DIMAPUR, AUGUST 20: It lags behind other districts of Nagaland in almost every indicator of health, education, employment and income ~ for long struggling at the lower rung of the development spectrum. But Mon, the remote and “backward” district apparently scores higher on the COVID-19 response indicator more than even the Government of India.
The first COVID-19 positive case in India was reported as early on January 30, 2020. But even as the Government of India was found dragging its feet on travel ban, the Konyak civil societies of Mon had issued a diktat banning entry of tourists into the district. Till date religious gatherings in the country in violation of social distancing norms continue to add to the spread of COVID cases. But the Konyak Union exercised prudence to restrict local gatherings during Aoleng festival, the most important socio-religious event for Konyaks.
Addressing issues of employment, education and above all awareness about COVID-19, Mon has adopted a holistic response to the crisis with the community working in tandem with the civil administration and Medical Department.
Early Response to COVID-19
“The Konyak Union had started discussing COVID-19 in January as we heard about the spread of the virus in China, in Italy and parts of Europe. We realized that the Coronavirus was spreading through travel. So by February we had decided to ban entry of tourists,” says Honang Konyak, Vice President of the Konyak Union, an apex body of Konyaks comprised of Konyak Nyupuh Sheko Khong (Mothers’ organisation), Konyak Baptist Bumeinok Bangjum (Baptist churches organization) and Konyak Students’ Union among others.
Mon was spurred into responding early to the emerging threat taking into cognizance the district’s deplorable condition of healthcare infrastructure, remoteness and geographical vulnerability.
The Konyak Union declared a ban on entry of foreign and domestic tourists into Mon, a hot-spot tourist destination of Nagaland, in the first week of March, and gave the deadline of March 15 for tourists in Mon to move out. “We wanted to avoid tourists crowding Mon for the Aoleng festival celebrations with the threat of the virus looming over us.”
Reacting to the ban on entry of tourists by the Konyaks, the “State Government came out saying we are tourist-friendly state and in Nagaland we do not have any corona cases.” But when Prime Minister Modi appealed for Janta Lockdown, the “State Government jumped in,” Honang stated.
The Konyak Union didn’t stop at banning entry of tourists but also sealed borders particularly with Myanmar. “Geographically we are the most vulnerable sharing porous borders with Arunachal Pradesh, Assam and Myanmar. Konyaks, on the Myanmar side of the border, whose condition is worse than ours, come to Mon for essentials. But we informed them of the risks, and sealed the borders.” Subsequently, the Konyak Union also called on the people of Mon to abstain from social gatherings during the Aoleng festival, celebrated in the first week of April.
“Aware of the ground realities of Mon, the Konyak mass-based organizations were compelled to take stringent measures,” noted a senior Government employee, wishing not to be named, adding “The situation in Mon is beyond the imagination of people who are functioning from Kohima and Dimapur.”
“The condition of the Mon district hospital is pathetic,” the Konyak Union executive informs, adding that while it has been upgraded to a 100-bedded hospital, the manpower is not sufficient for even a 50-bedded hospital. There are few doctors and nurses, and even fewer 4th grade staff.
A source informed that one doctor is looking after one whole block ~ around 4 Primary Health Centres (PHCs), besides Sub-Centres. The hospital, part of which is functioning as the COVID-19 wing, has just 9 doctors, including 6 specialists. Around 8 technicians have been working for 5 months without a break, and no replacement, as part of the COVID-19 team. Only recently 2 technicians were sent from Kohima.
The Konyak Union had written to the Chief Minister for more manpower but has not received any response till now.
“We are not complaining because we are used to our district being neglected,” the source said while dwelling on the lack of manpower and infrastructure in Mon vis-à-vis healthcare. “When we had our first meeting with the Medical Department, they informed us that there was no facility to conduct COVID-19 tests.”
Mon recorded the second highest number of returnees, after Dimapur district, but it had only a single-channel TrueNat machine, set up at the Mon COVID Hospital on May 3, for screening samples of the returnees. The Konyak Union stepped forward and donated a dual-channel TrueNat along with 1000 screening cartridges. Minister Paiwang Konyak, after consultation with the district Medical Officials, donated confirmatory cartridges and Rapid Antigen test kits.
“We were sending samples, which tested positive on TrueNat screening, to Kohima, Dimapur and Dibrugarh for confirmatory RT-PCR tests. But the results were getting delayed. It was then that the Minister had a consultation with Health and Family Welfare Department doctors and the Konyak Union and decided to purchase the confirmatory cartridges and Antigen kits,” a source in the Mon CMO’s office informed.
We had purchased and donated one dual channel TrueNat and 1000 screening cartridges. The Medical Department had one single channel machine. The district hospital had only 200 cartridges.
Paiwang donated the confirmatory cartridges. He also bought Rapid Antigen kit in his personal capacity.
The Government later issued three 4-channel TrueNat machines for Mon.
Managing Returnees and Prolonged Quarantine
Mon has recorded about 2000 returnees. The district administration and civil societies worked together to arrange the required quarantine centres. Empty buildings were exhausted in Mon. After requisitioning buildings in different Sub-Divisions, the District Task Force (DTF) was faced with the challenge of arranging toilets at the quarantine centres.
Honang accepted that with inadequate quarantine facilities and huge number of returnees, the DTF faced a nightmare in segregation and management. “We had to keep them in a group of about 200, and when a few tested positive, the others could not be sent home.” He also accepted that violation of social distancing norms by the returnees created problems.
“Initially we had decided on segregating the returnees area-wise but they were kept together and transported together from Dimapur. So we had to segregate them batch-wise,” informed Honang. Some of the returnees who had tested negative in Dimapur tested positive after reaching Mon, sending the DTF into a tizzy.
This also prompted the District Task Force to come up with the 2-test mechanism. One has to test negative twice consecutively before being sent home. Moreover, taking into cognizance reports of people testing positive after the lapse of 20 days, the DTF decided on implementing a 28-day quarantine period as against the State Government directive of 14-day institutional quarantine. “We said let the Government sponsor the 14 days of quarantine for the returnees, and we will feed them for another 14 days from our own fund,” the Konyak Union executive informed. The DTF and the civil societies were on the same page and the 28-day institutional quarantine system was agreed on exclusively for Mon.
The prolonged quarantine period, two negative test mechanism and improper segregation has led to some of the returnees spending 80-90 days in quarantine and undergoing multiple tests. Some returnees from the first batch are yet to be released from institutional quarantine. While this has evoked criticism from several quarters, Honang says the Union was compelled to take this course of action, as it would be very difficult managing the situation if any of the returnees tested positive after going back home as some areas are very remote and access difficult.
Speaking to Nagaland Page, Mon Deputy Commissioner Thavaseelan K (IAS) also underscored the need for prolonged quarantine in Mon. “In most households in the villages, people sleep in one large hall, and so home quarantine is not really an option. Moreover people are testing positive even beyond 14 days, so we couldn’t take the risk.”
“It is difficult, and we have to console them regularly that if you love your parents and children you have to sacrifice. Some have been tested 6-7 times, but still not sent home as the risk factor could not be ruled out.”
Honang also informed that the DTF has been facing agitations in the quarantine centres but the situation is under control. “We have been counseling them.” Some of the members of the Empowered Committee of the Konyak Union also had to go into quarantine after coming in contact with the returnees while quelling the agitations.
DC, Mon, informed that the situation is largely under control in Mon, “thanks to the collaborative effort of the civil societies.” The Konyak Union, the mothers’ and students’ organizations and the churches have worked hand in hand with us, he acknowledged.
Currently the DTF is focused on quarantining each and every person coming from other districts and outside the state, the DC also informed. “Testing, tracking and isolating are the only ways forward. We are also talking to the elected members to arrange for testing kits in their own Assembly constituencies so that more tests can be conducted.”
Mon’s response to the situation has been multi-pronged starting from the constitution of a committee for examining opportunities for re-employment of returnees to Mon District. Spearheaded by Mon’s DC, the district has also come up with a COVID Adaptive Response (CARE) to create awareness about COVID-19. Under the initiative, every household in Mon, including even those in the remotest villages would be given a questionnaire to test their knowledge about the virus, and educated. The huge exercise involved many stages starting from training of area coordinators to designating wardens for every household.
Also to address educational needs, the DTF has formulated a strategy for home-based education with uniform syllabus for every student in the district. Mon’s civil societies are also working on strategies to bring about temporary alteration of socio-religious norms to ensure social distancing during the pandemic.
“COVID-19 is a reality and there is still no vaccine. So we have to adapt and continue with our lives. This isn’t the time to complain”, says Honang Konyak.