By Madhuri Mondal
Dakshin staff have been closely associated with coastal Odisha for nearly two decades now. The fishing hamlets around the olive ridley turtle mass nesting rookery at Rushikulya have been a part of Dakshin’s work since 2008, both for monitoring turtles as well as engaging with small-scale fisheries. In 2019, the Community Wellbeing and Environment programme team at Dakshin undertook a scoping study at these sites to assess the health and developmental needs of the fishing communities.
Of the various themes which surfaced during these interactions, many were directly linked to fishing such as dwindling livelihoods, large-scale migration, encroachment of coastal commons, effects of aquaculture and industrial pollution. On the health front, the foremost challenge was access to healthcare. Not only were vacancies for doctors left unfilled, but there was also a lack of trust in the government healthcare mechanism. Out-of-pocket expenditure on healthcare by the marginalized fishing families was reported to be quite high. Poor hygiene and sanitation were common issues across all fishing hamlets. There was lack of awareness about non-communicable diseases like hypertension. Despite the important work being done by community health workers in these villages by providing care to pregnant women, nursing mothers and children, much needed to be done to improve sexual and reproductive health, basic hygiene and sanitation.
Many studies have shown interconnectedness between community wellbeing, social and environmental sustainability. Human health plays a key role in the viability of livelihoods dependent on natural resources like those of the fishing communities. Poor health of fishing communities has significant implications for the social integrity, economic viability and sustainability of fisheries. The genesis of Dakshin’s Community Wellbeing and Environment programme is rooted in this understanding. The programme aims to improve the wellbeing of fishing communities and build their capacity to manage coastal and marine resources with the long-term vision of both the community and its ecosystem’s health in mind.
When the pandemic broke out in several parts of India, the community wellbeing team was in Ganjam, Odisha ideating with the village institutions for the initiation of the programme in the area. The pandemic broke out while we were making plans to conduct workshops and awareness programmes on hygiene and sanitation. Numerous myths started circulating – e.g that the virus spread through the consumption of sea food and meat; that the consumption of garlic and tulsi leaf would prevent the infection, and many more. Community health workers themselves were also not completely aware of COVID-19 and the precautions required to contain it. It was obvious that we needed to clear the confusion around COVID-19 first before discussing anything else. We immediately collated information on COVID-19 from reliable sources like Centre for Disease Control (CDC) and World Health Organization (WHO). We then conducted capacity building workshops for the community health workers of the two fishing villages we were working most closely with. However, in face of the lockdown restrictions, soon after, we had to return home.
The lockdown brought forth multiple issues for marginalized fishing communities across the country including complete loss of income, dwindling food security, hunger and piling debts. Fishing families ran out of cash and food reserves soon as they could not go fishing or sell their catch. Rations provided by government were inadequate for larger families and those without a ration card were left out of government relief schemes. Apart from food rations, families ran out of sanitary supplies, daily medication for existing conditions and emergency medical help. Family members who had migrated for work to other states were stranded without food and shelter. In order to put basic meals together and to purchase tickets for their family members stranded in various states, many families borrowed money frantically from money lenders, putting them in a debt spiral.
In mid-April, the local administration directed community health workers to start preparing a list of stranded members who wanted to return to their villages. Migrant workers slowly started returning from other states in the beginning of May. Schools, panchayat buildings and cyclone shelters were turned into quarantine centres. Our field site Ganjam has since registered many COVID-19 positive cases, which has created further panic in the community and stigma around the migrant workers who have returned. Most of the community health workers have indicated that they have not been provided with PPEs. Field contacts reported that some quarantine centres lacked sanitation facilities.
In these sites, community health issues now have to be tackled at two levels: firstly, the immediate concerns with COVID-19 and secondly, the larger issue of accessing affordable healthcare as well as generating awareness about sanitation and other common health issues. Strengthening health systems, building the capacity of village institutions and community health workers in these sites are vital for the long-term social and environmental sustainability of these coastal villages.
We would like to thank Bipro Behera and Madhuri Mondal for their images, appearing in the order of their names.