Priority zero group

When the countrywide lockdown was imposed in March 2020 everyone was locked up at home obeying the governmentrsquos orders Everyone but us Before the pandemic I used to do odd jobs and even worked as a househelp near Swami Narayan Police Chowky in Dadar When I lost my job I had no option but to beg I lost my husband in 2011 and my only son who is 35 is handicappedrdquoFor Geeta Shyamsundar Singh 56 stay home stay safe means little She has been living on the footpath under the Tilak Bridge flyover at Dadar for four decades Although she grumbles about uncontrolled blood pressure and a nagging kidney ailment she says with confidence ldquoI have not contracted COVIDrdquoSheela PawarLast week a petition filed by lawyer Kush Kalra through advocate Mohit Paul was heard by the Supreme Court The first prayer in the petition asked for restraining beggars vagabonds and homeless people from asking for money at traffic junctions markets and public places in all states and Union territories across India to avoid the spread of COVID19 The apex court refused to ldquoentertainrdquo it The bench of justices Dhananjaya Y Chandrachud and MR Shah noted ldquoWhy do people beg Because they have no choice They are deprived of sufficient means of livelihood Nobody wants to beg otherwise If we issue a notice on this petition in the way it has been drafted people will think the Supreme Court of India wants beggars removed from their eyes The Supreme Court would never take an elitist viewrdquo Calling it a socioeconomic problem the bench added that the Centre and states ldquomust address it as a wider issue of social welfare policyrdquoManish Jha professor at the School of Social Work at Tata Institute of Social Sciences Mumbai hails the Supreme Courtrsquos decision ldquoIt was a preposterous petition The bench has now agreed to issue notices to both Centre and the Delhi government seeking their response on how to deal with this sensitive situation and prepare a plan to vaccinate beggars vagabonds and homeless people and provide them with basic amenities during the pandemic Until now inoculating this community was not on anybodyrsquos agendardquoBarbara Dipietro and Bobby WattsSocial distancing among the homeless is close to impossible in dormstyle shelters as well as on streets A single case in this community can spark an outbreak with devastating results According to a study led by the MSF Meacutedecins sans frontiegraveresmdashrendered in English as Doctors Without Borders almost half of the homeless people in emergency accommodation had been infected by the virus by July 2020 in the greater Paris regionAccording to FEANTSA the European Federation of National Organisations working with this community people experiencing homelessness tend to be in worse health than others the same age ldquoIn France according to estimates from the Abbeacute Pierre Foundation 106 million people are deprived of their own home In Poland 80 per cent of the 30330 people counted on a given night in 2019 were living in temporary or emergency accommodation with 6007 people still sleeping rough In Sweden 18 per cent of the 33269 homeless people counted were experiencing a severe form of homelessness of whom 647 were sleeping rough In Portugal of the 6044 homeless people counted in December 2018 40 per cent 2428 people were without sheltermdasheither sleeping rough or in night sheltersrdquo reveals data recorded in a FEANTSA study titled Sixth Overview of Housing Exclusion in Europe 2021Sheela Pawar 60 lives on a footpath outside JJ Hospital She does not want to take a vaccine ldquoI have no fever or coughrdquo she reasons PicsAshish RajeThe situation is equally if not more alarming in India According to the 2011 census there are 177 million homeless people in India which is 015 per cent of the countryrsquos total population And yet we havenrsquot heard from the central or the state governments about a plan to protect or vaccinate this community Brijesh Arya convenor of Homeless Collective a forum of concerned individuals NGOs and advocates to guide the homeless says ldquoMaharashtra has 210908 homeless personsand Mumbai has 57416 Despite being Indiarsquos most populous city the BMC has not prioritised vaccination of Mumbairsquos homeless population With the ongoing destruction caused on the streets due to incessant rains and the fear of an impending third COVID wave we want the government to take up their inoculation on priorityrdquoArya works with 10000 homeless people in Mumbai of which he is directly in touch with 5000 ldquoWe have been monitoring their health since the start of the pandemic There were people in the administration claiming that beggars might prove to be big transmitters of the Coronavirus infection However our work so far has proven that none of the homeless people we are in touch with have been infected by the virus even once It is quite incredible given the uninhabitable conditions they are in Having said that this shouldnrsquot be the reason to ignore this population They need to be vaccinated to prevent community transmissionrdquo Arya warnsManish Jha and Brijesh AryaIn France people in precarious situations are in the fourth or fifth phases of the national vaccine rollout plan Meanwhile Hungary included homeless people in the second priority group after health workers Thankfully the Navi Mumbai Municipal Corporation NMMC has shown the lead and began vaccinating beggars and homeless persons in the township last month Since homeless people do not possess identity proof they were being registered on the government portal for vaccination using their biometric data ldquoBut itrsquos not enoughrdquo adds Arya saying ldquoMany civic bodies in Maharashtra have held such vaccination camps for beggars including in Dhule Amrawati Jalgaon Udgir and even Nagpur However BMC is yet to join the bandwagon So far SOPs have come in for shelters where some homeless people stay But not a word is being said about inoculating those living on the streets of Mumbai This is a big failurerdquoDeepali Vandana of Urja Trust agrees Started in 2011 with its first centre in Dadar Vandana works to rehabilitate young women who find themselves homeless ldquoThe problem with our country is that we havenrsquot done a census recently on our homeless If we havenrsquot counted them how will we roll out vaccines for them The last census was done in 2011 As of now we are trying to connect with the healthcare system But every time we do we are told about a vaccine shortage in the city Since most of them do not have documents like Aadhaar card for registration we write letters to government hospitals like KEM to include them on their vaccine list As an NGO we are playing the role of mediator But what about those who have nobody to fight for themrdquo Vandana wondersIn a column published in BMJ Opinion part of a weekly peerreviewed medical trade journal authors Margot Kushel Barbara DiPietro and Bobby Watts have highlighted a tailored approach to bring COVID19 vaccines to high risk populations like homeless persons DiPietro who directs policy and advocacy for the National Health Care for the Homeless Council shares the suggestions made to the US governmentldquoThe US did a complex set of priority categories for when different populations could get the vaccine Unfortunately this was a statebystate processmdashwe have 50 states so there were 50 state plans Additionally the distribution was often different between communities in the same state So it was very complex Some states recognised the vulnerability of people who are homeless and included them in Priority 2 after healthcare workers so they could be grouped with other populations that live in congregate settings like nursing homes Other states put homeless populations in lower categories and then others didnrsquot mention them at allRegrettably some states initially prioritised homeless populations but then there was a public backlash and the political leaders removed them from the priority listrdquo DiPietro informsWatts who is the CEO of National Health Care for the Homeless Council says ldquoMost people experiencing homelessness PEH are not able to practice basic measures to reduce the risk of being infectedmdashsocial distancing and handwashing If you are staying in a shelter you have little power to maintain social distancingmdashit is up to the shelter to make that possible and there is great variation among the practices of shelters If you are unsheltered and living on the streets or an encampment you have little access to running water The Centre for Disease Control CDC emphasises the importance of washing onersquos hands with running water for 20 seconds frequently to keep oneself safe And these same measures help keep those in your community safe So if you are unable to practice them because of the conditions associated with experiencing homelessness you arenrsquot safe and you are more likely to transmit contagious illnesses to those near yourdquoDiPietro agrees that there is ample evidence that shows how vulnerable the homeless people are to contracting the virus ldquoI believe Indiamdashand all governmentsmdashshould be prioritising people who are homeless for the vaccine But this is bigger than COVID19 The reason this population is at such high risk for COVID19 is because they donrsquot have stable housing Providing stable housing is really the answermdashbeyond simply giving a vaccine There is nothing good that comes from homelessness Every community should be acknowledging the violation of human rights this represents and taking concrete steps to provide housing so they are able to live healthy productive dignified livesrdquoLack of awareness little or no access to smartphones to register for vaccines and vaccine hesitancy have come in the way of efforts made by various nonprofits to get the homeless people inoculated against COVID19Sheela Pawar 60 lives on a footpath outside JJ Hospital in South Mumbai As far as she can remember this place has been her home since she was 10 ldquoI have children but they are married and live with their families I live hererdquo Pawar tells us We ask her if she is aware of the safety measures ldquoWhen the lockdown began last year some civic authorities came by and asked us to wear masks and use sanitizers But we knew nothing about the vaccine until recently when members of Homeless Collective told us to get the shot But if I donrsquot have fever or cough why should I fall into this trap I donrsquot want the vaccinerdquoSingh shows similar hesitancy towards the vaccine ldquoI have heard that after taking the dose a person can fall sick and get fever I cannot afford that Who will cook for usrdquo Singh protestsArya says that a lot of men in the homeless community believe the vaccine has side effects ldquoThey think the dose will make them infertile Some fear the rich get a better quality vaccine and the poor get a diluted dose We have been trying to raise awareness but it is the governing authorities that must communicate with this populationrdquo Arya explainsJha suggests that the BMC connect with NGOs and other community groups that work with the homeless so that their identification can be fasttracked ldquoSpecific locations can be earmarked with the help of organisations and a dedicated camp organised for their vaccination In the absence of adequate knowledge information technical knowhow along with lack of resources and vaccine hesitancy they need to be engaged by the BMC via community groups who can spread awareness and convince them to take the vaccinerdquo Jha adds He challenges the 57000 figure arguing that their experience and on field work suggests the number is far higher in Mumbai ldquoWith the recent fury of the monsoon the worries of the homeless have increased manifold during the pandemic With strict lockdowns and prolonged restriction most of them have lost odd jobs and other means of livelihood living in penury It is the statersquos responsibility to put a system in place to vaccinate themrdquo177 MNumber of homeless people in India which amounts to 015 per cent of the countryrsquos population according to the 2011 census