Dear all,

We are sending you the synthesis document of the discussion along with a summary of the webinar. Based on your inputs, we have listed some recommendations.

While the discussion elicited several case studies of how local leaders and elected representatives have promoted CABs, we did not get any inputs to the second section on examples of how panchayats, CSOs or other local organizations have managed solid waste from households with COVID-19 patients.

Hope you enjoy reading the document.

Regards,
Nitya

Dear members,

I am posting this on behalf of Gram Vikas. Thanks to Chandrika Patnaik and Liby Johnson for sending these interesting first person accounts. The link to the YouTube Video is here:

.

Gram Vikas used COVID-19 survivor stories to reassure the communities and motivate adoption of COVID-19 appropriate behaviour. They recorded and shared experiences and messages from community leaders, some of whom had overcome COVID.

Bahan Swain of Kusugama village who had tested positive for COVID 19 elaborates on the steps to be taken when symptoms appear and not panic.

On 18 April 2021, I had high fever and went to the hospital and got myself tested. I tested positive for COVID 19.  I stayed at the hospital and got myself treated there. I recovered completely and came back home. Now I am completely fine. I would like to tell brothers and sisters of my village that if you have fever or cough, do not be scared.  Please visit the hospital and take the doctor's advice and test yourself. There is nothing to be scared of. If you test positive take the medicines the doctor prescribes and stay at the hospital or come back and self-quarantine yourself at home and recover.

Manikya Chandra Naik, secretary of the Bafla Jana Sangathan, Dalguda village, Kalahandi district, says:

My dear brothers and sisters, you must be aware of the second wave of the COVID-19 pandemic which had led to a surge in COVID positive cases in our country. We need to take more precautions and remain alert. This is also the reason why we have to follow the government's instructions.

Kamala Sahu of Adri Gram Panchayat, Kalahandi, encourages people to take vaccination for COVID-19. Hear her as she motivates community members to wash hands regularly, follow social distancing and avoid crowded spaces.

Namaste! My name is Kamala Sahu. I am a member of the Adri Panchayat Samiti. The COVID-19 virus has spread across our district and entire state. To remain safe we must take the COVID-19 vaccine. Vaccines for the age group 18-44 are available in our Adri community centre. Please take the required two doses. To remain safe from the coronavirus we must keep physical distance, wash hands frequently, avoid crowded spaces and use a sanitizer.

Watching and hearing from their leaders has encouraged many village residents to adopt the COVID-19 safety protocols.

Posting on behalf of Shantanu Kumar, WaterAid India.

In recent past we have seen that as the response to this disastrous COVID 19 took shape and the State of Bihar moved towards lockdown. State-wide lockdown was announced restricting movement as preventive measure to control the infection among 12.7 crore populations. After this announcement a mass movement of people across the country was observed. The labour as well as service class population started to move towards their native town or villages. Various quarantine centres were built for the migrants who were heading home to stay for 14 days and ensure that they do not take the corona virus infection home. All the districts were divided into three zones that are green, red and orange based on the number of cases. As the number of cases started to rise during the period of March 2020, with return of urban settlers to rural parts in Gaya It created a sense of fear among the villagers especially when we focus towards the Lakhanpur Gram Panchayat of Manpur block in Gaya. The Panchayat has taken various initiates to curb down the impact of COVID 19 and enhance the level of awareness among community.

See the attachment for more details.

Dear all,

I am posting this on behalf of Pankaj Papnoi, Centre for Microfinance, that is implementing WASH projects in the districts of Sirohi and Bali in Rajasthan. Thanks to Priya John, OneDrop, for coordinating the write-ups.

The team interacted with few Sarpanchs, BDOs from Bali and Pindwara. The common view of BDOs was that the PRIs  support in the second wave of Covid has been minimal (in contrast to  good support during the first wave). The situation is worse in tribal  dominated villages.
 
No panchayat from Bali in the tribal belt (majorly Garasiya and Bhil) has  set any good example in handling of COVID-19. Rather they are making no attempts to counter beliefs among tribals that vaccination would harm them. One shining example though is the Lundara Panchayat (non-tribal or mix  panchayat). The Sarpanch is Jawara Meena.

Last year a core committee active (with block level officer, teacher, AWW, Sarpanch as members) was formed for handling COVID. Such a committee was formed in all panchayats in 2020. During the second wave, the Lundara Panchayat activated the Core Committee
again. The first step it took was to convince the returning migrants to undergo home quarantine and had all immigrants tested for COVID if they had  not tested negative yet.

When the Panchayat convinced them for COVID tests, 5 of the migrants tested positive.  They were then sent to Sirohi district hospital for treatment and the local MLA was contacted to ensure good care (proper arrangements, reasonable cost) of these 5 persons.

Those immigrants who did not heed the Panchayat's advice were brought before to traditional leaders and  influential people from the village for counseling. For example, for one person who was not following advice, a FIR under the Pandemic Act was filed against him in the police station.

During the second wave, the panchayat also distributed, 10 kg wheat per member through Panchayat funds (provisioned under state and central schemes) to compensate for loss of employment/wages. The Panchayat funds were also utilized for sanitizing common places

The panchayat sought support from police and core committee members to limit the number of persons in marriages. Unnecessary movement in villages was restricted. Announcements of COVID-appropriate behaviour were made through loudspeakers and door-to-door awareness campaigns were conducted by the core committee members. A camp was organized with support of Hospital and 200 vaccination (for Covid) done for 45+ years age old persons. The Madan Foundation supported with the distribution of medical kits through anganwadi workers.

In the Pindware block, the block development officer (BDO) said only the Undra Panchayat had taken steps to tackle the pandemic. It was led by Mahendra Kumar. In Undra Panchayat  there are two non-tribal villages (Undra and Parlai) and two tribal villages (Muri and Kerlapadar). There is stark contrast between the tribal and non tribal villages. People in both the tribal villages are not getting themselves vaccinated owing to misinformation, while both non-tribal villages have been majorly vaccinated.

During the 2nd wave, 15 migrants came and they were asked to be in home quarantine. The Core committee was made functional here too. The ANM was asked to track the infected persons. COVID medicine kits were made available to infected persons. However, tests of infected people are not done. The block officials and sarpanch conducted a survey.

After rigorous followups in the two non-tribal village village proper follow up, all 45+ year olds were vaccinated. But in the tribal villages, no follow ups were done and no vaccinations happened. In case of death by COVID, the family was asked to not uncover plastic sheets. The community was instructed to control crowds in funerals. The Sarpanch monitored the  funerals at least in 2 non tribal villages.

Dear Members

Apologies for late response 

1. for the first phase , Habitat India -is reaching out to communities with awareness sessions ( online and physical) , distributing CAB based pamphlet, distributing hygiene kit including soap and mask to practice learning and also advocating for sanitation facilities especially in urban spaces ( like toilets, hand wash stations and decent houses) . As associate Director my responsibility is to build capapcity of staff, partner orgainsation members and communities on CAB along with advocacy for CAB within organisational structure, funding support for CAB within projects 

2. second phase : I am focusing on mestrual hygiene related education , emphasing on menstrual waste and safe disposal -as part of CAB , the environment friendly alternatives are introduced in my sessions and training guidelines like reusable blood absorbent material ( cloth napkin or menstrual cups) , awareness on waste and safe disposal especially covid19 related waste is included in project interventions. distribution of equipments to collect and dispose is advaocated within projects like dustbins, incinerators ( with CAB to use) etc. O& M by local people to enhance governance is embedded in my messages and training material. 

reagards, 
sophia 

Coordinator's note:

We are still struggling with the second wave of the COVID-19 pandemic. Earlier this month, we had started a thematic discussion on the promotion of COVID Appropriate Behaviour on the SuSanA Chapter and many of you were generous enough to take out time in these difficult circumstances to provide examples of panchayats that have done this successfully. As the pandemic shows a few signs of coming under control in some urban areas, it is the rural areas that are bearing the brunt of it and will face a bigger challenge given the state of the rural health infrastructure.

We will keep the discussion open till the end of May so that others may be able to provide inputs and responses. As a reminder, we are seeking examples where panchayats or municipal corporations have successfully promoted CABs to tackle the spread of the pandemic. Please provide as much detail as possible along with contact numbers. We would like to share these are best practices so others can learn and adapt from these examples.

COVID-Resilient Wash-Sensitive Panchayats and Communities in Maharashtra

The “COVID-resilient Wash-sensitive Panchayats and Communities in Maharashtra” project was implemented from July 2020 to March 2021 as part of the collaboration between the Government of Maharashtra and UNICEF Maharashtra. The impact of COVID-19 and the lockdown related to it led to an unprecedented humanitarian disaster. The crisis affected the already poor and marginalized groups disproportionately and disturbingly brought down the resilience of many more who had hitherto been able to sustain themselves.

The influx of returning migrants into rural areas led to additional strain on people, causing the poorest communities continued distress. Migrant workers, the rural poor, women with children, people with disabilities, the elderly and socially excluded groups faced an extensive humanitarian and social crisis in the form of food shortages, closure of basic services and large-scale unemployment.

Designed collaboratively with the district administrations of Osmanabad, Latur and Solapur at the peak of the lockdown, the project responded to the needs of a large number of vulnerable people who had lapsed into poverty and had no access to health and social protection services. It addressed multiple levels of challenges faced by the target groups and beneficiaries, across the intersectionality of social exclusion, poverty, gender and cultural biases.

This ‘Process Document’ details and documents the approaches, results and challenges addressed through the project and celebrates the communities and frontline workers who demonstrated ways in which accountability and democratic participation were fundamental for good governance.

Sanitation's foot soldiers (Swachhagrahis) are once again geared up for ensuring COVID appropriate behaviour in rural Madhya.

“We all are together in the fight against COVID-19!” This fits appropriately with the Swachh Bharat Mission-Rural arm (India's flagship programme on Sanitation) of Panchayat & Rural Development, Madhya Pradesh. In 2020, a pool of 23,000 Swachhagrahis (frontline sanitation mobilizers) engaged under this rural sanitation programme reached out to every corner of the state to enable COVID-19 risk communication and community engagement (RCCE) and infection prevention and control (IPC) in rural communities.

The Swachhagrahis promoted CAB to tackle the spread of COVID-19 among the rural households, such as frequent handwashing with soap, maintaining social distance, wearing a mask, proper use of a toilet, and managing water collection. Over 23,000 Swachhagrahis and frontline workers reached 12.3 million people in communities to promote and monitor CAB in over 50000 villages of the State. In addition,
the SBM teams mobilized additional resources to set up over 13,500 COVID sensitive handwashing services in communities and institutions to help people access safe behaviour of handwashing with soap in public places.

In 2021, the rules of the game have not changed, but the magnitude has. While India battles the second wave of COVID-19 with a massive caseload coming in, the need for such outreach initiatives  is all the more urgent. The Panchayat & Rural Development Department quickly mobilised SBM support in time and along with its sector partners National Health Mission (NHM) and UNICEF. On 30^th April 2021, they organized a one day workshop for 354 district & block-level functionaries and Swachhagrahis. The training addressed CAB and response preparedness, clarifications on myths & misconceptions of vaccination, home isolation protocols and Liquid Waste Management (LWM).

The department also used the opportunity to roll out its outreach strategy to rural areas. The training also focused on the technical aspects of liquid waste management under SBM and dovetailing funds from the 15^th Finance Commission and other rural development schemes such as MGNREGS (Mahatma Gandhi Employment Guarantee Scheme) and Jal Jeevan Mission (JJM).

In light of the COVID situation and lockdown, the training was held virtually and was attended by more than 12,000 participants concerned with SBM. The National Health Mission and the UNICEF Health team disseminated information analogous to the need to vaccinate and demystified myths commonly prevailed in the society.

The State Mission Director of Swachh Bharat Mission, Nidhi Nivedita, IAS, emphasised the critical role played by Swachhagrahis in
reaching the community to achieve goals set under the mission. She illustrated the approach matrix to community engagement under this initiative and common health goals set under NHM and SBM. Vaccination, the first line of prevention, is crucial to a healthier society at this pandemic stage, as she explained.

The UNICEF contribution from the WASH Specialist, WASH Officer and Chief of Field Office included: 

1. Technical support for the co facilitation of the workshop where the WASH Team specified key COVID preventive hygiene behaviours and protocols for home isolation
2. Development of training materials and monitoring package for the initiative
3. Reiteration of Key messages Including: - the importance of  
4. Consistent practice of COVID19 preventive behaviours  (CAB including  adhering to lockdown protocols at the individual level).
5. The need for additional support to communities for dissemination of correct information on  the COVID 19Vaccination initiative. c)  prioritizing home-based care for the  assymptomatic patients (currently forming 80-90% of the total caseload) as this would allow the healthcare system to effectively function.  

To ensure continued safe learning,   UNICEF advocated for the sector to put in place adequate COVID 19 protocols to ensure a COVID Free learning environment when Schools and Anganwadi Centres re-open.  The team advocated  for optimal utilization of funds available under SBM to leverage towards the common goal to promote personal hygiene and safety gears (mask, soap and sanitizer) for front line workers against COVID-19 and the setting up community handwashing units and mobilization campaigns. Maintaining a clean and healthy environment requires  robust waste management systems  in Rural Areas: Deputy Commissioner SBM Ajit Tiwari disseminated the importance of Liquid Waste Management (LWM) and “Catch The Rain”, a water conservation initiative by the Government of India As part of comprehensive resources for participants, organizers provided COVID-19 resource materials packaged in a google drive. The key outcome of the training is to mobilise communities in rural areas in all 52000 villages of Madhya Pradesh with the help of Swachhagrahis for the next three months, to focus on practicing COVID-19 infection prevention and control (IPC) measures and COVID19 appropriate behaviour (CAB). Department seeks to monitor this by deploying a three-layered self-reporting monitoring system. One each at district and block for cumulative reporting and to adjust guiding principles (should this be there? on the key activities and outcomes
accomplished. UNICEF remains committed to supporting SBM in implementing innovative and sustainable initiatives that contribute to the  realization of the rights of children and women in the State.
-Pankaj Mathur and and Nagesh Patidar

Dear all,

I am posting a case study from Mr Saji Sebastian, Executive Director, Socio-Economic Unit Foundation, Kerala. It has been compiled by Mrs Sruthy, programme officer.

Kunnukara is a census town and gram panchayat in Paravur Taluk of Ernakulam district, Kerala, India. The village is situated on the Airport road connecting North Paravur (NH66) and Nedumbassery (NH544). North Paravur is the nearest town, 7 km from this village. Aluva (10 km) and Angamaly (12 km) are also near to Kunnukara. The Mini Civil Station has four hospitals, all the Govt. offices, a Khadi Unit Supermarkets, etc. The main source of income in the panchayat comes from agriculture. Different crops are grown in the panchayat. On 18 May 2021, 1620 positive cases were reported and  50 are under treatment with 18 deaths.

A comprehensive COVID-19 preventive programme was implemented in the panchayat down to the ward level. As part of the programme, several administrative measures were taken. The preparations are part of the steps to prevent the possible community spread of COVID-19.
 

1. 24 hour control room in PHCs to coordinate health activities
2. Steering committee including opposition members meet regularly for quick decision-making.
3. Ward level sanitation committees set up
4. WhatsApp group of 250 implementing team members (Covid 19 rescue team) for effective coordinatio

MEASURES TAKEN TO MITIGATE THE RISK

1. Public place disinfection. In the wake of COVID-19 spread, team members of Covid 19 rescue team and local people have disinfected public places, hospitals and other facilities visited by patients.
2. Hand washing facilities in public spaces; installed 50 facilities 
3. Distribution of masks
4. Distribution of immunity boosting traditional medicines to all houses
5. Psychological counselling to frontline workers

WhatsApp groups have been set up at the CDS level and at all ADS levels and in all possible neighbourhoods to ensure timely delivery of various directives and notifications issued by the government as part of COVID disease control.  Those who are in home quarantine, those unable to cook because they stay alone in lodges or have no essentials, the elderly and the indigent, destitute people, bedridden patients, and those who seek alms will be provided food from the community kitchens.

Kunnukara gram panchayat launched a mobile application to improve the reach of its various services to the people. Two types of facilities have been made available under institutional quarantine that is paid and free as demanded by individuals. Free institutional quarantine arranged in 21 anganwadis, one in lower primary school and one in Pakalveedu. Paid institutional quarantine made as per individual demand. For home quarantine, strong support from panchayat has been made available.

The attachment has the complete details.

Regards,
Nitya

Dear all,

World Vision India works across the country on WASH. Its programme officers have been at the forefront of the battle to control the pandemic in its project areas. These are three case studies from Jharkhand from the districts of Giridih, West Singhbhum and Ranchi.

While WVI worked with the mukhias through virtual trainings. the panchayat members conducted awareness and other activities in their respective villages. The mukhias have distributed medicines, promoted the use of masks and social distancing, and encouraged hand washing with soap among their constituencies. These measures, along with ensuring the availability of beds, water and access to toilets, mitigated the impact of COVID in these panchayats.

I am posting this on behalf of World Vision India. Mr. Roufi Wiliams and Mr. Bipin Singh from Jharkhand provided the case studies. Mahesh Nathan leads WVI's WASH portfolio in India. Amit Pillay coordinated the stories.

Regards,
Nitya

Dear all,

I am posting an example sent by Nasiruddin Nasir, who runs an NGO called the United Nature Sustainability Foundation in Western Uttar Pradesh in the districts of Rampur, Moradabad, Sambhal, Amroha, Hapur Ghaziabad etc.

Example : Village Dhani / Khorhasa , Gonda

The village is composed of marginal farmers who are seasonal migrants to different parts of India including out of India in middle east
countries. Most young people seasonally migrate to earn extra income. As Covid-19 spread in urban agglomerates, the return of people started to village.
The pradhan, being an active citizen did the following actions- 

1. Calling Village Assembly and agreeing upon common protocols : a congressional meeting was organized by the pradhan wherein he informed about the COVID-19 and risks associated with the lives of
everyone. Key decisions/agreements were taken in the meeting as follows:

• everyone will avoid visiting anyone else's house unless its most urgently needed or except in emergency situation
• a common support fund for most needy families and with assurance to provide free ration support
• an emergency response team (comprised of active youth, and women) was set-up to voluntarily support villagers in case of need
• People agreed that villagers will not sit in crowded  places and villagers will be fined if  found doing so.
• social events like marriages will not be planned, if already planned then will be conducted with less than 10-15 people and will adopt  all precautionary measures.
• No one will be allowed to directly go to their homes (if coming from out of village) but they will  have to compulsorily observe 15 days stay in the observation center (created for the purpose to observe suspected COVID patients) wherein all food and  other facilities will be provided by the pradhan and person will be  allowed to go their homes only after he/she is found healthy.
• Volunteers were mobilized to guard the village and keep an eye on movement of people or people not  adhering to village protocols.
• no group pooja or namaz will take place unless under strict regulation 
• disinfecting clothes of every migrant returning from outside will be done through boiling it in water with neem leave. People will also bathe in this water and  drink at least one spoon neem oil daily to keep respiratory system free of  infections.
• villagers agreed to provide food to their family members who return from outside only at the  observation camp, not at their houses. 
• villagers were shown news clippings and pictures, posts on social media regarding the situation of  COVID
• Villagers were told about social distancing, isolation, symptoms of COVID, etc.
• Villagers agreed to observe isolation in the Observation Camp to be established by the pradhan either  in the school building of village or in some huts
• villagers agreed to restrict participation of people in funeral/burying with not more than 3-5 people in the person has died of COVID
• villagers agreed to restrict/control their children not to play together but stay in their  homes as much as possible.
• villagers agreed to Greet without handshake --- namaste ! , use towels on face/nose, not discriminate against one found COVID positive, help each other,  avoid  coughing, spitting and sneezing in public, etc. 
• The panchayat has arranged gas cylinders, utensils etc. necessary for cooking and serving food for  those who were under observation

2. Creating list of people outside/ migrants : 

• a database was created of all such families whose family members were living outside and about to  return.
• contact established to everyone living outside about their health situation and possibility to  return home
• village level protocols was explained to each one while contacting so that everyone be mentally  prepared while returning to home
• Emergency transportation vehicle were arranged in case of emergency health  situation

3. Arrangement of Steam, Neem Oil and Food : A team including women was formed tovoluntarily provide steam, warm water, lemon juice ( lemon with salt), Neem oil, etc., to everyone on demand, especially to those coming from outside and staying at the Observation Hut. Neem patti was compulsorily added to water for disinfecting the clothes of people coming from outside as a measure of natural disinfectant. Village volunteers cooked food.
4. Medical Check-up The nearest PHC was contacted to do the health check-up specially testing of corona infection 
5. Corona Chaupal : Corona Chaupals were organized almost daily where people used to sit together ( keeping social distance ) to discuss about the Corona virus and explore more information and knowledge.
6. Arrangement of Music/Radio : At the, Observation Hut music /radio was arranged so that people staying there not get board. 
7. Designation of area for Sanitation : To avoid any infection possibility a separate area was designated where people can go for defecation purpose, rather using common toilet. 
8- Safety Kits Overcoats were stitched out of plastic in case there was a need to handle a COVID patient. Gloves were also stitched out of plastic and  plastic of X-ray films was used to develop Face Shield. 9- Public Notice & Barricade : In agreement with the villagers, a barricade was established at the common entry point to restrict entry and a banner was put up to explain why entry is restricted.
10- Database of daily health : Panchayats designated few people to record daily health status of families and if needed, provided extra help for further health care. 
11. Arrangement of Kaadha etc. 

• Kaadha ( made out of Tulsi, Adhrak, Dalchini, Neebu, giloe patta, cloves ) was arranged both at the Observation Center ( isolation hut for migrants)
  and people were encouraged to drink it daily rather than  simple tea and milk. 
• Doodh mixed with turmeric were advised to be taken before going for sleep,  people who  were non-vegetarian were advised to use fish ( fried/fermented) for boosting  immunity and strength
• Rice ( khichdi, moong daal mixing with black chilli and lemon) was advised to be taken as light food Kaadha was served free to every household by volunteers to prevent respiratory infections.

12. Use of Mask, Sanitizer Kit etc. Everybody was advised to use masks when going out of their homes along with sanitizers. 13. Exercise/ Yoga for those quarantine : Those migrants were observing isolation in the isolation center ( Hut, school building) were encouraged to keep doing some physical exercise to keep themselves active. Religious leaders ( pundits, maulvi etc.) visited the center to provide them psychological support and strengthening their belief.

Dear all,

You can view the webinar's recording at this link:
sphereindia-covid19academy.zoom.us/rec/s...0-3.yN4bGuQ6bWJd3Qme .Use the passcode of WaterAid_050521 to access it.

The presentation is attached. 

Regards,
Nitya