For Delhi health volunteers, the fight is twofold: virus and its stigma

ASHAs and CDVs providing care to patients in home isolation often face hostility

January 25, 2022 01:41 am | Updated 07:34 am IST

The Omicron variant of COVID-19 may be relatively milder than its more devastating predecessors but the efforts to tackle its spread have by no means been easier.

It’s not just the high transmissibility of the virus that bothers the Accredited Social Health Activists (ASHAs) and the civil defence volunteers (CDVs), who are at the front lines of the city’s fight against the virus. The volunteers say they have to face “rudeness and hostility” of patients as well as their family members in most cases.

The work of the ASHAs and CDVs has become more important given their role in forming home isolation teams that help in creating strict micro-containment zones, which is the most effective weapon in the administration’s arsenal against Omicron. “Micro-containment and strict perimeter control are of utmost importance given the transmissibility of the Omicron variant,” a senior government official said. “While more and more containment zones have been chalked out, deployment of teams on the ground has also been increased to ensure stricter perimeter control,” the official said.

Almost 37,000 COVID patients were isolated at home compared to 2,394 admitted at city hospitals till January 22. From just 207 containment zones in the city on December 24, 2021, the number spiralled to 44,464 on January 24, 2022.

According to a senior government official, the number of home isolation teams has increased from 813, deployed during the second wave, to 1,282 in the third wave — an increase of around 58%. This shows that the onus on home isolation teams has been far greater in the third wave than in the second wave. One team has at least one ASHA and one CDV each.

For 24-year-old Rohit Kadyam, a CDV who is a part of a Delhi government home isolation team, the process is filled with challenges on a daily basis. His job includes tracing COVID-19 patients, providing care and following up on their condition day in and day out for 7 to 10 days after they test positive.

Going door to door in personal protective equipment (PPE) kits, with a stock of medicines, pulse oximeters and other essentials, Mr. Kadyam, who previously worked at a private firm, says “hesitancy by patients in discussing their condition due to social stigmas , and non-cooperation by their families” have been the recurring difficulties that he has facedsince joining the team at a dispensary in Chirag Delhi close to 11 months ago.

Speaking to The Hindu , most volunteers said a widespread hesitation by COVID patients in sharing their details has been among the biggest obstacles that they face while trying to assist them during home visits, with some patients outrightly rejecting their aid.

“I have been a volunteer with a home isolation team for the past nine months. I pursue my college studies on the side. During the second wave, we faced plenty of problems, including patients getting verbally aggressive. The situation has not changed in the third wave,” said 19-year-old Khurshid Alam, adding that the highest number of cases that their team at Chirag Delhi had attended to in the third wave was 326 in a single day.

“During the current wave, these problems have continued to an extent. I do this solely because I want to be of help to the people and I am open to volunteering in other domains as well, if the requirement arises,” Mr. Alam said.

Challenges galore

However, the challenges are not limited to patients isolating at home. Aman Prasad – who serves as the District Nodal Officer for home isolation at a control room in the city’s Raja Garden – said volunteers testing positive for the virus also adds to the caseload and further reduces the team’s strength.

Mr. Prasad said the daily duties of the volunteers begin from the control room, where a list of patients along with their details – ICMR ID, testing laboratories – is received in the morning. While 26 teachers are deputed at the control room for tracing contacts of the infected person, a total of 90 CDVs are deployed in the field and on COVID helpline duties, said Mr. Prasad.

He added that the cases are further tagged after receiving the list and sent to the dispensary teams for their field duties. There are instances where the patients provide wrong addresses, which are rectified after verification. Also, patients complain about not receiving pulse oximeters or other essentials. “We ensure that the teams provide the essentials if they are not provided during the initial rounds,” said Mr. Prasad, adding that his control room had received close to 1,200 cases on January 18. He said seven dedicated helpline numbers were in place on 24x7 basis.

Responding to these observations, Kriti Garg, District Magistrate, West Delhi, said despite the awareness drives carried out over the past two waves of COVID infections, there was no improvement in terms of the challenges faced by the home isolation teams during the current wave.

“I would say that people have not been sensitive towards the duties that these teams carry out every day. Earlier, people would appreciate how the teams reached out to them with the aid. But over time, these teams are being perceived as part of the grind and are often ignored while the social stigma around the infected patients remains,” she said.

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