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Dhaka Tribune

Can Bangladesh follow the Kerala model?

Kerala’s approach has proven less disruptive, less costly, and more effective than any other state in India

Update : 12 Apr 2020, 03:51 PM

The South Indian state of Kerala has been spearheading the country’s fight against the novel coronavirus.

From innovative schemes like mid-day meals being delivered at homes to South Korea-like isolation testing kiosks, the state has been at the forefront in India’s battle to control the Covid-19 spread.

Kerala was the first state to record a positive Covid-19 case in India. In January, a medical student returning from China’s Wuhan tested positive for the virus.

Kerala has been on alert mode since, trying to bring the situation under control.

The state soon began implementing mandatory quarantines for visitors arriving from China, weeks before India’s central government instituted similar measures across the country.

In early March, a BBC News talk show referred to the success of Kerala in containing the first three positive cases of coronavirus and its previous record in dealing with the Nipah and Zika viruses.

Kerala currently has 364 cases of coronavirus, making it the eighth most stricken among Indian states.

Crucially, however, it has recorded the highest number of recoveries, with 123 people getting better as of Saturday.

This impressive track record has also earned world attention.

On Friday, The Washington Post credited the robust response of Kerala to the coronavirus pandemic.

The Washington Post noted Kerala resorted to “aggressive testing, intense contact tracing, instituting a longer quarantine, building thousands of shelters for migrant workers stranded by the sudden nationwide shutdown and distributing millions of cooked meals to those in need.”

Could Kerala provide a workable model for the Bangladesh government to follow?

Need to speed up testing

During the period of the lockdown, anywhere in the world, there is large scale testing.

The Washington Post noted Kerala had conducted over 13,000 tests for coronavirus by the first week of April, more than larger states such as Andhra Pradesh and Tamil Nadu.

Kerala was also taking a lead in doing rapid tests and walk-in tests.

According to pandemic data site worldometer, in South Asia, Bhutan has tested 1,511 people per million, followed by Pakistan (192 per million), Sri Lanka (211 per million), Nepal (152 per million) and India (137 per million), as of Sunday.

Bangladesh tests only 50 people per million. It is clear that the first thing Bangladesh needs to do is to ramp up its rate of testing.

Physical distancing, social solidarity

Through appropriate and effective early actions, Kerala has successfully slowed the spread of infection in the state, largely by promoting physical distancing and mainly sanitary precautionary measures, and providing better protection for health staff well before the hugely disruptive and draconian lockdown imposed in India in late March.

The state government invited religious leaders, local bodies, and civil society organizations to participate in policy design and implementation, considering its specific socio-economic conditions, including urban slum environments.

It has communicated effectively in different languages to educate all, including migrants, and to prevent stigmatization of those infected, even opposing the term “social distancing,” which has caste connotations, with “physical distancing and social solidarity.”

Returning migrants

Despite Kerala’s long-standing achievements in education, health and science, highly educated Keralans tend to migrate to work out of state, if not abroad, seeking more lucrative employment.

The state was still recovering from the devastating floods and Nipah virus epidemic of 2018 when tens of thousands began returning after losing jobs in the Middle East.

Kerala is also the destination for a large number of Indian internal migrants. With the nationwide lockdown, non-residents, equivalent to almost 5% of Kerala’s population, have returned, causing a surge of new infections, which is very much similar to Bangladesh.

Such unusually high movements of people have made the state more vulnerable. Despite some controversy, the state appears to have handled the migrant issue very well.

The state health department promptly went into action, setting up a coordination centre on January 26.

Recognizing there was no time to lose, the Kerala government set up mechanisms to identify, test, isolate and treat those infected, quickly earning an excellent reputation.

Less disruptive, less costly, more effective

The Kerala government involved a range of relevant state ministries and agencies to design measures to improve consistency, coordination and communication, and to avoid confusion.

At the same time, there were community consultations, including experts, to find the most locally appropriate modes of limiting infections, along with the means to monitor and enforce them.

Communities were provided essential epidemiological information to understand the threat and related issues, ensure compliance with prescribed precautionary measures, and avoid panic.

Credible leadership

The Kerala government has set up 18 committees and holds daily evening meetings to evaluate the situation, issuing media updates about those quarantined, tested, and hospitalized.

Kerala’s approach has proven less disruptive, less costly, and more effective than any other state in India and even other countries in the world.

After recording its first Covid-19 case on January 30, its infection and death rates have been kept relatively low despite much more tracing and testing.

Surely, there is a lesson there for the Bangladesh health authorities, if they care to take heed.


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