Outside/In: When a Public Health System Collapses

I arrived in India on February 1, 2020 to begin the final steps of my daughter’s adoption proceedings. While COVID was not yet making front page headlines anywhere in the world, I was already seeing Hindi-language public health posters when I landed in Patna airport, the capital of Bihar. By early March, the country had mobilized quickly, with an austere lockdown that even the cultural festival of Holi did not manage to break. Embassies began closing and we packed our bags to leave.

We arrived in New York City, the heart of the pandemic. 

A year later, I, along with most of my friends and colleagues in the US, are fully vaccinated. I’m not just saddened by the numbers and images coming out of India – I’m angry. I had a lot of questions and brought together respected friends from the fields of journalism, sociology, economics, and data science to help us navigate our raw emotions together.

Across all sectors, there was consensus on three things:

Governance failures and social inequity were always there. Only now, they have taken the spotlight. 

There is a universal understanding that COVID has spotlighted existing class and social dynamics pervasive to wherever its hit. The situation in India is no different. Many middle and upper class households have been vaccinated, while the brunt of the crisis has been felt by people with little access to resources. Tech founder Vijay Sai Pratap commented, “a lot of the government social benefits and entitlements were promised, but most of [vulnerable groups, such as migrant workers] did not get access to them…and the pandemic was like a gust of wind that actually blew the blanket open” — exposing the existing systemic issues.

Lives vs livelihoods – economics rarely presents a simple answer.

“The initial lockdown destroyed livelihoods, but it saved lives,” mentioned Radhika Ralhan, Atlas Corps Fellow and sociologist. Speaking to us from one of New Delhi’s most prosperous neighborhoods, Radhika recounted the story of her relative’s recent experience “he was not able to get a hospital bed…and he lost his life. That is not because of COVID, it’s because of total healthcare failure.”

A lockdown must happen – but it’s not that simple an answer. While the initial lockdown caused the loss of livelihoods, it also reduced COVID fatalities. And with (at the time of writing) 22.9+ million cases and nearly 250K reported deaths already, this measure must be taken. But this poses a serious economic challenge. 

“Many countries have faced very difficult trade-offs between protecting lives and protecting the economy — with an emphasis on protecting lives at this stage — but it’s still hard to get this policy right because a lot of this depends on domestic and global inequality,” said Karna Basu, Associate Professor of Economics at Hunter College in New York. “There should be advanced announcements and cash or food transfers to migrant workers to offset the impact of sudden lockdowns during the pandemic.”

Open dialogue, criticism, and friendship will always hold a place in our national disasters. 

One thing I learned, was that the conversation, and specifically bringing the diaspora in touch with communities in India, helped the panelists, even those at the center of the chaos, feel less alone. 

“In a situation where the shared experience is mostly that of fear and distrust, we see so many situations when humanity comes together,” Divya Manocha, a Solutions Journalism Fellow highlighted. “Journalism can play a large role in directing attention to communities that need it, and to transform feelings of uncertainty and fear to hope and positivity.” Radhika pointed to the power of the people. “What keeps me moving also is the power of partnerships and the power of collaboration.” When governance fails, people step up.

It took just a few days to make this entire event happen. I asked Nada Zohdy, Director of Open Gov Hub, if we could host the fundraiser: I just couldn’t imagine us not doing anything. And Nada and our colleagues were happy to pitch in – although we hardly ever do paid events. The team rallied, the panelists were eager to join, and we raised close to $3,000 in a few days. 

With these funds, we are able to purchase 100 beds, 100 oxygen concentrators, 50 oximeters, and 50 PPE kits for the people in India — and give relief to migrant workers as well. The Open Gov Hub is covering the transaction fees so that all of the collected funds go towards the cause.

Beyond raising funds, this event gave people the chance to have their voices heard and to feel less alone. I’m thankful for our community. For me, perhaps the most important learning came from my colleague, Yeukai Mukorombindo, who shared, “the open government space talks a big game.” Many of us work on promoting transparency, accountability, open data, effective governance, all in an effort to avoid these types of government failures. In moments like this, what we do as a group of individuals coming together matters.

For more ways to help, see this crowdsourced list of other places to donate.