Rural healthcare in times of Covid-19

Rajesh Nirmal

Ground Report | Uttar Pradesh: 65.5 percent of India’s total population resides in rural areas. Tucked away in some of the remotest corners of the country, these areas are often characterized by poor development infrastructure. Unavailability and inaccessibility to health care services is the most crucial gap. There are certain barriers faced by the rural population, especially women while accessing health care that restricts their ability to obtain the care they need. In current Covid-19 times, these barriers have multiplied making the lives of the rural populations even more challenging.

During different phases of lockdown, people with access to smartphones, the internet, and correct information, could reach out to doctors for online consultation. More than half of the rural population, on the other hand, continued to rely upon the medicines they identify only by their colour mostly available at the local medical stores. "Almost everyone in our village depends on these locally available medicines. We have a habit of curing sickness without visiting any doctor. As the nearest government hospital is 8-10 km away from our village, no one has time and other resources to be spent on hospital visits,” shared 34-year-old Laalti Devi from Rampur Babuan village in Sultanpur district in Uttar Pradesh. (Rural healthcare in times of Covid-19)

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Laalti whose husband migrates to the city in search of work informed that in his absence, she looks after the family. “In such a scenario, if anyone from my house gets sick, we get medicine from the medical store and follow the instructions given by the pharmacist,” she said. Visiting private hospitals is not an option for the rural poor who find it difficult to make ends meet. 

During both the first and second waves, the majority of district hospitals were converted to Covid-19 facilities, further limiting the access of villagers especially in case of emergencies. According to Laalti, during the horrific waves of the pandemic, people feared even thinking about visiting the hospitals. They were, and still are, afraid that they will get infected with Covid-19 if they will visit hospitals. They are also frightened that they may be forced to get vaccinated if they will visit the government health care facilities.

Sharing her experience regarding obtaining medical treatment during the pandemic, Laalti informed, "Last year, I had developed certain health complications. With my husband not around, I had no one to seek advice from. The fear of Covid-19 was such that I decided to wait. After the lockdown was lifted and my husband managed to return, we went to the hospital for treatment. The infection, however, had spread because of the delay.”

47-year-old Prabha Devi, another local resident of the village, had to undergo uterus removal surgery. Due to the flooding of hospitals with Covid-19 patients, she could not avail of services of government hospitals. "I wanted my aunt to undergo surgery in the district hospital, but I was not capable of that kind of hustle. Due to Covid-19, people with other health complications were not being treated properly. Doctors were overwhelmed with the Covid-19 cases,” shared Sandeep, a relative of Prabha Devi.

"Looking at the Covid-19 situation, my family had decided that even if they had to take a loan or sell our fields, my treatment will be done at a private hospital because they could not put my life at stake," rued Prabha Devi. (Rural healthcare in times of Covid-19)

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Not every woman is lucky to have access to financial resources to get their illness treated. They keep suffering in silence. One of the reasons that prevent rural women from receiving institutionalised health care is the unavailability of hospitals in their villages. This year, the finance minister has, however, allocated Rupees 64,185 Crore towards strengthening health services in rural India. Besides, 35000 crores have been set aside to tackle the Covid-19 pandemic, which is planned to be spent on primary, secondary, and tertiary health care. Overall, there has been a 137% increase in the national budget as compared to last year. It is, however, not only the infrastructure that needs to be strengthened.

The issue of health literacy among the rural populations, especially women, also needs to be addressed as it impacts their ability to apprehend health information provided by frontline workers like ASHA. Due to poor health literacy, women feel reluctant to seek healthcare as they fear communicating with a healthcare provider. Additionally, low health literacy impacts the implementation of government initiatives. (Rural healthcare in times of Covid-19)

Drawing upon the experiences of the villagers, especially women, it is quite clear that a strong health care network must be established in rural areas sensitive to their needs. Using the budget allocated by the Union Government, the local administration should devise a special program, where the doctors and medicines should be accessible to villagers, and a strong healthcare workforce should help address the health illiteracy gap in these rural areas.

(The writer is a recipient of Sanjoy Ghose Media Award 2020. This article was first published in The Pioneer) Charkha Features

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