It is vital for all of us to keep track of emerging needs and challenges as we contain the pandemic, such as livelihood support and mental health support.
We are in the midst of a massive health and humanitarian crisis and civil society has sought to fill every void in current health infrastructure that markets and governments have not been able to fill. While oxygen was the focus, GOONJ’s Anshu Gupta has rightly and impressively argued that the crisis is not just about oxygen, but also about food for so many people. And while relief efforts are in full swing, conversations about vaccination (the paranoia, care and commitment) have also begun across the country and are being carried out at different paces depending on the income and influence of the vaccinated.
While both aid and vaccination are very important, it is important to imagine the world we will live in once we have the current pandemic under control. The secondary effects of COVID-19 are already playing out across the country and years of advances are being washed away. It is vital for all of us to keep an eye on the emerging needs and challenges that will grasp the entire nation as we quickly plunge into this future. I have outlined eight areas on which we need to focus strongly and sustainably in order to mitigate the negative effects of the crisis.
> Holistic primary vehiclee: The current crisis has neglected the critical needs of local primary health care, including maternal and child health measures (screening, vaccinations), which can lead to intergenerational health and economic impacts. The health behavior of populations suffering from chronic diseases such as tuberculosis and diabetes has also had a significant impact. Our disease-specific, unified approach to health care cannot meet society’s needs for COVID. Solid primary care is critical for us to respond effectively to the third wave, which will have a significant impact on children (and therefore mothers).
> Mental health support: In contrast to primary health care, there is a lack of infrastructure at the national level to address mental health problems. Local communities lack the vocabulary, awareness, access and commitment to this issue. At the same time, the ongoing crisis had a significant impact on people, leading to a higher incidence of depression and cases of self-harm and violence. There is a tremendous need to envision and implement mental health on a demographic and geographic scale.
> Child protection and well-being: For all its shortcomings, school has always been the safest place for a child. A child out of school is always exposed to myriad risks, including substance abuse, physical abuse, homelessness, and human trafficking. Discussions with organizations working in the field of child protection showed that more and more children are running away from home, who are often victims of human trafficking the moment they enter a city. The unexpected death of both parents has led to an informal model of adoption that puts children at significant risk. Our commitment to rethinking children, whether in schools or in communities, based on their safety and social and emotional wellbeing is vital as they re-emerge from childhood after the pandemic.
> Financial security: Even before the pandemic, 65% of all personal expenses were accounted for by the health care system. The current pandemic has made it worse, causing many families to tap into their savings or take out loans from the informal moneylenders. Although there is talk of insurance, in the past I have written about the challenges to make it work for the poor and how to use them. The government is unlikely to announce any major relief in the face of exhausted government coffers and dire financial prospects. The immediate financial risks families face are therefore daunting and require actual cash with very little overhead.
> Securing livelihood: This leads to the next livelihood challenge. Unlike the sledgehammer lockdown across the country, local locks have allowed economic activity to continue. However, due to the slowdown in the economy, health effects on workers, lower spending across all walks of life and reduced mobility, the effects on livelihoods are real for many segments. Several initiatives need to be launched targeting different segments in order to both promote growth and create equitable economic opportunities for women and men.
> Waste management: One of the issues that has not been adequately discussed is the enormous amount of organic waste generated due to the current crisis and the total inability of the backend systems to deal with it. We continue to bear considerable risks, as the increased organic waste ends up on the landfill. Our waste management systems are already broken, but the health and environmental impacts of bio-waste on this scale can be significant if not proactively addressed.
> Children’s learning continuity: Much has been said about the complete loss of learning faced by teachers when students return to school after two years with no or limited learning. There is ample evidence of the ineffectiveness of current online models in ensuring large-scale learning outcomes. The coming months are critical to piloting innovative personalized learning models that engage communities that bridge the digital divide to ensure equitable learning access and a learning model that is optimized for current constraints.
> Gender equality: The number of child marriages increases as girls do not go to school. The issue of violence against women is increasing. As Sohini Bhattacharya has strongly argued, we need to put gender equality at the heart of the reconstruction effort to “restore equality”, fully aware of the increased risks women will face in the post-pandemic world. A holistic response to gender equality in the areas of education, health, livelihoods and general agency is crucial. And that starts with equal access to vaccinations for women.
As I write this, I am aware of the somber picture that I am painting. Efforts are already underway in each of these areas to resolve large-scale problems of organizations, collaborations and public-private partnerships. In the coming weeks we will be addressing each of these areas and delving deeper into possible solutions. It is important for us to realize that these are all pressing problems and that we cannot afford the luxury of solving them one by one. We will need more of everything in the post-pandemic world – more determination, more innovation, more funding, and most importantly, the will not only to survive but to rebuild better so that we don’t call back when the next crisis hits us. And as clichéd as it may sound, the answer to this is at the heart of the Sustainable Development Goal 17 of the United Nations – partnerships across the board to achieve these goals.
Rathish Balakrishnan is Co-Founder and Managing Partner at Sattva Consulting. The views expressed are the author’s own.
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