Equipped with a non-contact thermometer and oxymeter, A Sumathi, a fever surveillance worker employed by the Greater Chennai Corporation, knocks at the door of S Raja in Anna Nagar every morning. Her job: to enquire about the latter’s well-being and his family, and provide any assistance they may need. This is a source of assurance for Raja, who feels safe that his family is being tracked on a day-to-day basis for over a year now. A few days ago, when his wife, R Rani, developed symptoms of COVID, he immediately sought Sumathi’s help for testing and triaging.
“The fever survey worker informed us that my wife tested positive and sent her on an ambulance to the screening centre to identify the intensity of the disease. As the infection was mild, she was isolated at home. Sumathi dropped by to hand over the home kit and showed up every day to know how my wife was progressing,” Raja says.
Sumathi is one of the 12,000 fever survey workers deployed by Greater Chennai Corporation (GCC) last year in the wake of the global pandemic. The civic body adopted a mixed mode to recruit volunteers. “We put out an official call on newspaper and through word of mouth, and then we hired the volunteers for door-to-door surveillance,” says an official from the civic body. When the curve plateaued early this year, the services of these workers were terminated but they were called back as the second wave hit the city.
None of these engagements entail a written contract. For many like Sumathi, however, even this temporary opportunity has been a big support. Sumathi, a single parent to two pre-teens, worked as a home nurse before this. When the nation-wide lockdown was announced, the home care sector was affected and she found herself without a job. Sumathi came to know of the opportunity through zonal corporation officials and volunteered to join.
What did hit her though was the revised terms of engagement in the second wave. While they were paid Rs 15,000 during the first wave, their salary was revised to Rs 12,000 when they were rehired in the wake of the second wave.
“We are risking our lives every day, visiting the residences of COVID patients, monitoring them and doing everything to help them; so this drop in compensation was a blow I did not see coming my way,” she adds.
“When we hired them last year during the pandemic, the lockdown was intense and shops functioned with restricted timings. Price rise was steep, and hence they were paid Rs 15,000 in the beginning. As the lockdown eased, access to groceries and fruits and vegetables became easier, so we reduced the pay to Rs 12,000,” clarifies the GCC official. There are currently no plans to increase their pay.
A critical role
Sumathi’s points are legitimate. The Chennai civic body has been implementing successive interventional strategies to combat the spread of the virus, the most recent being the launch of a ‘GCC Brigade’ by roping in NGOs in the city who will assist the civic body in various COVID management duties. But fever workers, who will continue to work alongside the new volunteers, have been on the ground since the early days of the pandemic, playing an extremely important role and serving as the pillars of the GCC programme to contain COVID cases.
Each one of them visits around 150 to 300 residences every day. These workers are instructed by the civic body to check 11 Influenza-like illness (ILI) symptoms that include cold, cough, fever, sore throat, throat pain, wheezing, loss of taste, muscle pain, headache, body pain and fatigue.
N Somasekar came to know of the opportunity through a zonal official at the corporation and joined as a fever volunteer, after the marketing department of the private company where he worked shut down in the pandemic. He describes their regular duties on the job:
“Our day starts at 7 am, we assemble at the zonal office of the corporation office in Ambattur for a roll-call. The officials summarise the tasks cut out for us, this is also an opportunity for us to voice our concerns and difficulties, if any,” he says.
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By 9 am, Somasekar is out on the field, visiting the COVID patients first and enquiring about their well-being. He maintains a notebook that has details of all residents and the list of COVID residences. As part of his work, he also advises quarantined/isolated patients on what to do and helps families with consultation with zonal doctors, as and when required. He also calls in the conservancy workers to collect their COVID waste.
“I am in charge of whoever tests positive in the four streets that I monitor. Soon after the test results are declared, we direct them to the screening centre to diagnose the severity of the infection. We have to keep a tab on them every day and submit reports to the Area Health Officer (AHO),” explains Somasekar.
In case the condition of the patient worsens, the surveillance workers must alert the Division Health Officer (DHO), send an ambulance and ensure that the patient is hospitalised. “We need to keep track of where and when they have been admitted, note down the caretakers’ details and include these details in the report we file to the AHO on a daily basis,” adds Sumathi.
After visiting the COVID patients, the workers visit other residences in their locality. “I cover about 170 houses a day. There are some people who do not want us to visit them, fearing they may contract the disease from us. We get a letter signed by such individuals stating their reasons for reservation, and do not visit them unless we are called back,” adds Somasekar.
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Although in theory, duty of fever surveillance workers is supposed to be over by 2.30 pm, in reality, it rarely works out that way. “I receive calls from people under my watch at odd hours, even after work is officially over. I feel overworked sometimes and feel that the compensation we receive is not commensurate with all that we do,” says Somasekar.
There is also the mandate of working to dispel vaccine-hesitancy. The fever workers are asked to spread awareness among people about vaccines and convince them to get vaccinated. It is not always a smooth ride for all. “I visit around 250 households every day. There are men who ogle at me and call me names. I have no choice but to ignore them and get going,” says R Sarala, another fever worker, working in a few slums in Egmore.
Professional hazards, with little cover
As frontline workers, these volunteers have a very high risk of contracting COVID. M Ramesh, another fever worker, was infected during the first wave. “I had mild symptoms and was admitted to the Siddha hospital for a week and got back to duty 20 days after recovery. But in the present, only workers with co-morbid conditions and severe symptoms can get admitted to the hospital,” he adds.
The civic body distributes multivitamin and zinc tablets every day and kabasura kudineer (a herbal concoction). They are also given masks and gloves for their protection, though not every one is convinced about the efficacy of such measures. “All these may have been adequate for the first wave, as we did not have so many cases back then. Today more than 20 people tested positive in the 200-odd houses I visit. We need double masks and gloves to prevent ourselves from getting infected,” she adds.
Another nagging worry for many of these workers is the cost of treatment if they get infected, since they do not have any kind of insurance cover. “Since these volunteers are temporary workers, they are not provided medical insurance. In case of volunteers testing positive, they will be given paid leave for 20 days,” said the corporation official we spoke to.
While it is true that the Corporation has been taking over many colleges and other institutional facilities and converting them to COVID Care Centres, the struggle to find hospital beds remains a tough one. “I got infected along with my family in the first wave but there was no priority or special arrangements for frontline workers. We had to scramble to get admitted to the government hospital, despite being frontline workers hired by the corporation. I was marked absent until I returned to duty and salary for 15 days was cut from my pay,” alleges Sarala.
However, as frontline workers, fever volunteers were prioritised for vaccination. A majority of them were vaccinated when they were rehired in the wake of the second wave.
Although these are testing times, what keeps these fever workers going is the spirit and mission of their work. “We play a major role in identifying cases early and containing the spread of the virus. I’m happy doing my bit for my city in this way,” concludes Somasekar.
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(All names in the story changed on request)