Corona update brief van Jaydeep Chakraborty - Augustus 2020

Dear Friends of Calcutta Rescue,

The situation in Kolkata has altered dramatically since my last email, some time ago in mid-May so I thought it was high time to update you on what has been going on here. There is a lot to catch-up on, so I have broken it down into sections allowing you to focus on what is most important to you if time is tight:

WHERE WE ARE WITH COVID

After the nationwide lockdown was lifted in June the virus spread rapidly across India, There are currently around 3,000 new cases a day in West Bengal, most of them in Kolkata - triple the number of cases we had a month ago. So far 2,500 people have died here, and there is no sign of any slowdown in the spread of the virus. Across India, where there are now over 2.7MM cases, only in Delhi is it clear that the virus is on the decline. In Kolkata we are still months away from reaching that point.

As we can’t have another total lockdown for economic reasons, the West Bengal government has announced two lockdown days per week. While understandable, this also has negative consequences such as food inflation which has increased markedly in recent weeks, and which is hard for people in the slums, many of whom are now unemployed or earning a lot less than they did in March.

THE KOLKATA COVID CHALLENGE

So, I want to say an absolutely enormous thank you to everyone who supported the Kolkata Covid Challenge last month - whether as a walker or by making a donation. From Hawaii to South Africa almost 150 people answered the call to take part in the 10km sponsored walk on Dr Jack’s 90th birthday and hundreds of you made donations. You can see some great photos of our walkers here -


 www.calcuttarescue.org/blog/2020/08/12/kolkata-covid-challenge-tops-120000/

We were astonished by your generosity at this critical moment and so far the appeal has raised more than £120,000 - with the prospect of that figure almost doubling once Barclays completes the match-funding process. The money will be used to buy everything from PPE to protect staff, extra food and sanitary kits for patients and the families of schoolchildren, smartphones so youngsters can continue their education remotely and a host of other life-saving and life-enhancing measures.

I cannot adequately express how grateful and relieved we all are, knowing that this money will not only cover our current estimated extra Covid-costs for the coming year but should give us a contingency fund to provide extra support in the slums, as and when the need arises.

The event on July 25 came after a very difficult few weeks at CR. First several staff members at Tala Park Clinic & School tested positive for the virus and then came the death of Uttara, who had worked at Tala Park for many years - which was very sudden and very shocking for us all. 

So your support for the Kolkata Covid Challenge gave us a massive lift here at a critical time. In Kolkata the number of cases was climbing rapidly by late July which  meant that it would not have been responsible to ask people to take part in the sponsored walk. So instead we decided to do a two-hour live broadcast about the charity that day which is still available to watch on Facebook and YouTube. I hosted it from my garage as that particular day was a lockdown day and I was also self-isolating after coming into contact with someone with the virus. Fortunately I didn’t develop any symptoms and the broadcast was nerve-wracking but very well received - with almost 18,000 views so far. The success of both the global sponsored walk and the live broadcast demonstrate the strength of support for CR which is hugely reassuring at this deeply worrying time for all of us in India.

 

If you haven’t seen the broadcast yet please have a look at:
Youtube - www.youtube.com/watch?v=7OH7ztcXnjE&ab_channel=CalcuttaRescue
Facebook - www.facebook.com/calcuttarescue/videos/1055291114873915/

On the day of the broadcast, we were unable to show you Dr. Jack himself  but here is a short video of him cutting his cake on that day - Dr Jack cutting cake on his 90th birthday

STAFF
So far five members of staff have tested positive for the virus. Three were asymptomatic and then Uttara tragically died of Covid. Gopal, Dr Jack’s old driver, and a wellknown figure at CR for so long, was hospitalised with the virus at the beginning of the month. After several very worrying days I am glad to say that today he has been discharged. 

Just a few weeks before Uttara died Dr Jack, with his own money, established a staff benevolent fund to help staff, and their families, who need financial assistance. I have spoken to Dr Jack several times in the past few weeks about the situation and he is very clear that the fund is there to get staff the best treatment we can during this crisis and support their families should the worst happen.  So it will now be used to help Uttara’s family and to pay Gopal’s medical bills. 

What Dr Jack has done has provided a vital safety net for the team, allowing them to go to work confident that they will be well cared for should they fall ill. You can imagine just how important that is at this critical juncture. Once again Dr Jack has ridden to the rescue, this time at the age of 90. Unbelievable, inspiring and incredibly touching.

Whenever one of the team is suspected of having the virus we look at which other members of staff they have been in contact with in the proceeding days and some of these may have to self-isolate as a precaution. Then there are staff who have to self-isolate because a family member falls sick. Just in the past few days we have finalised the procedure for how we will respond when staff fall sick or suspect they may have been infected. If someone has been in contact with a person who goes on to develop the virus, then that staff member will self-isolate if they are not showing any symptoms. If they do have possible Covid symptoms they will be screened by one of two designated CR doctors who will decide whether they should be tested.

The government service is currently providing testing for free (it takes up to 48 hours to get a test, and another two days to get the result) and doing a good job, but if the system becomes inefficient we will pay for private testing. If a staff member needs hospital treatment then the government will provide this if they have tested positive. 

However, if there are delays in admission or the treatment they receive is inadequate, or the person has not had a positive test result but is sick with the virus, then we have agreed that if need be, we will fund their treatment privately using Dr. Jack's Benevolent Fund. Just getting a bed in a hospital if you have Covid is becoming increasingly difficult so CR's medical director
 Dr Ghosh and the team have drawn up a list of all their contacts in good hospitals (state and private) that we can call on for help if we have to get someone admitted quickly. 

When the first member of staff tested positive there was a lot of concern, panic even. But now we know we have to live with this for the foreseeable future. Suchandra, our school counsellor, has also been providing psychological support over the phone to members of the team who are finding it most difficult. Because we have dramatically reduced numbers attending the clinics, staff are only working for half the time.  It is too risky for them to travel in by bus or tram so we are ferrying them to work in CR vehicles. Those who live far away but whose skills are vital, are staying in our new school building, which is now a temporary staff guesthouse. 

MEDICAL
Prior to the easing of the lockdown here, we put a lot of effort into refining our procedures for how we were going to operate the clinics safely once they reopened. Three UK doctors provided invaluable advice on best practice and we ran a number of training sessions with staff so they fully understood what they needed to do to keep themselves and their patients safe. We physically reorganised the clinics into green and red zones and installed plexi-glass shields at key points to provide a physical barrier between patients and staff. To stay safe we needed to reduce the number of people attending the clinics by three quarters. 

We retrained all our doctors to do telephone consultations, with only those who had to collect medicine, food or be examined by a doctor being invited to attend. Admittedly, I was worried, but the doctors have adjusted very well to the new system. We also decided to stagger the reopening of the clinics so that we could focus on each in turn to ensure they were operating safely.

The good news is that all that preparation really paid off when the government finally lifted the lockdown. We started reopening the clinics in June, first Tala Park, then Chitpur and then Nimtala last month. Our TB clinic clinic never really stopped operating and our street medicine teams are delivering medicines to registered patients around the city.

Since the clinics reopened we have managed to re-establish contact with many of the patients who had lost contact with us during the lockdown. At Tala Park we have also restarted our programme giving catch-up vaccinations to children. Thanks to our new appointment-only system, and the fact that the trains aren’t running, we are seeing around 23 patients a day at our main clinic Tala Park instead of 80 - which is exactly what we wanted. Doctors have so far not had to carry out a single face-to-face examination inside the clinic. Patients remain outside and communication with their doctor is through a plexiglass screen.

This way of working is set to continue for as long as Covid remains a significant risk. And like health services around the world, once the crisis is over we are becoming excited about using the benefits of mobile technology to allow many patients to access our services remotely. So we are currently buying laptops so doctors can properly log consultations and access online medical information.  We have also identified a suitable patient management system and are going to work with a software developer to tailor it to CR’s needs. Thinking ahead, this may allow us eventually to provide healthcare to a lot more people, people not just in the slums where we now work, but right across the city and beyond…

One big area of concern at the moment is that we cannot take our mobile clinics out into the slums because the very high level of demand makes Covid-safe operations impossible. So it is certain that people who need help are falling through the cracks and we are not detecting them. So we are going to trial a new system in three slums (Garden Reach, Anandhapur and Kolkata Station) where we have identified women who we can train up to be local community healthcare workers and be our eyes and ears in the field.  We need a presence in these communities, and if the trial works we want to roll it out to many other slums. 

SCHOOLS
One of the most satisfying things in the past few difficult months has been the children’s exam results - which were the best we have ever achieved! Twenty nine children passed their Year 10 exams, and six passed their year 12 exams, with five of them achieving over 70%. It is doubly impressive under the current circumstances and I want to pay tribute to Ananya CR's head of schools and all her teachers who have shown such commitment to improving academic outcome over the past few years and to providing outstanding support for CR pupils from the start of the lockdown. Of the 29 who passed in Year 10, nine were borderline and we are working to get them on vocational training schemes as past experience shows they are unlikely to succeed if they continue further in school.

It now seems likely that schools across India will remain closed until December 31 - though nothing has yet been confirmed. 
Which means it is doubly important to provide access to smartphones for all CR students who currently don’t have this. Without this we fear that many will fall behind, lose motivation, and drop out of education altogether.

We have now finally purchased the first 20 smartphones, have organised data plans, have drawn up an agreement for parents to ensure the phones are properly accounted for, and yesterday we distributed the Tala Park School batch. Since the Covid crisis began there has been a shortage of smartphones for sale in Kolkata and regulations here mean people can only purchase 4 phones online a month. So a number of us are buying phones as fast as we can to give to the students - and thanks to the Kolkata Covid Challenge we now have all the money we need.

Up to now teachers have been working one-on-one with students via Whats App, audio or text. But with all students soon being able to access the internet Ananya is keen to move over to using virtual classrooms (rather like a Zoom meeting) so that they can once again benefit from student interaction - which is so important. 

Of course, we are continuing the regular supply of dry food rations, vitamins, masks, sanitisers and sanitary napkins to students and their families. Many families living in slums or on the streets simply cannot afford three meals a day anymore. Where previously vegetables, eggs and fish were common items - even among the poor, they now consume the very basics of just rice and potatoes. We are ensuring Calcutta Rescue students and their families do not fall prey to the consequences of poor nutrition.

We are still aiming to open our new school in 2021 and have appointed a licenced business surveyor to take forward the plans drawn up by the architect. He has great contacts and is currently working to get all the necessary government approvals. 

HANDICRAFTS
The project reopened last month and staff have been working on international orders placed before the Covid crisis began. Following this, they will look at producing masks for staff and patients when we run out of our current stock. Unfortunately there is no domestic market in Kolkata for the team to sell their products - with our customers saying they are unable to even shift old inventory. This indicates the turmoil many businesses in India are going through right now, as we enter the country's first recession since 1980. 

After reading this I hope you are reassured that, despite the huge challenges facing us currently, we are doing our very best to continue to care for our beneficiaries and keep staff safe. We are even beginning to think about how we might apply the lessons from this crisis to help more people more effectively in the future. 

None of this would be possible without your help and so I want to end by thanking you all again, on behalf of all of us in Kolkata, for your unwavering generosity since the crisis began. What you give is more than money. We know we are not alone facing this, that you care and that you will stand with us, shoulder to shoulder, until this crisis is past. 

And that is something that is beyond price. 

Jaydeep