Coronavirus pandemic: Two sides of India's virus crisis

Mumbai slum's dogged approach holds lessons for others

'Chase the virus' response in Mumbai slum yields rewards, while Delhi struggles to cope amid soaring cases and scarce testing capacity

Healthcare workers and volunteers visiting the Dharavi slum in Mumbai earlier this month. The authorities have knocked on 47,500 doors since April to measure temperatures and oxygen levels, and have screened almost 700,000 people, in an aggressive ef
Healthcare workers and volunteers visiting the Dharavi slum in Mumbai earlier this month. The authorities have knocked on 47,500 doors since April to measure temperatures and oxygen levels, and have screened almost 700,000 people, in an aggressive effort to stem infections in the packed squatter cluster. PHOTO: REUTERS

MUMBAI • India's Dharavi, Asia's most crowded slum, has gone from coronavirus hot spot to potential success story, offering a model for developing nations struggling to contain the pandemic.

The authorities in the Mumbai slum have knocked on 47,500 doors since April to take temperatures and measure oxygen levels, screened almost 700,000 people and set up fever clinics.

Those showing symptoms were moved to nearby schools and sports clubs that had been converted into quarantine centres.

Fresh daily infections are now down to a third compared with early May, more than half the sick are recovering, and the number of deaths plummeted this month in the tenement where as many as 80 residents share one toilet.

The numbers are in stark contrast to the rest of India, whose daily tally of new infected cases has quadrupled since early last month.

Located near Mumbai's financial district, Dharavi's dogged approach to "chase the virus" could be a template for emerging markets across the world, from the favelas of Brazil to shanty towns in South Africa.

"It was next to impossible to follow social distancing," said Mr Kiran Dighavkar, assistant commissioner at Mumbai's municipality, who is in charge of leading the fight in Dharavi.

"The only option then was to chase the virus rather than wait for the cases to come. To work proactively, rather than reactively."

Officials were initially worried as positive diagnoses rose, but Mr Dighavkar and his team made it clear that screenings and testing would continue even as the count increased - their objective was to keep deaths limited.

"We were able to isolate people in the early stages," Mr Dighavkar said. "Unlike in the rest of Mumbai where most patients are reaching hospitals at a very late stage."

The strategy has helped reduce mortality and improve recovery. About 51 per cent of Dharavi residents who tested positive eventually recovered, better than Mumbai's 41 per cent rate. Fresh infections are down to an average 20 a day from 60 early last month.

A strict lockdown and accessible testing was part of Dharavi's strategy. If someone was not feeling well and wanted to get tested, he needed only to get institutionally quarantined and on-site doctors would take care of it.

However, Mr Dighavkar knew none of this would be possible without gaining the community's trust.

Home to nearly a million people where a family of seven may be living in a 100 sq ft hut, word travels fast in Dharavi and small gestures help. For instance, Ramadan - the Muslim holy month - was crucial.

Those in isolation centres were concerned about how they would keep up with rituals, such as breaking their religious fasts at sunset.

The authorities ensured the Muslims got fruit and dates and distributed proper meals at appropriate times, while all others received three meals a day.

Everyone in the isolation centres also received round-the-clock medical supervision free of charge, even as millions around the country lost their jobs due to the nationwide lockdown and reports trickled in of people dying before they were allotted hospital beds.

Dharavi's methods seem adequate to contain infections and the authorities must test everyone with symptoms like fever or a cough, said Dr T. Sundararaman, the New Delhi-based global coordinator of the People's Health Movement, a public health group.

However, Dharavi's war against the virus is far from over. Once shelter-at-home restrictions are fully lifted in Mumbai and the bustling city goes back to work, there is a risk of a second wave of infections.

"The battle can't be over until the virus has gone from the entire city, state and country," said Mr Dighavkar.

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A version of this article appeared in the print edition of The Straits Times on June 15, 2020, with the headline 'Mumbai slum's dogged approach holds lessons for others'. Print Edition | Subscribe