Booster dose

Equipment and awareness campaigns, hospital care and food packets, training and testing — the Tata Trusts have played a meaty part across the country in helping contain the coronavirus pandemic

Pitching in with support for a collective cause can seem straightforward, but not when crisis morphs into catastrophe almost overnight. That’s what the Tata Trusts discovered when they began framing a plan to help rein in the lethal coronavirus outbreak in India. Here was an extraordinary emergency, a tragedy getting worse by the hour and it demanded a response out of the ordinary.

‘One Against Covid’, the Trusts’ relief initiative, began in mid-March just as Covid-19’s nasty teeth started showing. Italy was already reeling from a high death count and New York was on the verge of locking down. India’s positive cases were still below a thousand, but the number was rising every week. It was clear to the Trusts that danger was around the corner for the country. It was also clear that backing governmental efforts, at the central and state levels, was the best way forward.

The biggest challenge was apparent immediately — the holes in India’s healthcare ecosystem: lack of hospital facilities, unprepared medical workers, shortage of equipment and drugs, and an overall structure of care that could not but be overwhelmed. Add to these a paucity of credible information on community hygiene and safety, and a populace whose behaviour veered towards the reckless. There was little doubt about the areas the Trusts would have to concentrate on.

On March 28th, a couple of days into an unprecedented India-wide lockdown, chairman Ratan Tata said the Trusts would commit to “protect and empower all affected communities” against a pandemic considered to be “one of the toughest challenges the human race will face”. That was the starting point for an unprecedented, pan-organisational endeavour by the Trusts to lend a hand in countering the coronavirus contagion.

The capital idea was to find ways to support India’s healthcare system. Aligned to this was the intent to coordinate and collaborate with other constituents of the Tata group in providing necessary relief. The critical task of putting people in place to make it all work came with hydra-headed complications, not least travel constraints and the forced model of employees having to work from home. One advantage the Trusts banked on was the talent, from across functions and geographies, they could plug into.

Teams tasked with specific responsibilities were formed, channels for communications were created and, most importantly, on-ground implementation methods were cemented. “We set up a call every day with team leaders and [chief executive Narasimhan] Srinath to understand what was unfolding and to find solutions,” says Arun Pandhi, director, programme implementation. “It was a cross-functional marvel,” adds Abhishek Poduri, south zone head for the Trusts.

The relief work took on an identity of its own as normal operations were superseded and a new focus found. Defined by the altered circumstances and the most pressing requirements, the Trusts have crafted a multifaceted method to make their contribution count in India’s fight against Covid-19.

Personal protective equipment (PPE)

The Trusts have sourced 3 million pieces of masks, gloves, face shields and coveralls for health and frontline workers across the country. This was not an easy assignment. In charge here was chief financial officer Ashish Deshpande, one of the few in the organisation with procurement and logistics experience. With PPE supplies running short globally, he and his team sought help to identify aggregators with the capability to supply in large quantities. “We are a development organisation; procurement on this scale was a novel experience for us,” says HSD Srinivas, head of the Trusts’ health vertical.

The team reached out to state governments, charitable hospitals, implementation partners, associate NGOs and others to get a sense of the need out there. “In the early days of the pandemic, PPEs were scarce and the Trusts and the Tata group were among the few asking states what they needed,” says Mr Deshpande. It added up to 400 tonnes of material that had to be imported from China, stored properly and then distributed across India.

Managing the PPE shipments was an adventure almost. International flights had stopped, state borders were closed, and road transport required official permits. Against all odds, the first lot of PPEs arrived mid-April in New Delhi on an Air India chartered flight, one of 15 organised by the Trusts. The headache of housing was eased after Voltas offered a 100,000-sq ft warehouse in Pune. Trent pitched in with staff and warehouse management software. DTDC was roped in as logistics partner.

Coordination was centred in Pune. “Our team there went the extra mile, arriving at the warehouse every day in spite of the lockdown, managing paperwork and quality inspections, and even helping with loading,” says Mr Deshpande. “This part of the project would not have been possible if it hadn’t been for them.”

Mr Poduri’s team set up a system to allocate material to 30 state health departments, several hospitals, municipal corporations, NGOs in relief activities and more. The material was being donated for free but, as Mr Poduri explains, there was a “mathematical rationale [for donating] based on population, number of positive cases, probable progression of the disease and specific requests from state governments”. Since April, more than 200 lots have been dispatched, not just to health workers but also essential personnel in the Mumbai Police, dairy farmers in Haryana and Punjab, and the Border Security Force in Jammu and Kashmir.

Hospital facilities

Aiding in closing the gap in hospital infrastructure has been a vital component of the Trusts’ work during the Covid-19 outbreak. The cancer care team was entrusted with this activity. “We opted for the brownfield route and reached out to state health departments to see if there were any buildings that could be developed into hospitals,” says Dr Atamjot Grewal, head of medical planning.

Four such buildings were selected in collaboration with the Maharashtra and Uttar Pradesh governments, and the Trusts pulled in hospital architects and planners to design the facilities. Tata Projects stepped up to convert the four shells into fully-equipped health facilities. In July, within three months of starting, Maharashtra had a 50-bed facility in Sangli and 104-bed facility in Buldana, both funded by the Trusts. Uttar Pradesh got a 168-bed hospital in Gautam Budh Nagar and a 124-bed facility in Gonda, funded by the Bill and Melinda Gates Foundation and set up by the Trusts.

“These are not just Covid-19 facilities; they are fully-functioning hospitals, with fever clinics, outpatient departments, labs, state-of-the art intensive-care units, dialysis machines and engineering support services,” says Rishav Kanodia, programme manager for cancer care.

Testing

As Covid-19 took hold across India, it became evident that checking its spread was being severely hampered by an acute scarcity of testing kits. Here the Trusts’ associate organisation, the India Health Fund (IHF) stepped in with support.

The Truenat Beta CoV test by Molbio Diagnostics enables testing and reporting in 90 minutes. In April, it received approval from Indian Council for Medical Research and was quickly put into field use in Andhra Pradesh and Goa. IHF is currently working with partners to use Truenat to supplement testing capacity in Mumbai’s hotspots.

IHF also supports another tool: q-Scout, a smartphone app developed by a company called Qure.ai, which uses AI-based algorithms to analyse chest x-rays for signs of lung damage. Already deployed in several countries, the app is being used in nine hospitals and a mobile van in Mumbai for ‘progression monitoring’ of patients with the virus.

Dry food rations being distributed in a village during the lockdown period

Up for the fight

T he Covid-19 relief spread organised by the Tata Trusts has gone beyond the immediate and the obvious to reach people and communities in different parts of India:

  • In Mumbai, the Mission Garima team donated sanitisers, gloves and PPEs to the caretakers who clean Dharavi’s community toilets, while also providing safety training to some 1,200 conservancy department officers.
  • In Hyderabad, the Trusts’ Elderly Spring senior citizen helpline had volunteers handling requests from the aged for cooked food, groceries and medicine.
  • In Jharkhand, the Trusts and the Tata Steel Foundation formed the ‘East Singhbhum district coordination group’ to align relief work with NGOs in the field. Since the beginning of April, the group has distributed food and dry rations to 13,919 families. It has also developed a framework for skill mapping of migrants returning to the district.
  • More than 230 artisans benefited from an online campaign by Antaran, a Tata Trusts initiative. The artisans learned to use smartphones and Google Translate to connect to customers, and earned 3.9 million in pre-paid orders, enabling them to stay afloat.
  • Nearly 1,200 employees in the Tata Trusts family contributed about 3 million to fund food and rations for hundreds of migrant families stranded in Madhya Pradesh and Rajasthan.
  • In Madhya Pradesh, the Trusts team supported the health department in fielding hundreds of calls on its helpline.
  • In Gorakhpur in Uttar Pradesh, the Trusts’ Prayaas team got self-help groups to make low-cost masks for local communities.

Training

The Trusts have been involved with capability building for health workers to help them manage the disease. The training partners were Christian Medical College, Vellore, and Care Institute of Health Sciences, Hyderabad, which have compiled 50-odd courses that cover the gamut of Covid-19 management, from registration of positive cases and triage to cadaver care and the use of life-support equipment. The courses have been rolled out at 200 hospitals in 19 states and have benefitted more than 1,100 participants (the objective here is to reach 12,000 healthcare workers).

Affirmation of the training’s impact is visible in the Covid-19 data for Nagpur in Maharashtra, where the Trusts partnered the Nagpur Municipal Corporation (NMC). “Our team established protocols and processes for testing, tracking and tracing of cases, starting from testing passengers at the international airport,” says Nagpur health team lead Tikesh Bisen.

Nagpur registered its first Covid-19 patient on March 11. Within two days, the city had set up a control room and a rapid response team. The Trusts team supported NMC with training of health professionals and officers, identification of isolation facilities and more. “Because of the proactivity of NMC, Nagpur has managed the virus far better than other cities,” says Mr Srinivas.

In Telangana, the Trusts joined hands with the state government to deliver several Covid-19 services. The Trusts’ telemedicine centre in Hyderabad functioned like a Covid-19 control room, with added services such as appointment management, helplines and dedicated resources for rural health centres. The centre also monitored the health of some 10,000 patients in home isolation.

Behaviour change

Community behaviour is a make-or-break factor in controlling disease transmission, which explains why the Trusts have gone the extra mile in spreading messages on health and safety practices. The ‘paanch kadam, corona-mukt jeevan’ (five steps for a corona-free life) campaign, kicked off in end March, stressed the need for face masks, frequent handwashing, social distancing, etc. To stem the wave of misinformation about the virus, the Trusts linked all messages to the website of the Indian government’s Ministry of Health and Family Welfare.

Speed and scale were the order of the day as some 320 video messages in 22 languages, including dialects such as Kumaoni, Ladakhi and Garhwali, were recorded within days. “Our team members pitched in by suggesting more languages and volunteering to record the messages,” says Deepshikha Surendran, head of brand and marketing communications at the Trusts. Short films, celebrity messages, audio files, animation, infographics and text messages were the formats employed.

The campaign was rolled out through what Divyang Waghela, head of the Tata Water Mission, calls a “horizontal and vertical strategy”. More than 400 master trainers helped carry the messages to about 8,000 community resource persons in villages, riding on the Trusts’ pan-India network of field teams and partner organisations.

“We also reached out to government officials and NGOs to share these messages in their networks,” says Mr Waghela. Additionally, the Trusts even roped in 70 regional and national celebrities to appeal for safe behaviour. The reach of the campaign has been tremendous, getting to more than 12 million people in 21 states. More recently, messages have been created on accessing rural jobs and government aid, handling reverse migration and managing farming activities safely.

Food packets being handed out to migrant families returning home

Data platforms

As the pandemic spread, other verticals of the Trusts stepped up to contribute. In April, the data-driven governance team (DDG) was asked by NITI Aayog, the Indian government think tank, to conduct a household survey in the country’s backward districts. Were people aware of Covid-19 symptoms? Did they know about handwashing and social distancing? How had incomes and jobs been affected?

“We surveyed 18,000 households in 885 gram panchayats (village councils) and found that the majority of people were aware of Covid-19 and the need for safe behaviour,” says Poornima Dore, who heads the DDG vertical. It was not all rosy: 44% had lost their income source and 27% their jobs. On the brighter side, 70% were aware of government relief packages.

The DDG team had another significant contribution to make. During the lockdown, essential service providers needed travel passes to move around. A Tata Trusts partner, the eGovernments Foundation, built a Covid-19 e-pass platform that has been used by Haryana, Punjab, Delhi, Telangana, Puducherry, Odisha and Karnataka to collectively generate more than 500,000 daily passes.

Food aid

As the lockdown extended into months, millions were unable to earn. That meant families going hungry, among the worst manifestations of the crisis. The Trusts-run ‘central kitchens’ project in Nashik and Palghar in Maharashtra — which in normal times cooks food for roughly 28,000 tribal children every day — stepped in with help, distributing food kits and served meals daily to 5,000-plus stranded migrants.

The Nashik kitchen found it had plenty of staples and groceries to spare. It took about 65 volunteers from Tata companies and a local NGO one week to repack 53 tonnes of groceries into 2,800 food kits for supply to the needy.

The Trusts’ nutrition team assisted the food effort by distributing packets of GoMo, developed by the Trusts in partnership with Mars Inc. GoMo is a lentils-based snack rich in iron, protein and micronutrients. “We felt that GoMo could meet the nutrition needs of communities that are most vulnerable,” says Mansharan Seth, part of The India Nutrition Initiative of the Trusts.

About 1.6 million GoMo packets were dispensed to about 730,000 people in Maharashtra, Uttar Pradesh, Delhi, Telangana, Gujarat, Andhra Pradesh and Rajasthan, among them street dwellers, shelter-home residents, families of migrant workers, conservancy workers, police personnel, daily wage workers, artisans, women in red-light areas and ragpickers.

A consignment of personal protective equipment gets unloaded in Mumbai