By Sonnet Jose, Coordinator, Extended Medical Relief Centre, Kanjikuzhy, HelpAge India
The COVID-19 lockdown was received with complete dismay by the people of Kanjikuzhy in Kerala's Idukki district. It made them realise that they too would not be spared. Though the community knew the preventive measures, the inevitable drop in income for ordinary people in the village was a big concern.
The Kanjikuzhy area is commonly known as High Range with its hills, mountains and forested areas. Most people inhabit small houses and live below the poverty line. Families cultivate crops like pepper, bananas, tapioca and coconuts on their land.
Extreme weather is common in the area and landslides often destroy crops, causing many farmers to be eternally in debt. This burden has even caused some to kill themselves, particularly after the August 2018 floods. The bulk of the farming population are small and marginal farmers who have not found it easy. The global prices of their crops have dropped by nearly half. Many farmers do not have proper title deeds either, which limits their access to bank finance and nudges them towards private moneylenders.
The health services in this area lag behind other parts of Kerala. The nearest health centre is ill-equipped to meet the needs of the community, particularly older people, and the nearest hospital is 25 kilometres away.
Most people find it difficult to get treatment due to how remote the area is and the lack of available healthcare, but HelpAge India has been operating a medical relief centre in the area since the devastating floods of 2018. It strives to provide effective prevention and treatment services at the community level. The centre's mobile health staff are of particular benefit to older people, visiting them on their doorsteps to meet their medical needs, while a physiotherapy centre helps improve their physical wellbeing.
The lockdown now threatens the availability and affordability of medicines, which is a particular concern for those with chronic diseases, such as diabetes and heart disease. HelpAge India has continued its site visits to ensure these people will not run out of vital drugs.
One of our regular sites is in Thattekanny, on the banks of the Periyar River. A ward member brought all the patients' details to one place so that volunteers could find out who needs essential medicine and where they needed to go. Since older people were not allowed to leave their homes and there is poor mobile phone coverage, telephone consultations were not possible, so the information was noted down on patient cards for the volunteers to take action.
With public transport closed due to the lockdown, it is hard for anyone, especially older people, to reach health facilities. Our team’s arrival was emphatically welcomed by the whole community, as well as the local authorities. We dispensed medicine and hygiene kits to 130 patients through ward members, volunteers and ASHA workers, reaching out directly to the homes of people who would otherwise have to travel half an hour on foot to reach us, given the lack of public transport.
Jacob, a retired 70-year-old man living with his wife and his son's family was visited at home by volunteers. The family is fully dependent on the son’s wages as a daily labourer and from some farmland, but he cannot work at all due to lockdown restrictions and the prices of their produce in the market have plummeted. Joseph gets a pension of just 1,200 rupees (US$16), which is not even enough to meet his healthcare needs for a heart condition. The consultation, medicine and free support he gets from our mobile unit is vital.
I spoke with Thakanmma, a 77-year-old woman who is dependent on her eldest son who she has lived with since her husband died 10 years ago. She has no pension and needs daily medicine to control her blood pressure. She told me: "I don’t have the words to thank the entire team. If the visit had been discontinued due to the lockdown, my intake of regular medicine would have suffered, and my health would surely have deteriorated. Since there is no medical shop near our area, there was not even a faint possibility of getting medicines during these trying times. Moreover, my son couldn’t afford the prices as he is jobless, and the cost would have been a liability for him. Since the HelpAge India team is here I am able to consult the doctor and get medicines without paying a single paisa."
While everyone was happy with the healthcare, they wanted to know what they should do for food and their livelihood when their reserves run out and the lockdown is extended. In spite of its necessity to contain the pandemic, the more the lockdown is extended, the more their suffering will continue since no one can return to work.
The words of Joseph still reverberate: "The more I hear of the tragic news, the thing I fear most is for the future of my children and grandchildren. Will they be robbed of everything we enjoyed during our lives?"