The Maternal and Child Health Center: COVID Response and Relief Activities

The Johns Hopkins Maternal and Child Health Center in India (MCHI) has a mission to accelerate public health capacity in maternal and child health, and reduce gaps in knowledge translation through capacity strengthening that will ultimately reduce mortality and morbidity and improve the lives of mothers and children in India. The COVID-19 pandemic has had devastating consequences on families and societies in India.

The MCHI works alongside the Johns Hopkins India Institute, who formed a  COVID-19 Task Force to raise awareness, respond to current needs, and coordinate activities, services, and opportunities to address the COVID-19 pandemic in India. Below are illustrative activities of COVID Response and Relief, supported by funds generated from the Johns Hopkins India Institute.

The MCHI thanks all the generous supporters who donated to the Johns Hopkins India Institute’s COVID-19 Relief and Response activities. A special thanks to the video’s creator, Rishi Shet, who is cherished by those who knew and loved him. Rishi’s family has launched the Rishi Children’s Fund to support vulnerable children in leading healthy enriched lives and positively impact their communities to create lasting change. Please consider donating to the Rishi Children’s Fund today.


India’s Second Coronavirus Wave: An Urgent Summons To Protect Women And Children

A Director’s Message (June 2021)

Dr. Anita Shet

By Anita Shet, Director of Johns Hopkins Maternal and Child Health Center, India

The second pandemic wave caught India unawares. The COVID-19 pandemic was in full force this time, sparing no one. Every family I know, including mine, has suffered death, severe illness, and despair in not getting basic health care. And this time, its ferocity swept ever more children into the depths of tragedy. Deaths were unprecedented between April and May, with India contributing over 30% of COVID-19-related deaths globally. With a greater proportion of deaths seen in the 30-40 year age group compared to patterns seen last year, a heartbreaking set of new orphans are being formed every day. Children are facing mental health issues and are at greater risk of domestic violence, as lockdowns shut them off from their vital support networks.

Over 290 million children in the country are out of school because their schools are closed. Children of poor families are now engaged in child labor and it is not clear how many will return to schools when they do open. Malnutrition among children is very high; over a third of India’s children are stunted (35% in 2019) and almost a quarter are wasted, according to pre-pandemic times, but this problem is only worsening. With schools closed, the single mid-day meal that many children rely on, is available no longer. Routine immunization has almost come to a standstill in some places, and an estimated 5-10 million children may have missed out on general vaccines in India.

With the help of partners in different districts and states in India, our MCHI team is working to ensure supplies of essential medicines, oxygen, and vaccines reach health workers and community workers, provide nutritional support and PPEs to migrants and families in need, and provide support to community health workers to keep open primary care services such as routine immunizations, antenatal care and acute care services. These actions may be mere drops, but every drop makes the ocean. The call to arms is urgent. The fight against the coronavirus will not be a quick one. On a global scale, we need countries to come together and help each other. Whether we are next door neighbors or living halfway across the world, we will be safe only when we all are protected—together.

Community Relief and Mobile Medical Outreach

Photo: Mewat Mobile Health Van: Dr. Rajeev and another doctor are providing care to a child in Mewat being held by their mother.

BUDS supports communities living in densely populated slum colonies. These communities in Delhi have experienced food shortage and income loss as factories were closed, and small businesses were unable to work out of the streets. These populations are predominately migrant workers, marginalized and displaced individuals, and orphaned and vulnerable children. Across 39 villages in Mewat, BUDS supports predominately rural populations who have had limited work opportunities and reduced access to food during the second surge of the COVID-19 pandemic.

Activities include: (1) community health education; (2) distribution of food supplements; (3) primary health service outreach; and, (4) continuum of care through telemedicine.

Vignette: Neeta and Her Baby Get Life-Saving Care

Neeta, a 25-year-old woman who lives in a slum in Sarai Kale Khan (Delhi) with her husband, was pregnant and due for delivery in April 2021. The second wave of COVID-19 took everyone by surprise and the government announced a strict lockdown around her due date. Around the 20th of April, Neeta started experiencing labor pains. She went to a government hospital, but due to the alarming number of COVID cases, she was sent back home. Neeta’s husband took her to a private hospital, despite being a daily wage laborer and having limited funds. The family had no funds for the post-operative care and the medicines for the new mother and child. When BUDS was apprised of Neeta’s condition, the BUDS staff immediately arranged for medicines and some medical care for the newborn baby and Neeta. In doing so they alleviated stress that the family faced about accessing necessary medical care.

COVID Assistance Centers and Nutritional Support

Photo: Raising awareness through mobile CSK in a brick kiln in a village in West Bengal

CINI is working on diverse aspects of providing relief to families hit by COVID-19. MCHI is assisting with planning, implementing, and monitoring these activities, particularly on COVID Sahayata Kendras (CSKs) in under-served areas and routine immunization services for pregnant women and children.

These centers are managed by volunteers who guide the population in the catchment area on COVID appropriate protocols, including the appropriate use of masks, hand-washing, physical distancing, vaccine uptake, and spread awareness about emergency services, including hospitals, drug-stores, medical oxygen, community kitchens, laboratories for testing, government helplines, ambulances and vaccine centers. Health and wellness kits that include nutritional supplements, masks, soaps and personal hygiene products are also distributed to beneficiaries at these CSKs. The outreach of the CSK is enhanced with a mobile Information Education Communication (IEC) campaign program, where a 3-wheeler ‘autorickshaw/toto’ branded with COVID related IECs, government helpline numbers, leaflets and a loud-speaker, reaches out to vulnerable population residing in remote villages, urban slums, and homeless population in the catchment areas. During the second wave of COVID-19 in India, these CSKs have evolved into as a one-stop place for under-served and vulnerable populations to seek information about COVID-19 and extend referral services in districts of West Bengal and Jharkhand.

Vignette: Sashwat Receives the Help He Needs

Sashwat (name changed), who worked as a daily wage laborer at Falta Special Economic Zone resided with his wife and a five-month-old son. At the height of the second wave in India, he started feeling unwell and bought medicines from a local medical store, but there was no improvement in his health even after a few days. During this time, he learnt about COVID-19 symptoms, dos and don’ts, and more information about vaccine from CINI’s mobile CSK (Toto campaign), which led him to visit the CSK at the Sarisha village in the South 24 Parganas district in West Bengal, where CSK staff facilitated a Rapid Antigen test that confirmed his COVID-19 diagnosis. They asked Sashwat to isolate himself, provided medicines along with supplements like vitamin C and D, and provided counselling related to health and nutrition to aid his recovery process. Sashwat further reached out to the CSK staff asking for help since his family started facing social stigma. His neighbors were raising objections in his family fetching water from the same tube well and washing clothes in the same area. The CSK staff provided him continuous mental support and counselling through telephone. After a few days, Sashwat tested negative against COVID-19 and was very grateful to the CSK staff for providing all the support.

Strengthening Routine Childhood Immunization During the Pandemic

Map of West Bengal showing the districts where this work will be carried out (proposed districts depicted in yellow)

CINI is working closely with local authorities to support routine immunization services to provide routine vaccines to those eligible children and pregnant women within the proposed districts in West Bengal, to provide catch-up vaccines to those who were missed because of pandemic-related disruptions, and support community healthcare workers involved in maternal and childcare services.

Activities include: (1) support routine immunization services; (2) conduct community mobilization and prepare due-lists for children who need vaccinations; (3) and, support the conduct of the Village Health and Nutrition Days (VHNDs).

Providing Oxygen, Emergency Care and Referrals

Photo credit: Amarnath Dutta
An all-women’s team provides oxygen concentrators to ailing COVID-19 patients through the Oxygen on Wheels initiative.

The Liver Foundation supports the Oxygen on Wheels program, which organizes a 100-strong fleet of oxygen concentrator equipped ambulances (donated by the state government), and will circulate throughout the catchment areas of Kolkata/Howrah and neighboring areas. This project brings ‘mobile’ oxygen support to the doorstep of those in need, until more stable options such as oxygen tanks can be arranged. This project will be linked to helpline numbers run by the COVID Care Network, which will triage calls and redirect the ambulances towards patients most in need, especially women who are less likely to seek care. MCHI is assisting in coordinating supply of oxygen concentrators, documenting the implementation of these plans, and assessing the impact of these relief activities.