medical facilities nearby, they usually go to the jhola chaap (quacks). “But because of the fear of the coronavirus, even the jhola chaaps have closed shop,” he added.
Gaon Connection contacted Amit Mohan Prasad, additional health secretary, health department of Uttar Pradesh. But, he did not respond to the phone calls. A set of questions has been sent to him. The story will be updated once he responds.
Written and edited by Pankaja Srinivasan. With inputs from Ramji Mishra, Shahjahanpur; Mohit Shukla, Sitapur; and Brijendra Dubey, Mirzapur, Uttar Pradesh.