On March 25, India went into a nationwide lockdown that had been imposed with only four hours notice. The clampdown on travel resulted in millions of migrant workers being trapped in cities that, even at best of times, are hostile to their needs.
Faced with starvation and separation from families, lakhs of workers started walking or cycling hundreds of kilometres back home. Hundreds perished on the way – of exhaustion, run over by vehicles or after they were assaulted by the police. Many who made it home states faced police action and were stigmatised by local authorities and communities.
The restrictions on movement were justified on the grounds that this was necessary to limit the spread of the epidemic. We examine this assumption and, using a case study of Rajasthan and a Primary Health Centre area within it, argue that the reverse holds true: holding migrants back in cities was actually responsible for the spread of the coronavirus in rural areas.
The first phase of the movement of migrant workers, which started from the evening of March 24, lasted till the mid-April. During this time, lakhs of migrant workers travelled across the country – the visuals have been compared to those of Partition. After some time, police action and stricter lockdown enforcement restricted the migrants. By then, many city administrations, aided by non-governmental organisations, had put systems in place to provide them some food, preventing extreme starvation.
After extending the lockdown twice, the government of India on May 4 finally allowed inter-state movement. Special trains and buses started carrying thousands of migrant workers home, albeit not without further misery. While the movement back is still continuing, most of the workers returned home in the fortnight from May 4.
Two waves
This means that there were two periods during which an enormous exodus of migrants occurred from urban to rural areas. The first was in the initial days of the lockdown and lasted two weeks. The second started around May 4 and also lasted two weeks.
Colleagues at Aajeevika Bureau, which assists migrant workers, earlier estimated that about 5.7 million people from Rajasthan migrate seasonally to cities within the state and outside. About 40% of these – about two million people – migrate to cities outside Rajasthan. Their main destinations are Ahmedabad, Surat, the National Capital Region, Mumbai and Indore.
Though there are no official estimates of how many people returned to Rajasthan during the lockdown, newspaper reports suggest that by April 26, about 60,000 to 70,000 migrants had left Ahmedabad. It can be safely assumed that by the end of the first week of April, at least 100,000 migrants had returned to Rajasthan from Ahmedabad alone. Since other cities are further off, the numbers who returned during this period from three other major destination – Surat, Mumbai and Indore – could be half of this number. This means about 50,000 each or 150,000 lakh total. Adding an additional 50,000 for return from other cities – such as Delhi, Rajkot, Himmatnagar among them– we estimate about 300,000 migrants would have returned to Rajasthan during this period
For the second wave of return, again, there are no official estimates in the public domain. On May 15, official sources said that about 300,000 migrants had returned to Rajasthan since the interstate movement of migrants had been allowed. Assuming that another 50,000 to 100,000 people returned to Rajasthan over the next few days, the total numbers would be about 350,000 to 400,000, slightly higher than those who returned during the first wave.
Spread in the state
The occurrence of Covid-19 in the first and second waves allows us to understand how the epidemic would have behaved if all the migrants were allowed to come back home before the lockdown was imposed.
From the public sources, we plotted the numbers of cases of confirmed cases in Rajasthan, week by week from April 1, with the numbers of cases detected before that serving as the baseline. From the baseline of zero cases, over the next five weeks by April 7, the numbers of median Covid-19 cases increased only marginally to 1.5 cases per district. This was despite the fact that between March 24 and early April, about 300,000 migrants would have returned to the state.
When lockdown was relaxed and migrants were allowed to come back, about 300,000 migrants would have returned to Rajasthan between May 4 and May 15. They were screened at entry and quarantined for two weeks. During these two weeks, and over next two weeks, the epidemic spread in the state. The median numbers of cases per district increased from 1.5 to 30.
We manage a primary health centre in partnership with the state government in Dungarpur district of South Rajasthan. We had earlier reported that out of 1,129 migrants who returned to the primary health centre area in March and early April, about 13 were suspected and tested for Covid-19. None of them were found to be positive.
As per state protocol, we continued to monitor the returning migrant workers and tested them for Covid-19. We found that while the numbers tested positive remained zero till May 15, in the subsequent week, seven migrants were tested positive. Early detection and quarantine contained further spread. No more migrants returned to the primary health centre area in subsequent weeks.
The message is clear: most migrants who returned soon after lockdown had much lower risk of being infected and did not contribute to any significant spread subsequently. Held back in cities when the epidemic was raging there, the migrants picked up the infection. When they finally returned from May 4, the epidemic spread to the rural areas.
Allowing the migrants to return before the lockdown would have contained the epidemic in the cities, in addition to saving so much misery and violation of human rights that will continue to haunt all Indian citizens for decades to come.
Pavitra Mohan is co-founder of Basic Health Care Services, a not-for-profit that provides healthcare to rural, high migration communities in South Rajasthan. He also leads health services at Aajeevika Bureau. Arpita Amin is Executive Research at Basic Health Care Services.
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