Tag: slum residents and coronavirus

Children of M East, Mumbai’s Poorest Ward, Among the Worst Impacted by COVID Lockdown

From forcing expecting mothers to give birth at homes to the shuttering of immunisation services, the lockdown has had a wide-ranging impact on the residents of the city’s M East ward.

Mumbai: Thirty-one-year-old Usha Gautam went into labour almost a month before her scheduled due date. The government-run hospital she had enrolled herself in was over six kilometres away from her residence in the Mandala slums located in the city’s ‘M East’ municipal ward, called ‘M/E’ for short. It was March 27, only a few days into the nationwide lockdown that was imposed to contain the spread of the novel coronavirus. The state administration had forced the entire city into a “curfew-like” situation. With no public transport or ambulance service available in the neighbourhood, Usha’s family was forced to go looking for a Dai Ma, a local midwife, to help with the process of delivery.

Usha’s baby boy was born amid acute uncertainty. The infant weighed just over 2 kilos. He was frail, so was Usha. But Usha says she is grateful that they both survived. “My second child was born at home too. I had vowed after that delivery (of her second child) to never risk my or my child’s life by giving birth at home again. But here I was again, with my life in the hands of a midwife, just hoping to stay alive,” she says.

Usha Gautam with her newborn. Photo: Sukanya Shantha/The Wire

Dai Mas are an integral part of the slum ecosystem in the M East ward, located in the northern edge of the metropolis of Mumbai, where government facilities are scarce. Most lives here survive on the handouts offered by different non-governmental organisations (NGOs), which try to fill the gaps left by government apathy.

Non-institutional births, experts say, have been minimised in the past few years but the lockdown pushed many towards the dangerous, unattended birthing methods once again. “From 60% in 2010, the institutional birth had been increased to almost 99% in areas like Shivaji Nagar. But with the pandemic, all our efforts have gone down the drain,” Arun Kumar says.

Considered to be the poorest part of Mumbai, the M East ward is spread over a large expanse of Chembur East, Govandi, Deonar, Mankhurd, and Shivaji Nagar. It covers over 256 slums and as many as 13 resettlement colonies, and the 132-hectare Deonar dumping ground that processes 4,500 tonnes of garbage every day. Amid refineries, an atomic energy plant and several illegal chemical plants, most families here live in crammed one-room tenements that serve as a kitchen, living space and bedroom all rolled into one.

Also Read: Over Half of People in Mumbai’s Slums Probably Infected With Coronavirus: Survey

M East Ward: One of the poorest areas in Mumbai

The M East ward, one of the twenty-four administrative divisions of Mumbai and home to over 8,07,720 (Census 2011) residents, is also one of the poorest areas in the city. And in the past decade, experts say the population has doubled.

Government and NGO data shows that close to 78% of the ward’s population live in abject poverty, deprived of the most basic government facilities. From housing, water and electricity, every facility is questionable and citizens spend their life trying to prove they are “legal beings”.

Aisa Bano Khan, a woman in her mid-50s, is the go-to person for most expecting mothers. Khan, a class three dropout, has been delivering babies for the past three decades. She doesn’t have any formal training but relies on her experience.

The lockdown brought about an unprecedented crisis for expecting mothers, she says, one like never before. “I would receive one call every week, sometimes even two or three. Most of them could not travel to government hospitals. Their husbands and other earning members were rendered jobless. It was a desperate situation,” she says, adding that she must have delivered at least 30 children in just the Mandala slums since March.

Khan charges Rs 2,000 per delivery. This money, she says, is for the risk involved and the post-delivery cleaning she has does all by herself. “People trust me and my sole focus is to save the mother and her child,” she says.

Aisabano Khan has handled around 30 deliveries since the lockdown was imposed in March. Photo: Sukanya Shantha/The Wire

But when 21-year-old Hina Shaikh could not afford Khan’s fees, she agreed to accept some food that the family offered to pay in lieu of cash. “I did not want to add to her distress. The family paid a little in cash and gave me dry food packets that some NGO gave them. I agreed,” Khan says.

Tata Institute of Social Sciences’ field action project ‘Transforming M Ward’ points out that the human development index of the ward is the lowest in the city, with an infant mortality rate of around 66.47 per thousand live births, out-of-school children between the ages of 6 to 14 years is 1,490, more or less equally divided between boys and girls. More than 50% of children in the ward are malnourished according to HDR, 2009.

A midwife in every alley

Almost in every alleyway, there is a Hina or a Usha seeking help to deliver their babies. In a recent study conducted in close to 12 slums of the M East ward (of which Mandala is a part) by Apnalaya, a well-regarded NGO, it was found that out of the 534 deliveries, 32 were at home. Of them, seven were stillborn.

Hina Shaikh delivered her child at home. Her older son, three-and-half-year-old Ayan Shaikh, has been affected by Severe Acute Malnutrition (SAM) since his birth. Photo: Sukanya Shantha/The Wire

Midwives use their experience to handle the birthing process, but the overwhelming squalor and lack of appropriate surgical devices make it challenging.

The survey further states out of the 126 deliveries which took place in private hospitals, at least 81 women were those who were registered in a government hospital but had to be taken to a close by private hospitals due to the lockdown. Another 201 pregnant women (38% of the 534) had to move back to their village because they had no faith in the city health system.

“Lives here are difficult, more so for women. But the situation has got exacerbated further in the past five months,” Poornima Nair, director (health & disability) at Apnalaya, says.

Crisis of vaccination and nutrition

While new births have been one of the primary concerns in the region, Dr Vaishali Venu of Doctors for You (DFY), an NGO working in M East ward, points to the after-birth crisis as a bigger challenge. Venu says since the lockdown, the immunisation work carried out under the Integrated Child Development Services (ICDS) has virtually come to a halt.

Usha’s five-month-old baby has not yet been vaccinated, not even the first three vaccines—zero polio dose, perinatal Hepatitis B vaccines and BCG injections for tuberculosis—which are commonly administered soon after the child’s birth. Her three other children, all under five years of age have also missed their vaccines in the past months. Her husband, a daily wager, lost his painting job and the family has since been dependent on local NGOs for support. This also means that the nutritional requirements of Usha and her children have taken a backseat.

Health workers conducting immunization work in Mandala slums. Photo: Sukanya Shantha/The Wire

DFY, along with the local civic body, works actively in the M East ward and focusses on the immunisation work. Their data shows, the organisation was able to reach out to just 2,000 children in the past seven months. In 2019 and 2018, the coordinating figures were over 5,000. The earlier years’ figures, Venu says, is over and about the work carried out by the municipal corporation. But this year, since March, the civic body has entirely stopped its work.

Within days after the nationwide lockdown was imposed, the centre’s National Health Mission released an analysis of its first quarterly data. As per the NHM, nationwide, at least one lakh children did not receive their BCG vaccination for tuberculosis in March, and another two lakh children missed out on their immunity building ‘pentavalent and rotavirus’ that helps fight meningitis, pneumonia, Diptheria and tetanus, among other diseases impacting children.

There is a dire need to keep these vaccines within the reach of the population of M East, says Dr Arun Kumar, chief executive officer of Apnalaya. “The state administration has focussed on the ‘legality’ of where poor live as against their fundamental right to life. In this process, even the most basic citizenry rights are denied,” Arun Kumar points out.

Also Read: A Cruel Lockdown: Lessons From Relief Work in Mumbai

The region comprises of Bahujan population who have migrated from various parts of India; among Muslims too, Arun Kumar says, it is mostly the Pasmanda (low caste) Muslims who live here. The state government, terming the region “unauthorised” or “illegal” has shirked its responsibilities. “When you term them illegal, what you are actually doing is legalising their exclusion,” Arun Kumar says.

Nair says the problem in the area can’t be looked at as something that suddenly cropped up with the outbreak of COVID-19. “Children and their health concerns have remained a neglected issue forever. Like, for instance, the number of anganwadis is disproportionate to the number of children living here,” she points out.

A locality in Mandala slum. Photo: Sukanya Shantha/The Wire

Anganwadis shut

Anganwadi, a government-sponsored child and mother care centre, play a crucial role in areas where families aren’t able to provide essential care. Across the country, children between age 3-6 are provided with one hot cooked meal every day, and babies and toddlers are provided with “take-home rations”.

In the several slum clusters that this reporter visited, anganwadis were either shut; in some cases, they were never functional. Most children in the area accessed services made available by NGOs or survived on whatever their families could provide. Anganwadi workers are mostly from the community or nearby areas. The government, besides expecting them to take care of the child and mother development, also forces them to carry out several auxiliary works.

Sharifa, an anganwadi sevika in Rafi Nagar’s slums, says that her centre had to be shut down by the end of March. Instead of cooked meals, she and other angandwadi workers and helpers went door to door, handing over take-home rations. “Bread earners in most families had lost their jobs. The take-home ration for children became meals for most families,” she says.

According to the DFY’s data, in the few slum clusters that they are active, around 1,079 children were found to be malnourished in 2019. Among them, as many as 568 children fell in the severe acute malnutrition (SAM) category and the rest were affected by moderate acute malnutrition (MAM). The organisation fears that most children under MAM could have slipped into SAM in the past months.

Sakina Khan, a community worker associated with DFY, says that they have intensified their outreach program and have tried to cover as many children and lactating mothers as they can—providing them with ready-to-cook food mixes that are required to be fortified with specific micronutrients to tackle malnutrition. She says, “No amount of supplement would help if you are deprived of basic food, sanitation and healthcare.”

Health workers from ‘Doctors for You’ conducting screening near the Deonar dumping ground. Photo: Sukanya Shantha/The Wire

Failure of Centre’s decisions

Although senior civic health officials agree that Mumbai city, particularly the M East ward, was deeply impacted by the lockdown, they, however, attribute the failure to the Central government’s decisions. “March and April, we had to stall the work, since all our focus was to be shifted to COVID-19 related measures. Since public transport wasn’t available, our staff members could not report to work,” a senior health official on the condition of anonymity.

The official further added that since May onwards, they have shifted their focus back to the immunisation work and as compared to the past years, they have managed to cover more grounds this year. “As against 3500-3700 immunisation camps, just in June, we managed to set up over 4000 camps in the city. The M East ward has always remained a sensitive area and we are trying our best to rework plans to address the issue here,” the official added.

‘Stay Home’: Coronavirus Shows How the Government Has Failed Homeless Persons

In the days leading up to the nationwide lockdown, many reports of police attacking homeless people surfaced. With nowhere to go, this vulnerable section of the population cannot ‘stay home’.

Mumbai: In the past week, Prime Minister Narendra Modi, in every speech he made, stressed on the importance of staying home right now. Given the urgency to curtail the spread of coronavirus in the country, PM Modi said, “Ghar main rahiye, ghar main rahiye, ghar main rahiye (stay home, stay home, stay home).” A similar message was repeatedly broadcast by Maharashtra chief minister Uddhav Thackeray in his daily video bulletins. “Ghari raaha, surakshit raaha (stay home, stay safe)” was how he ended each of his speeches.

These sermons, however, had no meaning for the 20-odd Pardhi families that were brutally attacked and evicted from the footpath outside Bahar cinema in Ville Parle. During the early hours of March 21, when Dhansingh Kale and his family were sleeping, the police from the Ville Parel police station began beating up old and young alike. Even toddlers were roughed up, Kale says. This attack, he says, was unprovoked and the police wanted the streets to be “clean”.


The Pardhi community, a highly stigmatised and criminalised tribe in Maharashtra and other central Indian states, has always attracted the ire of the police. This Denotified Nomadic Tribe (DNT), some subcastes of which are classified under the Scheduled Tribes category in Maharashtra, live on the fringes, with very little state support.

Since the attack on March 21, the families have dispersed. While some have moved out of the city limits, others have gone to stay with their relatives. Similar cases of the police attacking homeless people have been reported in many states.

Kale, who knows very little about the novel coronavirus, says all he has heard is that mobility causes its spread. “It is the rich, mobile people who got this disease to the country and the government is keeping them in safe shelters to ensure they don’t spread the disease. But why doesn’t it think of us? Evicting us and forcing us to move right now could kill us,” an anguished Kale said over the phone. He and four members of his family are presently put up at a relative’s shanty in Nalasopara, situated in the northern end of Mumbai.

A family living on a footpath. Photo: YUVA

Just ahead of the shutdown, as many as 64,000 passengers, mainly Indians, had returned to the country. Their return increased the country’s vulnerability and to break the chain of a possible community transmission, the entire Maharashtra state first and subsequently the whole of India has been put under a strict lockdown.

This decision may be the only measure available at this hour, but it has a terrible impact on the country, its economy and most importantly, on its most vulnerable class.

Homelessness is symptomatic of every large city which witnesses both inter and intrastate migration. Many nomadic and denotified tribes, like Kale’s, continue to lead a nomadic life, traveling to different places in search of work and shelter. They have for years made footpaths and spaces under the flyovers their houses.

Also Read: How Distressed Rural Migrants Shelter in Cities

The 2011 Census data says there are 57,416 homeless people in Mumbai. This figure is an absolute underestimation, say most people working in the development sector, who argue that the actual figure is at least four times this figure. “Our estimate is at least, if not more, two lakh people live on the streets and footpaths and open spaces in the city. These people lack the most basic facilities and are dependent on daily labour work,” says Jagadish Patankar of the Centre for Promoting Democracy, an organisation that works closely with the urban poor.  

Over a decade ago, the Supreme Court in its judgment on the homeless persons in the country had directed each state to take their problems seriously and build one shelter home per one lakh population. The judgment observed:

“Article 21 of the Constitution states that no person should be deprived of his life or personal liberty except according to the procedure established by the law. Over the years, this Court’s jurisprudence has added significant meaning and depth to the right to life. A large number of judgments interpreting Article 21 of the Constitution have laid down right to shelter is included in right to life.”

If the civic authorities had honoured the Supreme Court’s judgment, Mumbai, with a population of over 1.84 crore, should have at least 184 shelter homes. But it only has 18 functioning ones, of which over 12 are exclusively run for minors. Another five, the state official claims, will soon be set up.

A homeless shelter in Mumbai. Photo: By arrangement

So, for families like Kale, when the state shirks its responsibilities off, the only option available is to survive on the roads.

For administrative purposes, the term “homeless” or houseless are defined as those who live in “the open or roadside, pavements, under fly-overs and staircases, or in the open in places of worship, mandaps, railway platforms etc.”

By this definition, only a minuscule 0.14% of the total population can be termed as “homeless”. Under this definition, the families living outside the Jogeshwari railway station are not homeless. These 250-odd families had lost their houses in a demolition drive that was conducted two years ago. Since then, they have lived in broken structures, trying to cover themselves with tarpaulin sheets every time the weather gets rough.

“These families are dependent on neighbouring bastis, and buildings for water. Since the state announced a complete lockdown, the families here are desperate for drinking water, leave alone to wash their hands and for other sanitary purposes,” shares Pooja Yadav, a project coordinator with Youth for Unity and Voluntary Action (YUVA). Yadav, who had been to the shanty last week, says the families there are on the brink of starvation without jobs, water and shelter.

“The police have been using force and raining lathis on those trying to fetch water. I met several women who expressed difficulty in accessing toilets. Many menstruating women did not find enough water to follow sanitary practices,” Yadav shared.

Also Read: India Needs a Human Rights Approach to Housing, Says UN Special Rapporteur

Sitaram Shelar, convenor of Pani Haq Samiti, a collective that has been addressing the issue of water in the state, estimates around 20 lakh people in the slums – both regularised and termed “illegal” – under the Mumbai Metropolitan Region are deprived of access to water. “The government gives multiple reasons for this. In some cases, the land they are living in is disputed and in some, the process of documentation delays the process. Either way, it is the poor who suffer.”

YUVA is a community organisation that has been working in some of the poorest wards of Mumbai’s civic bodies. In the past week, their volunteers have been traveling to bastis to identify the most vulnerable families and provide them with food grains that would last for at least a week.

A woman cooks on the footpath in Mumbai. Photo: YUVA

Building shelter homes is the responsibility of the individual municipal corporations and councils, which receive funds from the Deendayal Antyodaya Yojana – National Urban Livelihoods Mission (DAY-NULM).

Ravi Jadhav, the state shelter manager, appointed under the DAY- NULM, agrees that a lot needs to be done in the state. “There are around 76 shelter homes in the state. Efforts are constantly being made to increase the capacity of the existing ones and also have new spaces and organisation identified to run the shelter,” he told The Wire. Jadhav also said that the state is yet to direct them to take any new measures to arrange protective living conditions for those on the road. “There has been no communication about the coronavirus so far,” he said.

In reality, however, Maharashtra, like any other state, has only managed to tie up with different NGOs involved in helping the urban poor. Most of the 76 shelter homes are temporary ones that are available only for night shelter. These spaces are not adequate in terms of sanitation and space. The tie-ups with the NGO were not done in accordance with the demand on the ground, but arbitrarily on the basis of the willingness of the organisations to tie up.

“Maharashtra has been violating the Supreme Court order for over a decade now. Forget the underplayed figure of population explosion in the state, the government here is not even able to provide for those it enumerated in the 2011 census,” Patankar points out.

YUVA distributing relief kits. Photo: YUVA

Amrutlal Betwala, a community worker, said the situation on the ground is alarming and he fears deaths due to starvation. “Forget the coronavirus, some families will certainly die of hunger,” he said.

YUVA’s relief kit contains pulses, rice, wheat flour, oil and salt. “This is the bare minimum, but it will at least ensure they survive,” shared Amit Gawli, another volunteer. In one week of survey work, Gawli had managed to reach out to several aged and disabled persons in Malwani slums.

He said the slums lack water facilities and feared the lockdown could have a catastrophic impact on the lives of thousands living in precarious conditions.

Even before the state government had announced a lockdown, Anganwadi workers in Mumbai had to stop working. This meant that children in most slums of Mumbai were not getting their daily food and, putting additional strain on the adults of the families. One Anganwadi worker who works in Mandala, a north-eastern slum settlement of Mumbai, told The Wire that she has been reaching out to NGOs to step in until the state makes some provisions available.

“There are at least 20-25 kids in my locality who will starve if food is not made available to them immediately. I raised some funds locally and arranged for glucose biscuits and rice puffs. But this won’t suffice,” she said.

Most parents have been lining up at her residence, asking for help, she says. “My heart breaks to see them in such a desperate condition.”

In 2014, PM Modi had promised houses for all homeless people by 2022. He said over four lakh houses, and not just shelter homes, were to be built by 2022. This promise, six years on, feels like rhetoric.

But in the extraordinary times that we are living in right now, if the coronavirus infection enters the community transmission level, its effects, especially on the homeless citizens, would prove deadly. It remains to be seen whether the government, at least to contain the virus, will ensure the right to life with dignity of homeless persons and provide them with shelter and hygiene.