India Epicenter | Brunswick
Perspectives

India Epicenter

One state’s readiness could serve as a model for the nation and the world. “Coronavirus Slayer” K.K. Shailaja, Kerala’s Health Minister, talks to Brunswick’s Khozem Merchant.

The Indian Nobel Laureate Abhijit Banerjee has said India must be “fast not clever” in defeating COVID-19. In Kerala, the state first hit by the virus, they seem to have been both, earning the tribute: “Kerala leads, India follows.” The sprinters and strategists in Kerala’s coronavirus team line up behind K.K. Shailaja, a former junior school science teacher, women’s activist and now health minister in the communist-ruled territory in southwest India.

Ms. Shailaja is a textbook Kerala public servant. Her role as teacher is so highly respected that it is added to her name: K.K. Shailaja Teacher. From her teenage years, she was also a functionary of the Communist Party of India (Marxist). The CPI (M) ushered her into the local assembly two decades ago but the dual life of teaching physics and chemistry to teenagers and the Kerala assembly was crushing.

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A former science teacher, K.K. Shailaja is Health Minister and a leading figure in the country’s fight against the virus. She is one of two women serving in the government of the Indian state of Kerala. 

“This is about serving society,” she says of her two careers. “In science, I would encourage my students to look beyond their textbooks and understand the role of science in society. Politics I love because it allows me similar interaction with people, in healthcare and social justice and women’s development.”

But finally, she had to choose. “I would be in school and after 4 p.m. each day I would go to political meetings. I could not do both and be truthful to either occupation. So, I became one for politics.”

Brunswick Review spoke with Ms. Shailaja as Kerala, for the third year in a row, was handling a health disaster. In 2018, the state had seen an outbreak of the Nipah virus, which lasted just over a month and claimed 17 lives. A year later, major floods killed over 100 people and thousands were evacuated.

Soon after the COVID-19 outbreak began, Ms. Shailaja saw herself dubbed “Coronavirus Slayer” by news outlets. Since then, she and her chief minister, veteran CPI (M) leader Pinarayi Vijayan, have commanded a national audience. Kerala’s road-tested disaster protocols serve as important models for the crisis now being faced by the rest of the country.

Kerala’s Early Action

On a day toward the end of January, Ms. Shailaja saw an online item about a virus in Wuhan.

“I worried that this virus would come to Kerala because many of our students take courses in Wuhan. So, we started our precautions. From January 24 onwards, we set up a state control room [the war room]. Many special groups were created to address the potential pandemic. We knew what to do because we had been there before—with Nipah. We knew the protocols, we understood the chain of activity.

“That first student tested positive; he came into our custody, was quarantined, treated and recovered. It was a victory for Kerala.”

Attention quickly shifted from returnees from Wuhan to migrants from the Gulf, where millions of Keralites work and send money back home, providing an economic lifeline for the region. Kerala’s first-mover status was watched across India. In March, the country’s best-known broadcaster noted that Kerala’s actions were consistently ahead of those by Prime Minister Narendra Modi, including initiatives on fiscal support, free rice, lockdown and community kitchens. In early April, Kerala’s curve began to flatten, while elsewhere in India it was rising. Active cases fell in the first week of April, down 30 percent from the previous week. The rate of recovery in Kasaragod district, home to half of all reported cases in Kerala, was three times faster than the national average.

Kerala’s prospective lockdown exit was unveiled in mid-April, also a first for the country. That now permits a managed resumption of activity, such as small homestead farming, crafts, retail.

India’s Crisis

At that point, the rest of India was seeing the outbreak continue to spread and cases rise, causing Prime Minister Modi to announce an extension of a national lockdown by a further two weeks.

India’s positive cases and fatalities have so far been modest compared to big-population countries such as China and the US. However, India’s chronic lack of testing equipment means the spread is probably understated. A country of 1.38 billion people, two-thirds living in rural areas (in some 638,000 villages), the rest in densely populated cities and towns, India is exceptionally vulnerable to a virus whose identity is invisible and velocity a mystery.

In announcing the lockdown extension, the Prime Minister noted that he was juggling between lives and livelihoods, but so far livelihoods have been the greater casualty. On TV, viewers regularly see migrant workers with no money, having lost jobs at building sites, factories, shops, restaurants and other hourly employment, walking from Delhi to their villages in the hinterland. They have become the human face of a crisis that is bigger, more uncertain and more unusual than any economic shock before.

First, the scope of COVID-19 is bigger than the 2008 financial crash because it creates multiple big shocks in multiple geographies.

Second, uncertainty—always the enemy of economic stability—surrounds the spread of the virus. It also surrounds the public’s continued tolerance of invasive restrictions on behavior—social distancing works in urban middle classes but is probably unenforceable in rural India.

Every system has its own method and ours here in Kerala works with the participation of the whole society.

And finally, this crisis is unusual because its economic impact is elastic, impacting everything from manufacturing to services and in between. A big part of that “in between” is India’s informal economy, its supply chain and heartbeat representing four-fifths of the workforce—at least 350 million people.

India’s public healthcare system is under-funded and unprepared for the challenges of COVID-19, or its by-products, such as hunger. Health and hunger are obvious and immediate threats to out-of-work migrants, and the poor and elderly, and they are the current focus of official food and grains support. (Fiscal boosts for business may follow as the lockdown eases. Prime Minister Modi has long evangelized direct cash transfers and he can use this crisis to show how technology can deliver cash to the needy quickly.)

If that were not enough, the pace of GDP growth had weakened sharply between March 2018 and December 2019 and official unemployment was at a 45-year high. Just as coronavirus hit India’s southwest shores in late January, the country’s economy was already tumbling.

Beyond Communism

Health emergencies tend to show the better side of communist rule in Kerala. The party became India’s first communist government in 1957 and since then it has been a consistent presence—either in power or one step away. However the party’s popular appeal and effectiveness in a crisis are both built not on ideological slogans but on a foundation of community engagement and development.

Communist governments have lavished resources on building a network of primary and preventive healthcare, topping national league tables and mirrored in human development metrics. In addition, frequent disasters have given Kerala’s political executive, bureaucracy and police a practiced common purpose and rapid response capability.

The Nipah outbreak in particular helped Kerala develop the tools that have proven effective against COVID-19. In a country of monsoons and floods, collapsing bridges and buildings, Nipah was different because it yielded knowledge and expertise to handle COVID-19: testing and tracing, geolocation surveillance and data capture, social distancing, livelihood support and aggressive public education.

“Every system has its own method and ours here in Kerala works with the participation of the whole society,” Ms. Shailaja says.

For decades, the treasury of Kerala, a small economy dependent on tourism and rubber, has leaned toward social services. Local literacy is high while healthcare infrastructure runs deep to grassroots levels. Primary healthcare centers are modelled on the UK’s general practice clinics. One innovation (with an eye on thriving medical tourism that brings foreigners to Kochi for treatment at a fraction of the cost in Europe) is the creation of “harmony centers,” based on an idea from Cuba. A culture of democratic participation in each “panchayat,” or village, rounds off a strong, enduring social contract.

“They’ve had communists here and others running the state, but basically the social pact is secular and strong: it’s about the people, and in crisis the government, bureaucracy and police move into action quickly,” says Vijay Sakhare, inspector general of police for Kerala.

The emphasis on community creates unexpected benefits. A practice known as “social policing,” for instance, embeds police in the community, going beyond law and order to build pastoral relations with communities. This constant contact with the community led to Mr. Sakhare’s design and launch of an app to connect doctors and patients worried about coronavirus symptoms, broadening direct communication of reliable information.

The minister of the moment, Ms. Shailaja, admits that more than Kerala’s crisis credentials are currently on display, for India and the world to see. The state’s entire system is being judged, she says, and that includes credible governance, healthy and educated workers “and, most important, transparency.”

Those characteristics are equally prized by the world of capitalist investment—a fact she readily acknowledges. Kerala greets 1.1 million foreign visitors to its fabled backwaters each year and investors would be similarly welcomed, she says. But that must wait for a post-coronavirus world.

Until then, “I always feel there is unfinished work and that troubles me.”

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Khozem Merchant is a Brunswick Partner and the Head of the firm’s Mumbai office. Previously, he was a journalist with the Financial Times and President of Pearson India.

Photograph courtesy of Kerala, India Public Relations.

 

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