Covid-19 and Kerala: A Model for Medical Securitization

 By Vishakh Krishnan Valiathan
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With the cause yet to be confirmed, the outbreak of novel corona virus (Covid-19) in the town of Wuhan in the Hubei province of China earlier this year, is one of a new kind.[1] The situation is very alarming particularly in China with more than thousand deaths in a month’s time.  The virus which got identified in almost two dozen countries in the last few weeks, as many who had returned or visited China since January are been quarantined.[2] As per an Indian student who studies at Wuhan, there is a possible third evacuation of Indian students who are still stuck  there by the third week of February.[3] At the same time a small state in southern India has been fighting against this deadly virus and so far it has been successful. In India, the first case of Covid-19 positive was identified in Kerala who was a student of Wuhan University; and later two others were tested positive in the God’s Own Country.[4] However, the state’s medical infrastructure and facilities have so far tackled the virus given its earlier experience with the Nipah virus.[5]

Known for its tourism, the state of Kerala also tags along for the best human development indicators in the country, even matching that of the Scandinavian nations. This is not the first time the southern state of Kerala is faced with a situation like this. The Nipah virus outbreak in late May 2018 was centric to the northern districts of Kozhikode and Malappuram.[6] The virus had no particular vaccine or cure, and protection if any depended on the person’s immunity and a clampdown on the spread of the virus.  Moreover, this was a testing time for India’s best state in terms of medical awareness and infrastructure. Notably, the state government along with its health department was very alert and fought with the resources it had, giving importance to its clampdown. Importantly, the battle against the deadly Nipah virus represented a crucial test of Kerala’s substantial public health care system in a country that often neglects even basic medical hygiene.[7] Indeed, Kerala took it as an opportunity to lead the global response against the virus. However, it is seen that the state has delivered it almost with same alertness and efficiency with novel corona virus aka Covid-19 as well.

Remarkably, all the three Covid-19 positive cases in the state have been fully recovered and remains stable.[8] The Kerala State Government and the health department’s vigilance and awareness has been their key to the control of contamination in the densely populated state. To add, the state cabinet also issued a circular declaring the Covid-19 as a ‘State Calamity’ just after two cases were tested positive as many others were also quarantined at the same time and are still under observation.[9] Interestingly, other departments also had a role to play as well especially the police department by spreading awareness on the same. In 2018, just after the Nipah virus clampdown, the state suffered from the most disastrous floods since 1924.[10] Appreciation has to be given to the brave doctors and nurses and even the coordination of other departments for their effort, awareness and alertness for controlling further outbreak of diseases in the past few years. Undoubtedly, being the most literate state in the country, the governance for decades prioritise the utmost importance to human security and social welfare.

Interestingly, one among the students tested positive for Covid-19 was admitted at the Alappuzha Medical College at Vandanam, Allepey in central Kerala. The student was the first to recover fully from the disease. A nurse named Mridula Sree was on duty in the isolated ward for Corona in the medical college; she expressed her experience through a note in the social media and  thanked for the timeless, fearless and dedicated effort put up by the staff in the medical college.[11] However, these are just examples on the dedication and alertness that the state inculcates.

Ideally these cases indicate why the state has topped the human development indices for decades proving the importance of Dr KN Raj’s Kerala Model of Development that he had brought in during the 1970s.[12] In the recent past, Kerala has been in the receiving end with the Nipah virus outbreak, then the floods it suffered in 2018, and now this Covid-19. But this is where the most literate state in India has become a model not just to the other states in the country and also across the globe. By declaring the outbreak of the virus a state calamity, the government restricted tourists visiting the state despite the fact that tourism being a major revenue earning industry in Kerala. The decisions also included containing the flow of its own people for a specific period and urging people to take proper precautions with frequent check-ups and also installing isolation wards in almost all government medical colleges across the state which is vital for the clampdown of such outbreaks. These measures showcase the state’s ability to control such situations quite efficiently.

Given that health security is an important component of national security, the case of Kerala’s health infrastructure in curbing diseases even in the past is a motivation for the nation as well. A few suggestive measures that the nation could implement- one, a proper system of house to house quarantining by health officials posted in each taluk by dividing in teams; two, health precautionary messages through radio, television and newspapers advertisements initiated by both Central and State governments; three, free access of medical care and instalments of isolated wards in every government aided hospitals as a precaution to support every patient with symptoms; four, allocate more funds for medical infrastructure in both centre-state budgets while generating more employment opportunities in terms of human resources in these primary health centres, taluk and district hospitals including medical colleges;  five, as the National Institute of Virology is based at Pune, it takes time to access the results and would recommend the government to start National Monitoring Centres for arboviruses and other popular diseases in every zone including at least four to five sub-centres in each state as the number of units is less compared to the demographic density. Thus, reiterating the famous proverb- Health is Wealth since human security is a vital component in our country’s security and development.

In the meantime, the Kerala government also lifted the declaration as a state calamity as there were no more positive cases after early February though the strict quarantining will be maintained.[13] This model of medical securitization shows why the state tops among the health indicators of the second most populated country in the world even after been affected by back to back health hazards. Perhaps it is time that the country should try routing for the Kerala Model of Medical Securitization in the age of increasing health hazards.

References

[1] WHO,” What is a “Novel” coronavirus?”, World Health Organisation, February 11, 2020, https://www.who.int/news-room/q-a-detail/q-a-coronaviruses, accessed on February 16, 2020.

[2] WHO, “Coronavirus Disease 2019 (Covid-19) Situation Report-25, World Health Organisation, February 14, 2020, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200214-sitrep-25-covid-19.pdf, accessed on February 16, 2020.

[3]  Electronic communication with Monika Sethuraman, PhD Candidate at Central China Normal University, Wuhan, China, February 13, 2020.

[4] Directorate of Health Services, “ Media Bulletin”,

 nCorona virus Outbreak Control and Prevention State Cell, Health & Family Welfare Department, Government of Kerala, January 30,2020, http://dhs.kerala.gov.in/pdf2020/bul_30012020.pdf, accessed on February 16,2020.

[5] PB Jayaumar, “Kerala uses Nipah experience to effectively control Coronavirus spread”, Business Today, February 4, 2018, https://www.businesstoday.in/latest/trends/kerala-uses-nipah-experience-to-effectively-control-coronavirus-spread/story/395386.html, accessed on February 16, 2020.

[6] WHO, “Nipah Virus- India”, Disease Outbreak News, World Health Organisation, August 7, 2018, https://www.who.int/csr/don/07-august-2018-nipah-virus-india/en/, accessed on February 16,2020.

[7] S Yadavar, “More Indians Die Of Poor Quality Care Than Due To Lack Of Access To Healthcare: 1.6 Million”, IndiaSpend.com,Septemeber 6, 2018, https://www.indiaspend.com/more-indians-die-of-poor-quality-care-than-due-to-lack-of-access-to-healthcare-1-6-million-64432/, accessed on February 16,2020.

[8]  Directorate of Health Services, “2019-n Corona Virus Daily Bulletin”, nCorona virus Outbreak Control and Prevention State Cell, Health & Family Welfare Department, Government of Kerala, February 15,2020, http://dhs.kerala.gov.in/pdf2020/bule_15022020.pdf, accessed on February 16, 2020.

[9] Directorate of Health Services, “Media Bulletin”, nCorona virus Outbreak Control and Prevention State Cell, Health & Family Welfare Department, Government of Kerala, February 3,2020, http://dhs.kerala.gov.in/pdf2020/bule_03022020.pdf, accessed on February 16, 2020.

[10] A Roychowdhury, “Kerala floods: The deluge of 1924 was smaller, but impact was similar”, The Indian Express, August 22, 2018, https://indianexpress.com/article/research/year-1099-keralas-great-flood-of-1924-too-affected-same-areas-5317677/, accessed on February 16, 2020.

[11] Mathrubhumi, “ഭൂമിയിലെ ഏറ്റവും ഭീകരമായ അവസ്ഥ എന്തെന്ന് ഇപ്പോള്‍ അറിയാം;കൊറോണ രോഗിയെ ചികിത്സിച്ച നഴ്‌സ്”,Mathrubhumi News(Malayalam), February 14, 2020, https://www.mathrubhumi.com/health/my-post/heart-touching-note-of-nurse-treat-coronavirus-patient-1.4528484 , accessed on February 16, 2020.

[12] KP Kannan,”K.N.Raj: Development with Equity and Democracy”, Development and Change,2011, 42(1),379, doi:10.1111/j.1467-7660.2011.01692.x .

[13] “Kerala lifts declaration of State Calamity”, The Hindu, February 7, 2020, https://www.thehindu.com/news/national/kerala/coronavirus-kerala-lifts-declaration-of-state-calamity/article30764837.ece, accessed on February 16,2020.