Villages in Punjab boycott COVID-19 tests and hospital treatment due to fear, misinformation
On 28 August, the panchayat of Smalsar village, in Punjab’s Moga district, passed a resolution that any resident who tested positive for COVID-19 will be entitled to isolation at home or at a designated common facility within the village. The resolution further stated that government health-teams would not be allowed to test any asymptomatic resident who did not wish to be tested and that government doctors would not be allowed to take COVID-19 patients away from the village. The resolution added that COVID-19 patients would be attended to and treated in the village, “in consultation with doctors.” The resolution was signed by the sarpanch Amarjit Singh.
In the last week of August, like Smalsar, a number of villages in Punjab have passed similar resolutions. The villages have refused access to their residents by medical teams of the state’s health machinery, mandatory COVID-19 tests, and mandatory quarantine or treatment at government healthcare facilities. The actions were based on mistrust of the quarantine and treatment system. The resolutions alleged that non-COVID-19 patients have been hospitalised with COVID-19 patients. The residents of these villages told me about rumours on social media of COVID-19 care centres sending out large numbers of dead bodies and of patients’ organs being illegally harvested. The rumours even resulted in healthcare workers being attacked in several instances.
Amarjit told me of his own personal loss as an instance of “foul play and medical negligence.” Amarjit’s wife Manjit Kaur died at the Guru Gobind Singh Medical College and Hospital in Faridkot, in the last week of July. He said she had a respiratory illness even before the novel coronavirus outbreak and had been treated at a private hospital in Bhatinda, in June. According to Amarjit, she was perfectly healthy for a month till she experienced breathing trouble again. In late July, he took her to GGS Hospital. “She was forced to give a sample and was kept along with coronavirus positive patients the night we took her.” The next morning, he and his son were told that Manjit was being put on ventilator support and at around 4 pm, they were told that she was dead. “My wife was neither attended to nor given any medicines,” Amarjit claimed. He was also upset that the hospital would not allow him and his son to see her, despite their offer to pay for the personal protections kits that they would use. But what really hit him hard is that his wife might not have had COVID-19 at all. “The irony is that after her death, her report came out to be negative,” he said.
Amarjit said that there were similar cases at the GGS hospital. He recalled a cancer patient, who had come to collect his medicines, but was admitted for COVID-19 and then died. He said after the man’s death there was an argument between the patient’s family and the doctors. According to Amarjit, the Smalsar panchayat, along with many others, had donated beds and linen for a quarantine facility when asked to do so by the government. “When government facilities as such do not have anything and patients are left unattended, why should we send our cases to a hospital?” he asked. The Smalsar panchayat earmarked a school for isolation of confirmed COVID-19 cases. It decided to bear the expenses of patients’ medicines and other needs and to have volunteers from the village take care of them.
Jagtar Singh Tolewal, from the village Tolewal, in Sangrur district, echoed Amarjit’s worries about government hospitals’ lack of arrangements, even for basics such as food. He said he witnessed family members being denied information about a patient’s health at the Rajindra Hospital in Patiala. Jagtar also referred to rumours about COVID-19 patients whose organs were harvested illegally and who turned up dead. It is unclear where this rumour has originated. Tolewal village has also passed a resolution. “No police or administration officials can enter a village without informing the sarpanch as per the law,” Jagtar said. He added that the panchayat had made a public announcement that health teams were prohibited from entering the village and that villagers were ready to resist them if health officials ignored the announcement. Beant Singh, the sarpanch of Tolewal, said that any team that visited the village had to inform the panchayat. He also said that they were ready to follow all necessary protocols to treat COVID-19 patients with mild symptoms in the village itself.
On 29 August, Banbhaura village, also in Sangrur, passed a resolution refusing to allow medical teams to test residents for COVID-19. The village took responsibility for suspected cases and for people who found out that they were COVID-19 positive by taking tests of their own accord.
Jakhlan village in Sangrur also passed similar resolution on the same day against allowing government health teams to conduct tests. Balbir Singh, a resident of Jakhlan, talked about social media messages alleging that people went into COVID-19 facilities and emerged dead the next day. Again, the origins of these messages are unclear. Balbir, who is also the sarpanch Paramjit Kaur’s husband, said that people in the village who needed surgical treatment had postponed their appointments because they worried they would be tested for COVID-19 and quarantined. He referred to the unscientific claim that the infection could be treated with vitamin C and steam inhalation as part of his argument against going to hospital for COVID-19.
Rajpura in Sangrur district was yet another village that passed a resolution on 28 August not allowing the government to test anyone for COVID-19. The resolution, passed under the aegis of the sarpanch Joginder Singh, said that if a resident showed symptoms, the panchayat would take responsibility for treatment and isolation of the patient and family. To that effect, the resolution requested the administration not to send any COVID-19 teams to the village. Unlike Smalsar village, Rajpura’s resolution did not say anything about residents who wanted to get tested or treated at a hospital voluntarily. The resolution further warned that the administration will be responsible for anything that befalls a team sent to the village. Joginder Singh said, “Pindan vich dehshat da mahaul hai”—There is an atmosphere of terror in the villages. He claimed that when medical teams took people with the infection away, it caused panic. “There is no treatment for COVID-19, then, why leave our patients at government hospitals to die?” he asked.
In the Barnala district, several villages had jointly passed a resolution against COVID-19 testing and treatment at government facilities. Dr GB Singh, a district civil surgeon, said that the genesis of paranoia was in rumours circulated on social media platforms which alleged organ harvesting of COVID-19 patients. Meanwhile, Harpal Singh Cheema, who is an Aam Aadmi Party legislator and leader of opposition in the state, blamed the chief minister of Punjab, Amarinder Singh. He referred to an address by the chief minister on 22 August in which he referred to projections of cases and deaths in a update he got as part of the state’s COVID-19 Mission Fateh that showed that the number of COVID-19 cases could rise to 64,000 by 3 September and to 1.18 lakhs by 18 September. “He said that the figure of 957 deaths would rise to 1,721 on 3 September and 3,148 on 18 September,” Cheema said, alleging that this speech spread panic in villages. In fact, the chief minister was making the case for containing the spread of the disease so that there would be fewer cases and deaths. He made a plea in the same address asking people to wear masks and wash their hands. He also said that if people did not follow social distancing and safety protocols he would have to impose strict regulations to save people’s lives.
The fear and misinformation that has gripped the villages had already resulted in unfortunate incidents of violence against government workers, even before the resolutions. On 14 August, a multi-purpose health worker Mastan Singh was brutally assaulted by members of a dera—a socio-religious organisation common in the state—in Khanpur village in Ludhiana. Mastan had been sent to the area to encourage suspected COVID-19 patients to get tested. Rakesh Agrawal, the commissioner of police in Ludhiana, said that the accused seem to have been under the influence of drugs when the attack took place and they had all been arrested. Unfortunately, Agrawal said, the accused later tested positive for COVID-19 and so did five policemen who arrested them. Kanwardeep Kaur, the joint commissioner of police for Ludhiana rural, said that they had booked the accused under provisions of both the Indian Penal Code and Section 3 the Epidemic Diseases (Amendment) Ordinance, 2020 that defines acts of violence against healthcare workers as cognisable and non-bailable offences.
Jaffarpur village in Shaheed Baghat Singh Nagar district, which had been a COVID-19 hotspot in the early weeks of the epidemic, gave health workers a hostile reception in mid-August. According to civil surgeon Dr RP Bhatia, a former sarpanch from the village had been taken to the civil hospital with very advanced COVID-19 and with co-morbidities. He was referred to Rajindra Hospital in Patiala where he died. “Following this, a team was sent to the village for contact tracing on 17 August,” Bhatia said. “But the villagers misbehaved with the team and did not allow them to do their job. A call was placed to sarpanch Joginder Singh who is currently in US but he too didn’t hesitate from abusing and using foul language with the health workers.” Bhatia lodged a complaint with the police, who booked the sarpanch, a panchayat member and his son, and others under the epidemic diseases ordinance. On 21 August, the residents of Jaffarpur wrote a letter to the deputy commissioner of the district and said that a health team had visited them but the villagers unanimously said they did not want to be tested. “We want to request you not to send this team to our village again,” the letter said. “If any villager has any symptoms, he will get it tested on a personal level.”
On 26 August, inhabitants of the Deha Basti group of villages within the city limits of Dirba in Sangrur district pelted stones at police officials and health workers. Sandeep Kumar Garg, a senior superintendent of police of Sangrur, said that the area was declared a micro containment zone. He said that it was only a few miscreants who attacked the team that went there to conduct contact tracing.
Residents of Chatha Nathera village in Sangrur were upset after two young men amongst 70 shopkeepers were found to be COVID-19 positive in a testing drive. The men were asymptomatic but were taken to a treatment centre. When the health team came back to continue taking test samples, the village made an announcement from its gurudwara that no villager wanted to get tested for COVID-19 and if health authorities enforced testing they would be gheraoed. Ran Singh Chatha, general secretary of the local unit of the Bhartiya Kisan Union—a farmers’ rights organisation—said that if anyone chose to take a test of their own and were found to be positive they would be treated at home or in the government secondary school of the village. The health department would not be allowed to take them away. “All this, because the teams of the health department dump even the healthy individuals at government hospitals sans facilities and even food by falsely branding them as COVID-19 positive,” he said.
Garg, the SSP, said, “Resolutions to refuse sampling and not let the teams enter the area happened at more than 10 localities. It is more because of the rumours and lack of awareness and the same has now been taken care off.” He said that officials had held talks with village panchayats telling them that they must follow protocols if they wanted residents to isolate at home and also assured them that no one would forcibly be taken to hospital.
Singh, the Barnala civil surgeon, said that the district had constituted block level teams to make sarpanchs aware of the need to test and the right to self-quarantine in case of mild symptoms. “We are allaying their fears by informing them about the latest guidelines,” he said. “Out of 25,000 odd tested here, only 1,100 tested positive, of which 20 died. We are sharing these figures now with them.” However, it will take a lot more to convince the villages. Gurjant Singh, husband of Sukhwinder Kaur who is the sarpanch of Dhilwan Nabha, which passed the joint resolution along with other villages in Barnala, said that the villagers are living in “dar da mahaul”—atmosphere of fear.