Issue and challenge while fighting covid19 at in Manipur

Covid spread in Manipur: On 24th March 2020, Manipur reels under coronavirus panic among its populace with confirmation of first COVID-19 case on a 23-year-old student returning from United Kingdom. Since then, the state has recorded a steep rise in cases of corona virus, worsened by relaxation of travel restrictions by the Government, allowing operation of special trains and buses to transport natives of Manipur from other parts of India from first week of May.

This leads to an exponential surge in COVID-19 cases in the state. By 11th August, Manipur has confirmed 3981 COVID-19 positive case, while 12 patients succumbed to death. The recovery rate stands at 55 %.

Lockdown and challenges: The Government of India has responded to the pandemic by invoking the Disaster Management Act, 2005 (DMA) on 23rd March to enforce complete lockdown to contain the spread of Covid-19. The law gives the Government powers to take quick policy decisions and impose restrictions on people to manage a disaster.

The DMA covers all man-made and natural disasters which are beyond the coping capacity of a community. It also provides powers to the government to act against anyone not abiding by government orders and regulations . The Government of Manipur imposed public curfew in Manipur under section 144 of the Code of Criminal Procedure.

The enforcement of the lockdown led to cases of human rights violations targeting common people. Human Rights defenders critical of the State limitations in handling the lockdown in social media were arbitrarily detained.

On 26th March 2020, the Manipur police suspended a police officer for assaulting a person who returned home after procuring essential goods from a government PDS agent during curfew hours. In a video footage went viral on social media, the policeman was seen beating the man on a bicycle with bags of essential commodities with a cane in a deserted street at Yairipok .

Further, there are media reports of arbitrary detention of human rights defenders and harassment of medical practitioners on Covid duty. On 3rd April, Imphal West Police Station summoned Dr. Debabrata Laifungbam, President of Centre for Organization Research and Education with no arrest warrant in connection with his posting in Facebook .

A medical practitioner, Dr Ningthoukhongjam Haraba, who was returning home from his Covid duty, was physically assaulted by two Sub Inspectors of Manipur police on 11 June. Human rights group complaint to the National Human Rights Commission stating that such incidents targeting rights defenders and those combating COVID-19 by security force constitute a breach of their human rights.

The lockdown to combat Covid 19 Pandemic unleashed serious impact on the livelihood of indigenous communities. Immediate closure of traditional markets managed by indigenous women affect the economy of hundreds of families. Lack of State support to address the economic impacts of workers, street vendors, and daily wage earners has worsened their situation.

With imposition of curfew and in the absence of storage facilities, farmers of Khoijuman Village in Bishnupur district reportedly had to dispose tonnes of rotten vegetables. Even as lockdown is being eased for farmers by the Governments, this exemption fail to bring any relief to farmers as they struggle to sell their produces.

Cash crop farmers, like pineapple farmers of Churachandpur are hit hard as marketing avenues remain closed. Their situation has become gloomier with the State going for continuous rounds of lockdown and increasing number of Covid case keep away traders from visiting their villages. Most importantly, people who lose their land due to unsustainable projects like 105 MW Loktak project, Mapithel dam, Khuga dam etc. suffer more due to shortage of food and negligence from authorities.

Negligence of health infrastructures contribute to the rising cases of infection in the state. The government has established seven Quarantine Centres (QCs) with additional 770 communities QC, but the QCs are marred with limitations, shortage of food, sanitary facilities, inadequate testing facilities, with medical workers complaining of acute shortage of protective gears and other sanitary measures.

On 16th May, Doctors, and health workers at quarantine facilities complaint of inadequate Personnel Protective Equipment (PPE) from the government. The Thoubal Kendra COVID-19 Aid also urged the State Government to conduct testing of at least 400 to 500 persons in a day for the district by using Rapid Antigen Test (RAT). On 5th August, several COVID-19 positive patients undergoing treatment at JNIMS hospital stormed out of COVID care ward and demanded for timely and quality food. Delayed breakfast and lunch have caused severe inconveniences to the patients, particularly those who are on heavy medication.

Many doctors and nurses treating Covid 19 patients in hospitals and QCs are now infected with Covid. The inmates at Presidency College quarantine centre at Motbung in Kangpokpi district, protests over lack of basic amenities like water supply, electricity, separate rooms despite detection of COVID-19 positive cases from the facility. The rooms in QC facilities are often packed with 2-8 persons and sometimes more. During an event at a community quarantine centre, Speaker Y Khemchand Singh claim that not only the number of Covid-19 infection has exploded but also fatalities due to the disease are also increasing.

With the rise in number of COVID-19 case, there are incidents where patients suffering from different ailment were denied of medical treatment by government and private hospitals. On 31st July, a 3 years boy named, Md Himmat drowned and was rushed to a nearby hospital where he was denied of emergency care and eventually die without being treated.

Md Iqbal Haque, a resident of Lilong passed away after several hospital refuse to diagnose him. In what could be termed as medical negligence and irresponsibility, Kanpatliu Kamei, a-20-year-old pregnant woman from Noney district allegedly died after five hospitals turned her away.

Following the incident of the pregnant lady, the Government of Manipur issue a directive that all hospitals must attend all emergency and time bound cases on urgent basis with warning that any violations shall be dealt under Manipur Nursing Homes and Clinical Registration Act, 1992 and under Disaster Management Act, 2005. Despite the declaration, a five-day-old infant loss his life after a district hospital allegedly refused him admission the following day.

On 10th August, Sandhya Laishram, 21, of Wangjing Wangkhei in Thoubal district died after a private hospital staff informed the family members that no emergency case was being accepted. So far, no official action has been initiated against the hospitals for flouting the instructions.

In fact, there have been many unreported deaths caused by hospitals' refusal to attend patients coming from COVID detected districts even though the exact number of such death cannot be recorded. Marginalised section of the society hailing from remote areas are the main victims of such unsympathetic death as they lack proper awareness and have no one to turn to.

The gross misconduct or negligence by hospitals and their staffs should be seriously investigated followed by delivering appropriate action to those found guilty. If such situation is not immediately dealt with, number of deaths relating to denial of treatment by medical practitioner will exceed the number of COVID death in no time.

Community support: The COVID 19 pandemic also unravelled exemplary forms of community solidarity and support for each other. Despite shortage of food and neglect from concerned authorities, indigenous peoples' access and management of their land and resources has proven to ensure their livelihood in difficult situations like Covid-19 outbreak by providing food and medicine.

Villagers from hill districts of Manipur gathered their agriculture products and share it to nearby villages, quarantine centres, and hospitals during the phases of lockdown. To remedy the insufficient quarantine centres provided by the state, indigenous communities also set up their own quarantine facilities for housing returnees. Such generosity is made possible solely due to indigenous communities' rights and freedom to traditionally manage their land and resources.

An apex body known as "Tangkhul Co-ordination Forum of COVID19" formed by 15 NGOs in Ukhrul and Kamjong district formed a Village Quarantine Centre (VQC) in each village, which was developed and run by Tangkhul Community.

In these centres, COVID patients or returnees who completed 14-day quarantine at the Government maintained QCs and discharged by the authority are again kept for another 14 Community Quarantine under the strict surveillance of the concerned village community.

After this, another seven days home quarantine is enforced by the community. Thus, the total quarantine period is 35 days (14+14+7) . Such three-layer quarantine enforced by the community to make sure 100 per cent protection from Covid 19 shows the commitment and determination of the people of Manipur in the fight against the pandemic.

To aid the public in the fight against COVID-19, around 40 CSOs jointly formed a task force called 'People's Task Force for COVID-19' in early August in Imphal. The People's Task Force for COVID-19 held series of awareness programme, such as at Ngaikhong Khullen to sensitize on Covid 19, impacts and necessary precautions from community required .

To alleviate the impacts of COVID 19 lockdown, the Centre for Research and Advocacy, Manipur provided relief to several villages whose livelihood were undermined due to submergence of their land by Mapithel dam, 105 MW Loktak Hydroelectric Project etc.

Food items like rice, lentils, potato, salt, sugar etc and sanitary items were distributed in April and May. The organization also coordinated with organizations like the Social Upliftment Association to create awareness on safety measures and to provide food and sanitary items among those living HIV / AIDS, Orphans, Widows, Old Aged etc.

COVID 19 infection continues to rise impacting the social life and economy of Manipur in an unprecedented scale. The rising case in Manipur including fatalities is partly attributed to the relaxation of travel restriction from 'COVID Red Zone' that commenced from the unlock phase 1 i.e. 1st June.

The outbreak of COVID-19 pandemic has unveiled the poor medical infrastructure, food insecurity and dependency from outside the state. Currently, the biggest concern is the inadequate medical infrastructure, testing capacities of suspected cases, and limited capacity of hospitals to provide treatment for COVID-19 patients with occurrence of community transmission.

The increased cases of infection among the frontline workers aggravated the situation. Due to increasing numbers of cases among patients with no travel history and medical workers, there is an immediate need to identify people at greater risk with respect to age, gender, comorbidities, and other necessary health indicators to prioritise them for the test.

The Government should take urgent measures to increase testing facilities for all suspected cases on an urgent basis and strengthen the health infrastructure in all districts. Special attention should be accorded to ensure adequate supply of safety equipment and other essential needs in quarantine centres and hospitals.

All hospitals in the state must be closely monitored so that incidents related to demise of any individual due to denial of medical treatment will not occur any further. The protection of all frontline workers with provision of necessary support facilities is critical in fight against the pandemic.

The Government should ensure timely provision of essential items like food supplies and sanitary items, reaching all those affected by the lockdown. Special support is crucial for daily wage earners, indigenous cultivators etc. who are most affected economically by the lockdown.

The Government of Manipur should recognise that strengthening indigenous people's food production system, protection of land and resources, improving health infrastructures, and desisting unsustainable development processes is the rightful path to development of Manipur and one of the best strategy to cope with shortages of essential survival items in emergency situations like COVID 19 Pandemic.

The Government should recognize indigenous peoples' way of sharing foods among villages is a resilient way of combating major crisis like COVID 19 pandemic. The Government must ensure full adherence to human rights standards in its response to COVID 19 Pandemic, especially during the lockdown.