Kalabai Maravi, a 50-year-old health worker trained by the Jan Swasthya Sahyog, during her door-to-door monitoring of villagers for COVID-19 symptoms in Bamhani inside the core zone of the Achanakmar Tiger Reserve in Mungeli, Chhattisgarh. May 11, 2021.
Battling the Wave: Healthcare Efforts Fighting the COVID-19 Crisis in Rural India
India’s crumbling rural healthcare infrastructure was not prepared for the COVID-19 pandemic. In Chhattisgarh, one of India’s poorest states with a large indigenous population, only 40% of Primary Healthcare Centres have a medical officer. The country has a shortfall of 1.1 million doctors and 3.5 million nurses and midwives. The situation was notably worse during the second wave, which battered rural regions, home to two-thirds of the nation’s population. Testing was sparse or nonexistent there, coupled with a lack of access to essential healthcare, misdiagnosis, pandemic denial, and social stigma.
As all resources were diverted to fight the coronavirus, treating other diseases became a low priority. For instance, India accounts for 26% of the world’s tuberculosis cases, but reporting of new cases declined by 25-30% between January and June 2020. The lockdowns made it almost impossible for residents from remote villages to travel to the nearest town for healthcare.
During the pandemic’s second wave in May 2021, I travelled on a motorbike for 42 days through central India, documenting the work of doctors and healthcare workers at four non-profit hospitals operating in low-resource settings.
The project was supported by a grant from the National Geographic Society and has appeared in National Geographic and The Caravan. In 2022, it was awarded Amnesty International UK’s Media Award for Photojournalism and was also recognised at Asian Press Photo, Chennai Biennale Photo Awards, and News Photo Awards.
A temporary barricade put up at a coronavirus-control checkpoint at Sirpur, along the state border between Telangana and Maharashtra. May 08, 2021.
A person with a high temperature and suspected of having COVID-19 is brought to the Jan Swasthya Sahyog hospital at Ganiyari in Bilaspur, Chhattisgarh. May 18, 2021.
Dr Ashish Satav, 49, checks on Sonaji Savalkar, 60, who tested positive for COVID-19 at the MAHAN Trust’s hospital in Utavali in the Melghat region of Amravati, Maharashtra. The plastic sheets used when Satav visited the patient were intended to prevent the hospital’s only senior doctor handling COVID-19 cases from catching an infection. May 31, 2021.
A technician does a chest X-ray for Bhaskar Prasad Yadav, 47, in the COVID-19 ward at the JSS hospital in Ganiyari in Bilaspur, Chhattisgarh. May 15, 2021.
Sachin Kumar Gupta, 39, and Sivil Sarjan Paikra, 60, are both teachers who were part of a contact-tracing team in Batauli in Surguja, Chhattisgarh. May 25, 2021.
An old woman suspected of having COVID-19 was left with no medical attention in a room in Jakad Bandha in the Achanakmar Tiger Reserve in Mungeli, Chhattisgarh. Health workers from the JSS convinced her son to bring her later that evening to the hospital, seventy kilometres away in Ganiyari, but the family decided to take her back after being told that her condition was serious. “We’re leaving it up to god,” they said. May 19, 2021.
A 50-year-old prisoner brought from the district jail with COVID-19 symptoms is shackled to his bed in the isolation ward at Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh, India. May 22, 2021.
At a COVID-19 testing camp conducted at the Primary Health Centre in Khudiya in Mungeli, Chhattisgarh, 12 of 19 samples tested positive in a Rapid Antigen test. The more reliable and accurate RT PCR test is only available at a bigger hospital about 20km away. May 13, 2021.
Shyamkali Baiga, 30 and her four children have all tested positive for COVID-19 and are under home isolation in Bahaud in Mungeli, Chhattisgarh. The village of about 400 people has 16 active cases, even as half of the village refuses to be monitored or get tested. May 19, 2021.
A medical team led by Dr Pranav Dhamdhere, 29, and Dr Apoorv Gujar, 26, perform an arthrotomy procedure on Prince Yadav, a COVID-19-positive two-month-old baby with Septic Arthritis, to drain the pus forming in his knees at Jan Sawasthya Sahyog hospital in Ganiyari in Bilaspur, Chhattisgarh, on May 17, 2021.
Ashik Parvez, 28, plays an Islamic prayer on his mobile phone for his father, Nabi Khan, 50, who was critically ill in the COVID-19 ICU at the Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh. The ICU is being run by Sangwari, a group of doctors committed to rural healthcare, in collaboration with the hospital. May 23, 2021.
Doctors attend to Mithau Ram, 45, who was admitted in critical condition, in the ICU run by Sangwari at the Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh. May 23, 2021.
Kavita Kushwaha, 28, leaves latex gloves filled with hot water by her father, Dadanram Kushwaha, 80, to soothe his bedsores in the ICU run by Sangwari at the Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh. He passed away later that night. May 24, 2021.
Kavita Kushwaha, 28, leaves latex gloves filled with hot water by her father, Dadanram Kushwaha, 80, to soothe his bedsores in the ICU run by Sangwari at the Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh. He passed away later that night. May 24, 2021.
Medical staff tend to Suhanu Das, 46, who fainted as she watched a sample being taken from her husband Anand Das’s nose to test for Black Fungus (Mucormycosis) in the ICU at the Government Medical College Hospital in Ambikapur in Surguja, Chhattisgarh. May 22, 2021.
A nurse relaxes in front of an air cooler in the COVID-19 ward at Jan Swasthya Sahyog hospital in Ganiyari in Bilaspur, Chhattisgarh. May 17, 2021.
Manohar Patil, 50, holds a sacrificial goat as his daughter Jamuna More, 30, and son-in-law Suhas More, 30, offer prayers to it at an ashram run by Bhanlal Jawarkar, 70, right, in Dadida in the Melghat region of Amravati in Maharashtra. The Mores claimed Jawarkar cured Jamuna More of oral cancer two years ago by prayers after doctors gave up on her. May 31, 2021.
Sojar Chintaram Bilavekar takes a ritual purification bath with neem, tulsi and bel leaves upon reaching home in Dadida in the Melghat region of Amravati, Maharashtra. She spent INR 6000 on treatment for a fever from a quack, who told her she had typhoid. But when it did not subside even after many days, she travelled to the sub-divisional hospital in Dharni, where she tested positive for COVID-19. She spent 19 days there, 16 of them on oxygen support. May 30, 2021.
Village elders watch as Rajesh Vishwakarma, 30 and his wife Surekha Bai, 25, carry their dead infant home in Gidhali from Shaheed Hospital in Dalli Rajhara in Balod, Chhattisgarh. The infant, delivered in a PHC closer to their village, was brought to the hospital with complications arising from drinking amniotic fluid but died before the family could arrange for the money for a private ambulance to a better-equipped hospital at Durg, 85 kilometres away. June 14, 2021.
Members of a wedding band catch up on some sleep before their next event at a wedding outside Dindori in Madhya Pradesh. The state banned weddings in May, since they were believed to be a major reason for the spread of COVID-19 in villages. Local marriage-registrar offices were ordered to not issue marriage certificates for couples who married during this period and to even file cases against them. May 27, 2021.
Binda Bai, 50, holds a nebuliser for her husband, Sankuram Uike, 50, who was admitted to Shaheed Hospital in Dalli Rajhara in Balod, Chhattisgarh, after complications arising from the consumption of alcohol immediately after vaccination as well as a relapse of tuberculosis. June 09, 2021.
Suspecting she was there to vaccinate them, a member of a Baiga adivasi family taking a ritual bath warns a JSS health worker (not seen in the photo) in Jamunahi in Mungeli, Chhattisgarh. May 13, 2021.
Ruchika Behera, 26, pins a black band on a fellow nurse, Sarita Yadav, 35, as the medical staff join a nationwide protest by medical professionals against attacks by patients and their relatives on them, at Shaheed Hospital in Dalli Rajhara in Balod, Chhattisgarh. June 18, 2021.
Saraswati Bhurkhuriya, 22, follows her husband Suvilal, 23, in an orange shirt, leave after being discharged from the COVID-19 ward at Shaheed Hospital in Balod, Chhattisgarh, India. Saraswati, married for seven months and six months pregnant, had to be convinced by the doctors at Shaheed to get admitted after testing positive for COVID-19 and was one of the last three patients who were discharged together from the ward, after which it was locked up and fumigated. June 16, 2021.
The body of Sunita Bilavekar, 18, cocooned in plastic wrap lies in the bed of a pickup truck at the MAHAN Trust hospital to be transported home. Married for only six months, she died of COVID-19 complications minutes after being brought to the intensive care unit. She was later cremated on the family’s farmland. Midnight hours of June 02, 2021.