Dharavi, long and unfairly condemned as one of Mumbai’s sore spots, has thrown a surprise during this extremely challenging COVID-19 time. At the end of a difficult and tense April-to-June quarter, the number of positive cases declined, doubling rate of infections vastly improved, and the dreaded Coronavirus curve flattened. For once, Dharavi found itself in the good news section.
On April 1, when Dharavi recorded its first COVID-19 case and death, it seemed that cases would explode given its lack of sanitary facilities and super-high density which made social distancing impossible. The grim scenario of rapidly rising cases and deaths each day since then turned last month leaving Dharavi better off than most of Mumbai, though the battle against the virus is far from over.
On July 1, there were 2,282 cases — barely three percent of Mumbai’s total — and nearly 80 deaths here in the world’s most dense urban settlement of nearly a million people packed into a maze of tiny, tightly-packed tenements, commercial spaces, narrow alleys and common washrooms.
It’s worthwhile to unpack the strategies that succeeded in Dharavi. They not only reveal much about the settlement, but also hold lessons for rest of Mumbai, indeed the country.
Like Dharavi, Worli too beat back the virus, but Dharavi stands out given its accentuating conditions. What worked here was a combination of strategies which turned its worst liabilities — high population density, lack of space — into allies in the battle against COVID-19. This was done by testing maximum people in shortest time, laying emphasis on test-trace-isolate cycle at the micro level, and the unlikely partnerships between State and non-State agencies.
It began with the approach, that Assistant Municipal Commissioner Kiran Dighavkar told the media, “was to chase down the virus rather than wait for people to report it”. Area officials divided this ‘COVID-19 hotspot’ into zones that would allow for micro-management, and marked out clusters within each zone.
First, teams of doctors and health workers drawn from the Brihanmumbai Municipal Corporation (BMC) and state government identified local influential leaders, community organisations, and NGOs they could work with to access the area and residents. General practitioners were persuaded to open their clinics unlike in rest of Mumbai where most remained shut through summer. These partnerships paid off. The official COVID-warrior teams were not seen as ‘outsiders’ enforcing impossible rules and restrictions.
Second, the teams were assigned clusters and zones to assiduously and aggressively conduct the testing-and-tracing drill. Residents with symptoms were isolated or quarantined, and subjected to a rigorous follow-up. This drew heavily from the ‘Kerala model’ of tackling COVID-19, but had to be adapted to Dharavi on three counts — higher density, urban lower-class setting, and poorer public health infrastructure.
Week after week, nearly 2,500 doctors and healthcare workers of Mumbai’s over-burdened public health system made their way across Dharavi’s narrow alleys in their stuffy PPE suits knocking on door after door, paying particular attention to houses or workspaces in the vicinity of positive cases. It was test-trace-isolate-repeat.
Third, the BMC set up makeshift fever clinics and medical camps, the latter often a table covered with a garish table-cloth and a few chairs. Nervous or diffident residents were persuaded to head there. They were checked and re-checked with thermal scanners and oximeters. Anyone with even a hint of symptoms would be sent for lab tests and quarantined.
Fourth, even as LTMG or Sion Hospital, among Mumbai’s largest but packed public hospitals, made space for patients from nearby Dharavi, the BMC converted large community centres, schools and colleges, wedding venues into quarantine centres where nearly 10,000 people were placed. Additionally, some were in home quarantine and supplied food rations.
Dharavi’s biggest asset is people’s confidence to tackle any situation, Bhau Korde, among the area’s oldest community leader, always says. The fear of the virus was greater than its threat and this was addressed through ground-level collaboration between officials and local leaders. Along with the health crisis, a humanitarian crisis was unfolding as multiple businesses across Dharavi came to a standstill leaving tens of thousands without work and wage. The battle against COVID-19 had to factor in this too and reach food or dry ration to them. Eventually, nearly 100,000 migrant workers left.
The battle has extracted its price. More than 30 officials criss-crossing the area have tested positive for COVID-19. The coming months of monsoon and possible flooding could make things worse, but for now there’s reprieve.
Dharavi has shown that irrespective of aggravating circumstances, it’s possible to considerably slow down or pause the virus transmission by literally chasing it down, with micro-mapping and local collaborations. Call it the Dharavi Model.
Smruti Koppikar, a senior Mumbai-based journalist and urban chronicler. Views are personal.
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