Coronavirus outbreak: Is the state caring enough for slums?

Health experts warn spread of COVID-19 in pockets of Dharavi, Govandi, Mankhurd and Sahar will increase in coming days; tell officials to install sterile mobile toilets

Health experts have cautioned the civic administration that Coronavirus will spread further in slums with time and that it needs to take proactive measures instead of merely spraying disinfectant on the roads. Experts have suggested that sterile mobile toilets be placed in slums.

Many pockets in Dharavi, Sahar village, Govandi, Mankhurd have Coronavirus cases, with some of these also being Red Zones. Residentials have no option but to use public toilets which eliminate the scope of social distancing. Dharavi witnessed 12 new cases on Tuesday and the death of a 62-year-old was reported from Mukund Nagar area.

A public toilet being disinfected in Sahar Village

Nageshwar Yadav, a taxi driver residing near 90 Feet Road, Dharavi, said, "We have two civic toilets and two others run by the ONGC. We prefer the latter as it is cleaner. Around 500 people use the two toilets on any given day at a charge of R2. We usually visit at 5 am as that is when it is cleaned."

Dr Om Shrivastava, an infectious disease expert, said, "The unfortunate fact is that we do not have enough public hygiene. It is public responsibility in such pockets to ensure that every time a common toilet is used, it is properly disinfected before the next use."

Coronavirus testing positivity rates. Source: Journal of American Medical Association

Dr Wiqar Shaikh, well-known allergy and asthma specialist, said, "Hygiene is not maintained in slums where social distancing is practically impossible. Chances of an asymptomatic person transmitting Coronavirus to others is higher in public toilets."

"The nasal and respiratory fluid (sneezing and coughing) from an affected person, even if he is asymptomatic, in and around the public toilet, when inhaled by a healthy person, could cause the virus to enter his system," Dr Shaikh explained.

The only solution, according to Dr Shaikh, is that the civic body and residents insist on sterile mobile toilets which have disposable septic tanks. Also, every user has to disinfect and clean the toilet for the next person. "If we have multiple mobile sterile toilets in areas such as Dharavi, the spread of the disease will be contained and curtailed," said Dr Shaikh.

Also, the civic body can provide liquid hand sanitisers and disinfectants to clean the floors and walls of mobile toilets.

Dr Ketan Vagholkar, professor of surgery, D Y Patil Medical College, said, "Apart from wearing masks and social distancing, periodic internal sanitisation of public toilets is essential. People must wear a mask while visiting these toilets. There is a high likelihood of droplet precipitation while using the toilet. This applies to public bathrooms too.

"While there is overwhelming literature (Journal of American Medical Association, see box) on the spread and pathogenesis of COVID-19, there is no authentic evidence to support therapeutic strategy for treatment. Hence, meticulous, strict and rigid preventive measures are the only means of prevention."

"In slums, it is important to wear face masks throughout the day, including while being inside shanties. This will lessen the chances of the disease spreading," Dr Vakgholkar added.

Scores quarantined in Sahar village

Former corporator Nicholas Almeida said the administration has locked down few localities in Sahar village for three days as 10 people tested positive for COVID-19 and two infected women died at Cooper hospital. "Hundreds have been home-quarantined after they came in contact with a body. Others were in touch with the deceased before and during the cremation," Almeida said. "We took many preventive measures but our efforts were in vain. We are sending advisories to locals on the usage of public toilets. A good Samaritan from our area, Suresh Kamble, donated a few disinfectant spraying machines. We are using those to sanitise common public toilets," Almeida said.

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