The Covid-19 pandemic has taken a grim turn in India, with a massive surge in positive cases and deaths across the country and little access to medical care. Despite efforts by the central and state governments and members of the private sector to expand vaccination coverage and restrict the spread of the virus, there are many obstacles that may seem almost insurmountable to those most marginalized who do not have access to even the most basic medical and health care services. In rural areas, many exhibiting Covid-19 symptoms do not have access to testing facilities. Where vaccinations may be available, a number of people chose not to vaccinate given misinformation and stigmas associated with those taking the vaccine. With lockdowns in place and movement restricted, it is challenging to reach those living in the most remote areas with messaging about how to prevent the spread of the pandemic, access to testing, vaccination information and the dispelling of myths regarding the vaccines themselves.

Through our long term livelihoods program reaching the poorest of the poor, Trickle Up has built trusted relationships in many remote, rural communities. As part of Trickle Up and Tata Communications’ MPOWERED project, local women and community-based digital coaches—known as Smart Sakhis—were given smartphones with a pre-installed livelihoods application which helped them to access information about appropriate livelihood (such as agricultural) techniques. These phones proved to be an important communication tool in the pandemic, allowing Trickle Up to stay connected and provide Covid-19 messaging to the communities where we work.

In June 2021, Trickle Up launched the “Meet the Doctor” initiative, directly connecting the Smart Sakhis with doctors to provide clear messages on various issues and myths regarding Covid-19. Trickle Up planned a series of virtual discussions to provide better awareness about the virus and train Smart Sakhis to counsel community members more effectively on prevention and treatment. Dr. Ansewha Mishra, who is engaged in the treatment of Covid-19 patients in SCB Medical College at Cuttack, spoke with Smart Sakhis from Odisha (Bongomunda Block & Balishankara) and Jharkhand (Maheshpur & Manoharpur Block). Around 48 Smart Sakhis from Odisha and 42 from Jharkhand joined a one-hour session along with the field teams from both regions. More interactive sessions are planned to cover all the Smart Sakhis in the project.

The dialogue was conducted in the local languages of Odia and Hindi, making it accessible to many of the rural population who do not speak English. Dr. Mishra shared some of her personal experiences fighting the pandemic and provided advise on behaviors to reduce the spread of the virus, such as proper hand washing, how to effectively wear masks, the importance of home quarantine and social distancing, and the value of testing. She stressed the importance of immediately consulting a doctor or the nearest health worker if anyone displayed symptoms to avoid further complications and even death.

Interaction with doctors is rare in many of the remote, rural regions of Odisha and Jharkhand and the Smart Sakhis took advantage of the opportunity to speak freely with Dr. Mishra. The discussion allowed them to challenge misinformation and rumours by asking pressing questions, including:

• How effective are masks?
• What is the need for social distancing and is it effective?
• What is the impact of vaccination?
• How likely is infection after vaccination?
• How does vaccination affect pregnant women and nursing mothers?
• How does the vaccination affect those suffering from diabetes or other chronic diseases?
• What is the best food to eat if infected?
• What are the best practices to protect children during the pandemic?

Following the sessions, Smart Sakhis are now better informed to counter rumors, misinformation, and myths regarding Covid-19 prevention techniques, symptoms, testing, and vaccination. As a next step, the Smart Sakhis will reach out to each household in their respective communities to clarify doubts and confusion and council them on the spread of the virus, its impact, and how to prevent and treat it.

In the following weeks, Trickle Up will expand the “Meet the Doctor” initiative to include Smart Sakhis from additional areas in Odisha and Jharkhand.