Covid-19: Finally, a grassroots fight back

Battling a raging pandemic second wave with a centralised structure was never going to be easy in a city of 1.3 crore. The daily caseload of a whopping 20,000 had to be smartly tackled at the grassroots. Finally, after much delay and deaths, the bottom up, ward-level approach has begun to roll.

But the task is tough, and the odds are mounting. Months before the pandemic outbreak, the Ward Committees had wound up with the end of the Bruhath Bengaluru Mahanagara Palike (BBMP) Council. The committee members were, however, still around, ready to be activated.

Why it took hundreds of deaths to realise the untapped potential of these panels is a mystery. But the Palike has finally begun to set up Ward Decentralized Triage and Emergency Response (DETER) Committees to decentralise the Covid battle through localised action.

Beyond triage centres

Walk-in triage centres are now up and running in 28 assembly constituencies in the city. Simply put, triaging is a process that determines if a patient requires home isolation, stabilisation centres or hospitalization with or without oxygen and ventilators.

Also read: Covid: Walk-in triaging centres to help quick treatment

The challenge is to further decentralise and set up similar facilities in 198 wards. Currently, many ward committees chaired by nodal officers are in meeting mode, strategising, identifying centres for triaging and more.

Qualified health personnel

The arduous tasks ahead: To identify about 4,000 medical students to help do the triaging process at the ward level. An estimated 1,000 citizen volunteers have already signed up. But the technical part mandates involvement of people with expertise in health.

The DETER committees, essentially ward committees augmented by health personnel and morphed into disaster response mode, are required to first get organised locally. “They have to collect data on Covid patients in a ward, help people get tested early to reduce transmission, ensure timely results, and accelerate the triaging process,” explains Srinivas Alavilli from Janaagraha, involved in volunteer coordination.

Timely test results

The Primary Health Centres (PHCs) will play a key role in this decentralised setup. “PHCs, for instance, could keep a track on the oxygen levels of the identified patients in home isolation. The committees help ensure the communication lines between the patient and the PHCs are intact, be it sending timely test results or arranging ambulances.”

The ward level triage centres will follow a structure similar to the constituency-wise centres, but on a smaller scale. The existing triage centres are manned by doctors 24/7 in three shifts and equipped with medical devices and medicines. Based on patients’ condition, the doctors either admit them to Covid Care Centres (CCCs) or refer them to higher medical facilities.

Also read: Green startup launches in Bengaluru amidst pandemic

In the absence of elected corporators, the task of coordinating the entire Ward DETER committees fall on nodal officers. One of them at the forefront of these efforts is Shivakumar from Agaram ward.

“We have zeroed in on a few buildings including a kalyana mantap, a school and a defunct nursing home to set up the triage centres. Through NGOs, we are getting volunteers. I am preparing a list of doctors who can find some free time for the triaging. Besides, preparations are on to procure about 100 items for the triage,” explains Shivakumar.

Ward-level triage

Ward-level triage would also mean referring identified critical cases to bigger health facilities. “This would mean I have a ready list of hospitals to send the patients. Everything needs to be mobilised through a proper process.”

Also read: Karnataka reports 41,779 new Covid-19 cases, 373 deaths

Besides establishing trust with citizens and ensure Covid appropriate behaviours, the Ward DETER Committees (WDC) have their tasks cut out: To support home isolation and minimise hospital load; redress citizen grievances; mobilise resources and community volunteers; achieve universal vaccination; link to hearse van and crematorium teams and to become the first source of data on all things
Covid.