From medical students to self-help groups: These are the troops joining the fight against COVID-19 in India
Lakhs of ASHA workers, self-help groups and medical interns could indeed fortify our ranks to fight COVID-19.
As the Ministry of Health and Family Welfare expands preparations for COVID-19, a call has gone out to India's 11.57 lakh doctors — irrespective of specialization, and including retired doctors — and medical staff to join ranks against COVID-19.
A call has also gone out to other healthcare providers - from ASHA workers to medical college students. Lakhs of ASHA workers, self-help groups and medical interns could indeed fortify our ranks to fight COVID-19. Here's how:
1. ASHA workers
India already has a vast network of healthcare workers who are deeply entrenched at the local community level in our ASHA workers or accredited social health activists. As of January 2017, India had 8,82,947 ASHA workers.
Data show that ASHA workers have been an invaluable human resource in bringing down maternal and child mortality. To be sure, these women don’t have medical training. Yet, armed with simple tools and guidelines, ASHA workers can increase public awareness around health issues, monitor health and offer basic services in the remotest parts of the country.
Steps to recruit these women in the fight against COVID-19 are already being taken by the health ministry. The ministry has released detailed guidelines for how they can help disseminate the correct information about coronavirus infection, dispel myths and refer cases for further clinical assessment.
2. Medical students
The health ministry has already taken steps to tap another extremely important human resource for healthcare in the country: our medical college students. (Data from the Medical Council of India show that 536 colleges offer MBBS programmes in the country, with 79,498 seats.)
To be sure, India isn’t the first — or last — to tap its senior medical students and launch an appropriate response to end this pandemic. In other countries, medical students are helping in the assessment of suspected patients, collecting samples for testing, and looking after patients who need immediate assistance with a health problem other than COVID-19, among other crucial tasks. Our students could do the same.
India has three different types of centres to care for COVID-19 patients: COVID Care Centres for suspected patients and those with mild disease, Dedicated COVID Health Centres with assured oxygen support for moderate cases and Dedicated COVID Hospitals with ICU and ventilator support for severely ill patients. We will need people with medical knowledge to operate all of these stations. Medical students can also help with this.
3. Medical mentors
In an update on 12 April 2020, Health Ministry Joint Secretary Lav Aggarwal said that the government had enlisted 14 institutes of national repute like the All India Institute of Medical Sciences and NIMHANS to mentor medical students at government and private medical schools to help increase our medical capacity.
Indeed, the medical mentors from AIIMS and NIMHANS can help ensure that our medical students can help in the war against COVID-19 without endangering their own safety.
Another way in which medical mentors can help at this time is through teleconsultations with doctors and medical staff in B-towns and villages: Think of a general practitioner in a small village near Udaipur or outside of Madurai - this doctor, though qualified, has limited resources at her disposal. Having an experienced mentor to sound out ideas and work out problems could be immensely useful. This type of doctor-to-doctor consultation could help share and increase knowledge at a crucial time like this.
AIIMS is already running a 24-hour helpline for this.
4. Skilled and semi-skilled workers
Some of the interventions needed for the clinical management of COVID-19 are indeed technical. For this, our national skill development centres under the Pradhan Mantri Kaushal Vikas Yojana (PMKVY) could launch training in how to operate ventilators, give oxygen support, transport patients. At last count, there were 32,671 PMKVY training centres in India with 33,20,403 students enrolled. To be sure, these students were enrolled in programmes across sectors - from retail to the beauty industry. These new courses would be targeted to those interested in building a career in hospital and emergency work.
5. NGOs and volunteers
The World Health Organization has recommended that where COVID-19 patients are getting home-based care (recommended for around 80% of patients with mild infection), a healthcare worker should be assigned to assess the health of the patient and to verify if adequate arrangements have been made to care for the patient while observing all the precautions.
NGOs and community healthcare workers could perform this role of educating home-based caregivers. To give a small example, caregivers should be told that alcohol-based hand rubs are flammable. And though they should clean their hands before cooking, if they are using alcohol-based hand sanitizer, they should wait till the sanitizer has dried completely before they turn on the burner.
Volunteer groups are also assisting — medical and other support — in their respective capacities. For example, the Indian Association of Clinical Psychologists is offering free (volunteer) phone consultations to people in need of psychological counselling and psychological first aid.
5. Self-help groups
With the minimal training and lots of quality control, self-help groups (SHGs) across the country could make parts of the personal protective equipment (PPE) kits. As of mid-April, SHG women had already made over one crore masks, according to health ministry data. Gowns, shoe covers and head covers can all be hand-stitched, provided the women in these SHGs are given proper guidance on how and materials — especially fabrics that are impermeable to bodily fluids like blood — to work with.
Women in these SHGs can also stitch face covers or reusable cotton masks that will be needed by more and more people as state governments mandate their use in public.
Rural Development Ministry data show that India has 64,40,212 SHGs - 63.67 lakh of them have more than five members each. That is roughly a workforce of 3.2 crore people!
For more information, read our article on How to avoid getting COVID-19 infection if you are a healthcare worker.
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