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Covid Lockdown Leaves India’s Elderly Stranded without Carers or Family Support

India has the world’s second largest population of senior citizens after China — 104 million. The abrupt draconian lockdown left them without any help

In the days since Indian Prime Minister Narendra Modi announced a complete lockdown to curb the spread of Covid-19 in the country, development sector professional Sohini Sarkar has noticed something new on her mother’s face when they speak on FaceTime. Fear. Her mother, 73, is a retired professor who lives alone in Kolkata and suffers from a chronic kidney condition that has flared up over the past week. Sarkar lives in Washington DC in the United States. Her mother has part-time help and a carer from an agency who comes in for 12-hour shifts.

But public transport has stopped since the three-week lockdown started on 25 March 2020, and international flights suspended, making it impossible for Sarkar to fly to India if a health emergency arises.
Domestic flights and trains are also not operating, even the suburban trains that ferry millions of people into the cities for work. Buses are running at limited capacity in cities like Mumbai, Delhi and Kolkata, but police are restricting the movement of people.

Image sourced from the South China Morning Post where this feature was first published. Meant was use only on my personal website. No commercial intentions. Photo AP

Health workers are included under essential services but home care workers often lack this documentation, and many are fearful of the authorities after seeing images of the police beating people who are out on the streets. As a result, Sarkar’s mother’s carer and helper have not been able to come to work. “I have never seen palpable fear on my mother’s face. She is a fiercely independent person,” said Sarkar. “For the first time, I feel she would not resist if I arranged for someone to stay with her.”

After China, India has the world’s second-largest number of elderly people, numbering 104 million according to Indian government data as of 2011. Elderly is defined as those above 60. The majority – 73 million – live in the rural areas, and 41 million live in urban areas. There is no government data on what proportion are vulnerable and need care or how many live alone.

Home health care service company Medwell Ventures, which operates Nightingales home health services, estimates this market to be worth US$1.5 billion, made up of larger companies and small agencies which provide nurses and ‘attendants’ or ‘ayahs’. The restrictions on movement have made it mostly impossible for many of these care workers to get to work.

“All our staff have ID cards that say they are health workers, yet the police have stopped them in many places,” said Gaurav Thukral, COO of Health Care at Home. “It’s been a real struggle even though we have applied for police permissions for our cars to pick up and drop off our staff. In some cities, our nurses and nurse aides have had to leave their hostels and homes because of the anxiety of neighbours that they may be carrying the infection. But in some cities, we have added patients over the past week and are getting requests for more,” Thukral said.

Small agencies are bearing the brunt of the crisis as they do not have the resources to organise transport, get police permission or supply staff with ID cards saying they are health workers. The owner of an agency in Kolkata, who did not want to be named, said nurses and attendants are seeking work, particularly as they fear a long period of uncertainty ahead. But clients would have to provide transport. This is only possible for families who have cars or live with or near the elderly person being cared for. “Many like me did away with older arrangements of full-time help because of the availability of home health care services like this,” said Sarkar. “Now neither is there for my mother, and I can’t fly in.”

Anurupa Roy, a doctor in Singapore, learnt that her parents had run out of some food essentials on the third day of the lockdown. Her parents, both 71, live in Gurgaon near Delhi. Her father is a cancer patient in remission.
As she had worked for several years in India and knew a number of people in positions of power, she called an acquaintance in the army who delivered the goods within the hour. Over the past week, she has found herself inundated with requests from the Indian community in Singapore to help with arrangements in locked down India.
“I couldn’t do anything for a woman whose father passed suddenly. She wanted to fly home to be with her mother who is all alone, and an elderly person herself. But what do you do when flights are shut? I’ve decided to set up a website called Digitalis to connect people with health care providers, and other essential suppliers. There is a charge for services, but I am doing it for free. The idea is to help people like me whose parents live alone,” Roy said.

In Kolkata and Mumbai, community initiatives have started to offer help. Sarkar’s mother, for instance, has her groceries and medicines delivered by one such group in her neighbourhood of Naktala. Groups put up notices on social media with phone numbers to contact. The elderly are typically not social media users, but their children are. In Kolkata, the state government has copied the idea, posting the names of municipal councillors and offers to check on elderly citizens in their wards. Concerns have also been raised about dedicated care for India’s dementia patients, many of whom suffer from other chronic diseases. The government estimated in 2011 that 2.8 million Indians suffer from dementia and related diseases. The social justice ministry issued a circular asking for carers for the “disabled” to be issued travel passes so they could continue to work.

There is also the question of whether the government is violating an existing law that citizens must “maintain” their parents and elderly relatives. The same applies in Singapore, China, Bangladesh and South Korea.
“India has invoked the National Disaster Management Act, 2005, that gives the state some sweeping powers,” said Avi Singh, a lawyer based in Delhi. “Many of its laws may be violated under these powers. But the real issue is that the state may not even have considered this Act. The government should clearly say that its provisions have been overridden or otherwise deal with it,” Singh said.

This feature was originally published in the South China Morning Post