Acknowledgement: This article was made possible only thanks to the networks and resources generously shared by Mr Dev Pal, field researcher of the Housing and Land Rights Network. The author is grateful for their assistance.
On April 19th, the Central government announced that the third phase of India’s vaccination program would commence from May 1st for those aged between 18 to 45 years. After some delays due to nationwide vaccine shortages, on the 1st of May, Delhi’s Chief Minister Arvind Kejriwal finally announced that phase three would kick off in the city from the 3rd of May.
Residents of the city may have breathed a sigh of relief, given the capital’s grim battle against COVID-19 for the past year. As of 8:00 am on the 2nd of May, Delhi reported 25,219 new COVID-19 cases, 96,747 active cases, and 412 new deaths. Reports suggest that the unreported deaths in the city could be 5 to 10 times as many.
Scaling vaccination is the need of the hour to save lives. But, for young Delhiites and the ~595 million other Indians in the 18-45 age group, in order to get vaccinated, they have to be mandatorily registered on the Centre’s online CoWIN portal first. To sign up for the shot, these millions would have to ‘simply’ register on CoWIN from a smartphone or laptop, and then schedule a vaccination appointment at their nearest health centre.
This tech-heavy process is an invisible barrier that prevents thousands of Delhiites, and millions of Indians, from registering for a life-saving injection.
Take the example of Yamuna Khadar, an informal settlement located on the floodplains of the Yamuna river in northeast Delhi. Dev Pal, a field researcher at the Housing and Land Rights Network and a former resident of Yamuna Khadar actively involved with its development, tells me that approximately 1,500 families live in this agricultural oasis. They are largely employed as farmers, domestic workers, and vendors in the city.
Many of the residents here own inexpensive, functional phones—few of these are smartphones. Digital literacy in the area is also low. As a result, the residents of Yamuna Khadar who fall between the ages of 18-45 are either struggling to register for the COVID-19 vaccine on the government’s CoWIN platform, or simply do not have the means to.
“If you’re uneducated, or don’t know how to use a smart phone fully, or don’t own a smartphone, like many of the people living here, then you will lose out,” Mr. Pal tells me over the phone. “No officials have come to the homes at Yamuna Khadar this year to check on our wellbeing, or to register the residents either. So, they fall off the government’s radar. If things are left the way they are [without external assistance], I believe that 80% of the eligible people here will not register on CoWIN—which could affect their ability to get vaccinated at all.”
Mr Pal’s comments come off the back of the Centre’s frantic mass vaccination program launched in January of this year. While 15.6 crore Indians have received the jab under it, the drive been criticised from the get-go for its centralised, technocratic registration approach. Accessing CoWIN isn’t that simple for the hundreds of millions of Indians who don’t use or own smartphones, or for the significant proportion of the population who are less well versed with technology in general. On the 30th of April, even the Supreme Court questioned the Centre on how it would “ensure registration for vaccines for illiterate people considering the fact that CoWIN app registration is mandatory.”
After a year of prolonged COVID-19 mismanagement in Delhi, for the residents of Yamuna Khadar, the inability to get vaccinated would further deprive them of the fundamental right to life. How are the residents of this settlement—that lies on the margins of the Delhi government’s imagination—collectively circumventing and challenging the state’s ‘technical solutions’ to get vaccinated during this pandemic?
What Hurdles Does the CoWIN Registration Process Throw Up?
The process for signing up for the COVID-19 vaccination is as follows:
Once you do all of this, all you have to do is show up when asked and get vaccinated. Simple!
But, for the residents of Yamuna Khadar, this process isn’t so simple.
The first problem is that of the type of phones people own here, and how they use them. “While people might own phones, they usually own the smaller, functional mobiles,” says Mr Pal. “Even then, they don’t know how to use them beyond a point. Most buy phones for basic operations in their shops or businesses, or to listen to music.”
The Indian state’s fondness for ‘digital solutions’ has already caused problems in Yamuna Khadar during the pandemic. On April 5th last year, the Delhi government announced that it would provide free rations to those poorer residents of the city who did not have a ration card. To do this, it launched an ‘e-coupon’ system. Much like CoWIN, Delhiites were expected to register on a government portal using their phone number, upload a copy of the head of family’s Aadhaar, and download an e-coupon. This coupon is to be shown to the ration shop, after which supplies will be provided to the family.
This process didn’t account for the technology deficits prevailing among the city’s most marginalised, as corroborated by a PIL submitted to the Delhi High Court in May of last year. “Because of the digital literacy problem in Yamuna Khadar, in spite of owning phones, people here couldn’t apply for e-coupons,” Mr Pal explains. “To solve this, we [Mr. Pal and young students from the community] would call groups of residents to a specific meeting and apply on their behalf for them. We could do this somewhat easily, because an individual can apply for an entire family’s rations.”
This experience with e-coupons brings us to the second problem: which is that of the average family size.
“There are around four people in each family here. However, the size can vary, as the social system that operates here is like that of a village,” Mr Pal says. “Extended families prefer to live together, and I have even seen up to 18 people in a single home here. People choose to live together even once the family elders have passed away, or the children are married.”
But, the CoWIN platform only allows four people to register from a single phone. “Registration becomes a problem for bigger families, because they often only own one smartphone between them. If there is such a shortage of phones, then how are they supposed to register all their members for the COVID-19 vaccine?” asks Mr Pal.
Mr Pal further brings up a crucial point regarding the idea of the ‘family’ registering on CoWIN. “There are so many homeless people in Delhi, what about them? They may not have phones at all and would be completely missed out by the system as well.” There are approximately 2 lakh homeless people just in Delhi. In Yamuna Khadar alone, three government night shelters for the homeless operate with the help of NGOs. Around 15 people sleep in them every night.
These factors seriously compromise the ability of Yamuna Khadar’s hundreds of residents to get vaccinated—which may be the only form of protection against the virus given the non-existent healthcare infrastructure in the settlement.
The Effects of COVID-19 on Yamuna Khadar
Kaushal, aged 25, currently works as a driver in the city. “This is the first time a disease has affected Delhi like this,” he tells me over the phone. “But there have been hardly any cases in Yamuna Khadar. Only recently, in the past few days, I heard of four positive cases from Dev bhai.” When pressed on why this might be, Kaushal pauses. “Nobody is getting tested here, so we don’t know.”
The locals here depend on government healthcare, with the nearest hospital 7-8 kilometres away, and the nearest dispensary 5 kilometres. However, Mr. Pal tells me that the families here who have tested positive chose to isolate at home—this is easy to do given that houses in Yamuna Khadar are spread apart by a couple of hundred metres. “Many were scared to get hospitalised, looking at the conditions,” says Mr Pal. “They felt that going to the hospitals would kill them instead.” Kaushal agrees. “The doctor informed my family that my mother has COVID-19 this morning. We need an oxygen supply for her,” he says. “But, look at the situation in the government hospitals. You can’t even get a bed. You and I both know that the government will listen to the rich and powerful. When do they listen to the poor in these situations?”
The community here has repeatedly requested local officials to set up a Mohalla clinic in Yamuna Khadar. Mohalla clinics—a flagship initiative of the ruling Aam Aadmi Party—are free primary healthcare centres set up around the city, and have been a crucial element of the government’s fight against COVID-19. Despite meetings with local officials, Mr. Pal says no headway has been made in this regard. Despite the fact that government tenders for 30 new clinics were floated by the Delhi government last September, Yamuna Khadar remains Mohalla-clinic-free. The office of Manish Sisodia, the MLA for Patparganj, under which Yamuna Khadar falls, did not respond to The Bastion’s requests for comments on this matter.
In the absence of healthcare, getting sick would add insult to injury, after what has already been an economically devastating year for the residents of the settlement. During the first lockdown in March last year, the crops failed for Yamuna Khadar’s residents. A second rotation cultivated by May was damaged by untimely rains. The lockdown also restricted the mobility of the many vegetable vendors and drivers who reside here—as their entry to the city reduced, so did their incomes.
“I used to take English tuitions for around 50 children here,” 22-year-old Rupam Kumari tells me. “I used that money to fund my B.A. degree. But once the lockdown happened, my tuition classes stopped. My father is a rickshaw driver and the number of rides he got reduced too, so all our money goes to the house now. All of my siblings are younger than me and still in school, so they can’t work. I’m mostly at home now, doing housework. I want to study more and complete my final year of college.” Ms Kumari lives in a household of eight people.
An added barrier raised by the little government attention here is that not all residents may be willing to take the vaccine. Dev tells me that many young students here want to take the vaccine, that they want to register their families as well. Older members of the community without comorbidities are willing to do so if their peers do too. However, Ms Kumari is reluctant to take the jab. “I know it’s good for me, but I’m scared of needles,” she admits. “Both my parents are generally not keen on taking it either, they don’t want any of us in the family to take it.” Kaushal airs similar views. “We’re just not sure about the vaccine in my family, because we don’t know what’s in it. We could die even after taking it. My mother has sugar and blood count problems, how can she take such heavy medicine?”
How Can the Digital Divide Be Bridged?
When questioned about the registration barriers raised by Mr. Pal, a member of the Aam Aadmi Party working in the area confidently tells me that “we will definitely set up a registration centre in Yamuna Khadar for people to come to. We will vaccinate everyone.” However, when pressed on the specifics of when this camp will be held, or where, the official had this to say: “everything is in the planning stage right now. There need to be vaccines to vaccinate people with first.”
Vaccine shortages and pandemic pressures aside, this ambiguity doesn’t instil much confidence in the state government’s preparation for vaccinating every resident. One way for the local authorities to release this burden could be collaborating with intermediaries, like NGOs, to register people.
SEEDS—founded in 1994 and working towards “building the resilience of people exposed to disasters”—is one such NGO. It is undertaking a separate vaccination registration campaign for low-income communities in East Delhi’s localities of Mayur Vihar, Preet Vihar, and Gandhi Nagar since March of this year.
Many of the problems faced by Yamuna Khadar’s residents have been faced by SEEDS in their separate drive too. “The marginalised communities in the ‘slums’ here are struggling with online registration because they don’t own smartphones,” Mr. Yezdani Rahman, Chief of Programmes at SEEDS, tells me. “The other issue was that of trust: thanks to rumours on social media and mouth-to-mouth whispers, many older people thought taking the vaccine would be more dangerous than not taking it.”
The local District Administration reached out to SEEDS to help allay these fears and encourage vaccination. “We currently have a team of 175 volunteers each with their own smartphone spread across 18 District Administration centres in East Delhi,” says Mr. Rahman. “They go from door-to-door and inform people about the importance of the vaccine, help them register on CoWIN if needed, and follow up on them once they’ve taken their first or second shots.” Volunteers are given targets of covering at least 10-15 houses per day—this amounts to spreading detailed awareness on the vaccine among a minimum of 1750 families per month. Around 70 of these volunteers have been specifically trained by the District Health Officers on the precautions that have to be taken into account before getting vaccinated. “This helps the volunteers resolve a majority of the queries residents have then and there,” Mr Rahman adds.
Once families are informed, Mr Rahman says that around 90% of the registrations happen without the help of the volunteers and by the members themselves. 110 families have been directly registered on CoWIN by SEEDS volunteers since March, and in cases where even this isn’t possible, “we direct these names to the District Administration’s office, which has the authority to register such people for a walk-in vaccination [without CoWIN],” Mr. Rahman adds. “The authorities have been very helpful in ensuring that these kinds of cases are addressed.”
What is crucial about the work that takes place here is that the volunteers are from the areas they are canvassing.
“These drives at SEEDS are specifically conducted through our volunteers, who cater to their own communities,” explains Mr. Rahman. “They don’t go to different places because the case load is high. But, also because the trust of the families here to believe what they’re hearing about the vaccines is higher if the volunteer is from their own area.”
SEEDS has plans to soon launch similar registration drives in both Kerala and West Bengal—both states that are experiencing a huge surge in COVID-19 cases. The NGO has already reached out to over 4 lakh individuals across the country over the past year as part of its COVID-19 relief work.
Mr. Rahman is clear about the role of NGOs in this inoculation process. “NGOs are the actors who can mobilise people around the vaccination drive,” he says. “This is because they enjoy the trust of the people, especially when you’re talking about semi-urban, peri-urban, and rural areas. That help from NGOs is what can break the chain of infections.”
Similar ideas are on the mind of Mr. Pal, and the Yamuna Khadar Slum Union, which are looking to raise awareness in their own ways. Although collective action groups have been in operation here since 2011, the Union was initiated by students, elders, and local residents in 2019, and Mr. Pal is a member of it too. “We use the Slum Union to communicate with the government on political and social issues affecting us,” he says. The Mohalla clinic issues and the CoWIN registration process are two such issues the Slum Union has communicated with local officials about. However, given Delhi’s spiralling COVID-19 crisis, getting in touch with officials has been difficult for the team.
“They don’t pick up the phones because they are so busy handling the cases, so there are no answers currently,” Mr. Pal comments. “If things don’t resolve in the next few days we [the Union] will prepare a petition and file it in the Delhi High Court about the CoWIN system. We will also mention the need for a government registration centre to be set up here, where people can come and register for the vaccine if they don’t know how to do so by themselves. Students and community mobilisers from Yamuna Khadar can run the centre as they have a better understanding of the area and will know how to help people—after all, this is what we did during the ration crisis last year too.”
The Yamuna Khadar Slum Union is set to file its petition soon, Mr. Pal tells me. While the petition is specific to the area’s concerns, it may have larger implications for Delhi’s vaccination strategy. “We are not just talking about Yamuna Khadar this time—there should be a vaccination registration centre in every basti [informal settlement] in Delhi. Health is a fundamental right for everyone,” Mr. Pal says emphatically. “These individuals shouldn’t be left out because of the CoWIN registration process.”
Featured image: (L) Yamuna Khadar, courtesy of Vaishnavi Rathore; (R) A Union meeting held during early January of 2020 to discuss evictions in the area, courtesy of Dev Pal.