South Asia's battle against Covid-19

On March 15, Indian Prime Minister Narendra Modi did a video conference with heads of SAARC nations to discuss a joint plan to combat the Covid-19 pandemic and proposed a Covid-19 Emergency Fund and setting up of a Rapid Response Team of doctors and health specialists

Nirupama Sekhri Apr 05, 2020

On March 15, Indian Prime Minister Narendra Modi did a video conference with heads of SAARC nations to discuss a joint plan to combat the Covid-19 pandemic and proposed a Covid-19 Emergency Fund and setting up of a Rapid Response Team of doctors and health specialists. As the virus continued to spread, all countries South Asia - the world's most densely populated region - are in lockdown mode and trying to deal with the problems in their own way. Health ministers of SAARC - a grouping that has been virtually moribund till now - are seeking to pool data, knowledge, expertise and resources, giving a fresh hope to regional cooperation. 

SAM brings a roundup of developments in the South Asian nations vis-a-vis Covid-19: 

India reported its first Covid-19 positive case on January 30 in Kerala of a student who had returned from Wuhan, and the following almost 100 cases reported up until mid-March all had travel histories to the virus-affected countries. To prevent, or rather reduce, community spread, the government on March 14 declared Covid-19 as a 'notified disaster' that allowed the states to address it as an emergency. Prime Minister Narendra Modi addressed the nation on March 19 and advised voluntary social distancing and isolation of old people, followed on 24 March with an announcement of a nationwide lockdown for 21 days. This triggered a panic exodus of migrant workers, which both the central and state governments have been trying to address through various measures, like providing free rations, setting up public kitchens, extending 24-hour helplines, etc. On March 15, PM Modi also initiated a video conference of SAARC leaders.

While all international travel to India has been suspended since March 25, evacuation procedures have been ongoing since February 1 - both independently, and jointly with other countries. The Ministries of Health and Science & Technology by ramping up testing and training labs capacity across the country and making protective equipment readily available to health and law enforcement agencies. Till date, Covid-19 positive cases had climbed to over 3375 with 77 deaths reported.  

Bangladesh had evacuated its citizens from Wuhan in February, and reported its first Covid19 case on March 08, in the death of a 70-year old man on March 17. The country has reported almost 60 cases so far and six deaths, with Prime Minister Sheikh Hasina announcing a shutdown on March 26 extended till April 09 terming it a 'general holiday'. While essential commodities and services have been allowed to operate, the Prime Minister has specifically directed the Ministry of Agriculture to support farmers with resources to ensure optimum output for the present and reserves for the future. The Asian Development Bank and the US government have announced financial aid to Bangladeshi garment industry workers, as well as those in other export-oriented manufacturing.
Pakistan's first case was reported on February 26, and the few reported immediately after, were all traced to exposure in Iran, a hotbed for Covid-19 spread. By March 20 the numbers of infected had risen close to 500, and the first death was reported of a 77-year old man. By the beginning of April, 2450 positive Covid-19 cases and 35 deaths had been reported.
Pakistan had started screening passengers from China from January 30 but suspended all flights from there only on March 13; the suspension of other international flights and closing of borders was implemented on March 21. Prime Minister Imran Khan had resisted a total lock-down decree, citing an India-like panic exodus of workers; but did do on March 24 promising help to workers, and announcing the formation of youth force ‘Corona Relief Tigers’ on 27 March to help the government reach out to those in need to fight against the spread of the disease. 

Additionally, State Minister for Health, Dr. Zafar Mirza, who is a medical doctor with a post-grad in Public Health in Developing Countries and work experience with the WHO, has invited proposals from individuals and institutions to fight against Covid-19, with a provision for generous funding for promising ideas. The government has also announced that any doctor or paramedic dying due to Covid-19 will be considered a martyr and commensurate relief provided (Rs. 10-20 mill).

Sri Lanka had its first confirmed case of Covid 19 reported back on January 27th, when a 44-year-old Chinese woman who had traveled from Hubei province was admitted with high fever to the National Institute of Infectious Diseases in Angoda. Consequently, she recovered and was discharged on February 19. In quick response, the Government had evacuated 33 Sri Lankan students and families from Wuhan on 1 February and kept them in quarantine at a military facility at Diyatalawa. They were released after two weeks, and the Government got busy preparing quarantine facilities, which from the first week of March housed passengers coming from Italy, Iran and South Korea who were mandated to a two-week quarantine period at these centres. The second week of March recorded a spike in cases and the country suspended visas on arrival for tourists on 11th March to April 07. 

As of now, only aircraft with cargo, medical equipment or emergency transit passengers are being allowed to ply.Yet, like the trajectory everywhere else, infections have been on an increase, reaching to almost 150 confirmed cases and three deaths (first on March 28 off a 60-year odd man). In response, the country has hundreds of people who may have been exposed, under quarantine, as well as declared Colombo, Gampaha and Kalutara as high-risk zones with a lock-down imposed indefinitely for a maximum period of two weeks (till mid-April), and cordoned off villages and neighbourhoods from where Covid 19 patients have been reported.

Sri Lankan President Gotabaya Rajapaksa has initiated a ‘Covid19 Healthcare & Social Security’ relief fund to support citizens through the pandemic, towards which he himself contributed Rs. 100 mill. from the President’s Fund. In addition, he has deferred the payment of electricity and water bills for all citizens. The Government is also encouraging its citizens not to hide their travel history, and discouraging children and elderly from venturing out of their houses and urging only one person per family to visit markets. Amid the lock-down, the government has allowed a cautious permission to farmers, fishermen and cleaners to continue work. Banks and insurance companies have also been advised to continue basic services.

To impart clear information, the Epidemiology Unit of Sri Lankan Ministry of Health & Indigenous Medical Services is hosting a simple but succinct two-page update on the Covid-19. However, the country has waded into controversy recently after forcing the cremation rather than burial of two Muslim Covid19 patients despite WHO laying down clear guidelines for a safe burial procedure being followed in countries round the world. 

Nepal reported its first Covid-19 case in early January when a Nepalese student returning from Wuhan tested positive, but it was only by February 16 that 175 Nepalese nationals were flown back from China after due exit screening processes. They were all kept under observation in quarantine facilities that the Government had set up. The Nepalese government has conducted just over a thousand tests, found only five positive, believes that cases so far are all imported, and imposed a lockdown to avoid local transmission of the virus.
There has been, however, an influx of domiciles returning home and the quarantine centres have not been able to cope, leaving many Nepalese stranded, not least in India, which has around two million Nepalese workers, mostly in low or un-skilled jobs. Many of them panicked along with the Indian migrant workers after PM Modi's March 25 lock-down announcement, and joined the exodus to return home, only to find the borders sealed, where thousands remain stranded, like in Dharchula, Uttarakhand. 

Even though Nepalese authorities have assured that the Indian government will provide them with shelters and daily sustenance, the India-Nepal border remains flooded with cross-border migrant workers, desperate to get home. The same is true for about one thousand Indian citizens stuck on the other side of the border who are also in the process of being granted permission to return.  

Bhutan had confirmed its first Covid-19 patient to be an American tourist, and has had three more cases since, one being a Bhutanese student studying in the UK. but all imported. Bhutanese Prime Minister Dr. Lotay Tshering has announced a lockdown till April 21 of the mountain country. Health minister Dechen Wangmo has assured of sharing regular up-to-date information on the developments in the country, as well as maintaining the confidentiality of patients.

Maldives with a population of 428,000, invests 13% of its GDP on health, and swung into action quite early receiving 1000 testing kits for local testing and fitting its main airport with thermal cameras to screen inbound passengers in early-February. It reported its first positive Covid-19 patient on March 7, and has confirmed less than 20 positive cases since, with no deaths so far. The government has set-up 17 isolation centres, 867 quarantine facilities and three dedicated clinics for COVID-19 providing free consultation. 

Afghanistan, at the other extreme, has reported almost 240 Covid-19 positive cases and four deaths, and is seen as a global high-risk country for Covid-19 spread because of the country's fragile public health infrastructure and the fact that more than 100, 000 Afghanis are reported to have crossed the border from Iran since January. To reduce spread of infections in jails, prisoners not considered a threat to public safety, like the elderly, women and child prisoners are being released. Both the Taliban and the Afghan government are encouraging people to self-isolate and Kabul is under lockdown - but the Taliban locked in protracted negotiations with the government over prisoner swap, say they will not let up on the fighting. 

(The author is a writer and educator)

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