‘A world turned upside down: COVID-19, urban poverty and older people in Chennai, an Indian metropole’.

Dr Penny Vera Sanso, a Senior Lecturer in the Department of Geography reflects on the COVID-related suffering that will be detrimental to Chennai’s poor.

The expectation is COVID-19 will run wild through the high density low-income settlements that Chennai’s poor are forced to live in.  This may yet happen. What is happening is a great deal of COVID-related suffering, including excess deaths, deepening impoverishment and changing intergenerational relations that will force some older people into greater dependency and marginalization and others into more depleting economic engagements.

Currently the greatest threat for people living in low-income settlements is COVID-related impacts. How is this possible?

  • First, India is a highly segregated society. Segregated by class, caste and labour conditions, in which 90% of workers have no rights, most are employed on daily or piece rates. There are few points of contact that would provide person-to-person spread between slum dwellers and the ‘flying classes’ who brought the disease to India on flights from Wuhan, UAE, Italy and so on. Further, the longstanding stigmatization of slum dwellers and low caste people as sources of contagion, which underpins widespread Human Rights abuses in India, meant that the people most likely to be carrying the disease, the Middle Classes, shut off all direct contact with those least likely to have it, slum dwellers.
  • Second, India implemented a lockdown on the 25 March, when it only had 519 cases, quarantining tourists, banning international commercial flights and suspending train services.
  • Third, it established Containment Zones for any buildings or areas with one or more confirmed cases. Containment is backed up with targeted testing and tracing. As of 29 April 2020 there were 170 containment zones across India and 1075 deaths.  In this no-one can leave their homes: groceries are delivered through government channels. The lockdown and containment are stringently policed, often heavy-handedly.

For most of the urban poor COVID-19 has brought their economic lives to a standstill. Research undertaken in five Chennai slums between 2007-10, including the 2008 international banking crisis, that translated into a significant economic slow down in Chennai, is instructive.  Chennai’s labour market is segregated by age, gender and education, and has until now provided considerable economic space for older people, who occupied areas of the economy that younger people had vacated for higher status, easier conditions and better pay.

People on low, insecure, daily incomes do not earn enough to save. There is no question that after six weeks without work everyone in Chennai’s low-income settlements, whose nutritional status would not have been good, anaemia and malnutrition being endemic, will have cut food expenditures to the bone.

Beyond this, the wider context impinges on people’s health and capacity to seek healthcare. Water shortages and temperatures ranging from 34 deg C to 40 deg C contribute to dehydration and heat stroke. Free health services are centrally located, hence inaccessible for most people, while private doctors and medication need to be paid for. All this in a context where male slum dwellers already have a life expectancy of 5 years less than non-slum dwellers, reflecting globally established social gradients in morbidity and mortality.

For the urban poor starvation, non-COVID-19 sickness and deepening vulnerability are currently the greatest dangers they face; these will drive them back into finding work, often servicing those classes and sectors who comprise the current pool in which COVID-19 swims.  Hunger will bring the virus to the slums.

In this world turned upside down, the poor are, currently, much more at risk from excess, COVID-related deaths than COVID-19 itself.  Loss of health, assets, jobs, housing and the disruption of social and economic networks beyond their settlements are the immediate impacts of lockdown.  There will be mid and long term impacts.

At best mid-term impacts will be relatively short lived, requiring greater labour force participation for everyone in low-income settlements – but not the ‘pull your socks up’ participation that neo-liberal economists like to think will raise household incomes.  People of all ages and abilities will be forced onto the labour market, lowering pay rates.  Older women and men, a higher percentage of whom are already in paid work than are people aged 15-19, will be forced into even more body depleting hours and conditions on less pay, in a context in which age discrimination in employment and wages is well established.  Family and kin networks will develop holes due to the underlying health conditions, deepening nutritional deficits and untreated morbidity under COVID-19 conditions and directly from COVID-19 if it spreads through the slums.

Tamil Nadu is a state with a comparatively low fertility rate. COVID-19’s direct and indirect consequences will sharpen the long-term risks of reducing the size of family networks in the context of weak state support.

Older people with small, depleted or no family, with no or inadequate pensions or who have lost work will find their capacity to cater for themselves or to rely on others significantly constrained. They could well become even more tied into impoverished family networks that increasingly depend on older people’s inputs.

There is no getting away from the need for a realistic income for all people over age 60 and a pension programme that guarantees such.

Irrespective of whether COVID-19 finds spreads through Chennai’s low-income settlements or not, excess COVID-related deaths are a certainty.  It will be political will that determines whether these deaths and the pandemic’s long-term impacts on people living in low-income settlements will ever be recognized for what they are: the consequence of how India chooses to distribute its risks across society.

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Knowing death

This article was written by Khyati Tripathi, a Commonwealth split-site PhD scholar from the Department of Psychology, University of Delhi, India and pursing a year of her PhD in the Department of Psychosocial Studies at Birkbeck under the supervision of Professor Stephen Frosh. Khyati has been selected for Cumberland Lodge’s Emerging International Leaders Programme on Freedom of Religion or Belief.
coffinThrough my PhD project, I am trying to understand how varied social constructions of dead bodies lead to different conceptualizations of death in a culture with a special focus on mortuary techniques (embalmment per se). Death is more than just a biological fact; it is also a social phenomenon. A dead body is the carrier of the social meanings that a culture attaches to death. Each culture has a different lens to look at the bodies whether it be male bodies, female bodies or dead bodies. Through my research I want to know how these cultural lenses differ by drawing a cross-cultural comparison between Delhi (India) and London (UK).

As a curious researcher, I have always been intrigued by the untouched complexes of human existence and death is one of them. This interest is closely tied with my experience of losing a friend in an accident when I was 14 and since then I have been on an ongoing quest to ‘know death’. I have been working in the area of death and related themes for eight years now and this journey started with my first project in  the final year of my undergraduate degree, which focused on the impact of physical health on death anxiety, where I worked with terminally ill (cancer patients), chronically ill and healthy individuals. A second research project that soon followed studied death personification i.e. how would people perceive death as a human or a person? A third analyzed the death rituals of  three religions- Hinduism, Islam and Christianity and a fourth was an ethnographic study to explore experiences of Hindu death priests of north India.

I have had many different experiences working on these projects. I remember sitting in the waiting area of the hospital where I had to meet cancer patients for my first project and not wanting to go inside thinking ‘I cannot do this’. I had presumed that none of the patients would want to talk to me about death and I would out rightly be rejected and dismissed. Gathering strength, I went inside the ward where I could see at least 15 beds. I took a right and approached the corner most one. There sat a 73-year-old man reading a newspaper. I greeted him and explained to him the purpose and objectives of my study. He replied saying, “of course, ask me whatever you want” while signing the informed consent. My interaction with him lasted almost six hours. My first ever participant made me realize that as a researcher you need to have no notions and assumptions about your field. There were quite a few  patients who wanted to talk about death with me because they did not want to talk about it with their family members. I can’t say that I was never rejected, I was – a lot and I accepted all rejections with respect. I knew that I was working in a sensitive research area and needed to be receptive.

I am asked a lot if working in this area makes me ‘depressed’. I would say no, it doesn’t but it does make me ask questions about our existence as humans. It gets overwhelming a lot of times and I distance myself when I feel saturated. My parents have been my pillars of strength. They supported me in each and every endeavor of mine and have given me the emotional care, support and motivation that I needed to continue.

I believe that life is a mystery that unfolds gradually but death is a bigger mystery because it is uncertain and this uncertainty and unpredictability about death make people anxious. Through my research, I want to study different aspects of death (ritual-based, culture-based, etc.) and contribute to the field of ‘Death Education’ in India and elsewhere.

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Fostering collaborations between the UK and India – the way ahead for TB drug discovery research

This post was contributed by Arundhati Maitra, Associate Research Fellow at Birkbeck

Tuberculosis (TB) has re-emerged as a serious public health threat worldwide because of an alarming increase in the mortality rates due to drug resistant Mycobacterium tuberculosis strains and a deadly liaison between HIV and M. tuberculosis infection. There is an urgent need for identifying and validating new therapeutic leads to facilitate the development of novel anti-TB drug treatment.

An important element in intracellular survival and consequent pathogenesis of M. tuberculosis is its distinctive cell wall, of which peptidoglycan is a major structural, functional and regulatory component. The cytoplasmic steps of the biosynthesis of peptidoglycan are catalysed by a series of ATP-dependent ligases and they play a pivotal role by utilising ATP while incorporating specific amino acids sequentially to the C-terminus of the stem peptide; steps critical for cell wall cross-linking. They share a similar reaction mechanism and are essential for the growth of M. tuberculosis. As the reactions catalysed by these enzymes provide key precursors for the cell wall biogenesis and recycling, they are therefore considered as excellent therapeutic targets at the different physiological stages of the TB pathogen.

On a recent trip to India, Dr Sanjib Bhakta, Director of Mycobacteria Research Laboratory (MRL) part of the Institute of Structural and Molecular Biology, Birkbeck, University of London and UCL, visited a number of universities, specialised research institutes, organisations and schools to shed light on the world-class research being carried out at MRL researchers in the field of tuberculosis  drug discovery and to discuss new research and educational initiatives with India.

Dr Bhakta speaks to the Department of Molecular Biology and Biotechnology, Tezpur University (India)

Dr Bhakta speaks to the Department of Molecular Biology and Biotechnology, Tezpur University (India)

Dr Bhakta was invited by the erstwhile Vice-Chancellor of Dibrugarh University, Assam, India Professor Alak K. Buragohain, to engage in an interactive session with the research students of the Department of Molecular Biology and Biotechnology (MBBT), Tezpur University as well as the senior professors of the Department of Pharmaceutical Sciences, Dibrugarh University. A number of intense interactive sessions, held between July 23 – 25 2013 at the university departments was attended by the department’s students and faculty members and also by those in the Department of Chemical Sciences and Food Engineering and Technology. Dr Bhakta spoke about ‘Tackling drug resistance and persistence in Mycobacterium tuberculosis: integrative inter-disciplinary approaches in novel therapeutic intervention’, in the course of which he discussed whole cell assay techniques developed exclusively in his laboratory to evaluate potential anti-infective molecules. Highlighting some of the current work being carried out in his laboratory Dr Bhakta spoke about understanding ligand-protein interaction to unveil the mechanism of action of anti-mycobacterial compounds. He laid special emphasis on the need for an inter-disciplinary approach to fight TB and leprosy. A meeting with Professor Mihir Kanti Chaudhuri, Vice Chancellor, Tezpur University and other senior professors culminated in a proposal to forge collaborations between Birkbeck and Tezpur University, Assam, India. Any collective work between these two universities will benefit from the availability of potential anti-tubercular agents of plant origin harboured in the highly bio-diverse forests of Assam and the technical expertise of Dr Bhakta in testing the effectiveness of these agents in a wet lab setting.

Another invited seminar and one-to-one research meeting at which Dr Bhakta spoke was at the National Institute for Research in Tuberculosis, Chennai (India). Collaboration between NIRT and MRL is not new, as a materials transfer agreement already exists between the two world leading institutions. A memorandum of understanding currently being drafted will expectedly consolidate the existing relations.

Guest of Honour at the IDF Grants and Awards Function, Chennai (India)

Guest of Honour at the IDF Grants and Awards Function, Chennai (India)

A combination of social responsibilities, university outreach activities and common academic interests led Dr Bhakta to engage with the Indian Development Foundation (IDF). Established in 2005, the IDF is a non-government organisation with a three-fold goal to cater to education, development and health in the rural parts of India. Having been monumental in the elimination of leprosy in India, the organisation has moved its focus to tuberculosis. IDF hosted its Annual Grants Release Function on August 7, 2013 at Bharatiya Vidya Bhavan, Mylapore, Chennai at which Dr Bhakta was invited as a Guest of Honour to recognise the efforts of IDF and emphasise the need for continued support to such organisations. The annual feature is conducted to share resources with leprosy/TB projects and recognise schools in the region for their participation in social work and raising awareness of the cause. It was well attended this year with five-hundred audience members and renowned speakers on the panel including Mr. B.S. Raghavan (former Policy Advisor to the UN) and Dr A.R.K. Pillai (Founder President of IDF) and Mr. J. Ravichandran (CEO, German Leprosy and TB Relief Association) to name a few. The event was covered by Indian national television and print media units.

In an effort to stir the minds of tomorrow’s researchers, Dr Bhakta also accepted the opportunity to deliver a motivational talk at Maharishi School to a group of 50 A-level equivalent students, addressing their queries and encouraging them to embark on the life of a research scientist.

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Working elderly in India

This post was contributed by Dr Penny Vera-Sanso, Lecturer in Development Studies in Birkbeck’s Department of Geography, Environment and Development Studies and  V. Suresh of the Centre for Law, Policy, and Human Rights Studies, Chennai, India

In just three weeks the Photo Competition on the ‘Working Elderly’ became a people’s research project, revealing the widespread and diverse nature of older people’s work. With nearly 3,000 pictures up-loaded it is a permanent on-line record of older people’s work from across India’s mountains, plains, deserts, coasts, villages, towns and cities – an irrefutable documentation of what older people do and how they contribute to the economy, both locally and nationally.

Breaking coal for brick kiln Credit: Penny Vera Sanso and CLPHRS, Chennai

Breaking coal for brick kiln
Credit: Penny Vera Sanso and CLPHRS, Chennai

So far these pictures have drawn over 25,000 votes from thousands of visitors to the website and provide no hiding place for so many stereotypes of old age. Casual reference to ‘old age dependency’, ‘old age burden’, ‘people of working age’ as aged 15-59 years and the unthinking denigration of older people’s work as ‘passing time’, ‘helping out’ or ‘just…’ are now revealed to be more fiction than fact.

The photos show a huge range of work and could even be used as lessons in ‘how things are made’. The old woman picking cotton buds or cutting cane for brooms, the old cobbler sewing seals for large drains, the old rickshaw puller moving two-wheeler tyres from the manufacturer to the mechanic, the old man breaking and clearing ground for construction, the old gang-men who ensure that one of the world’s largest employers, India Railway, operates safely. The list is endless. And the conditions of work are diverse – too diverse to describe here.

Female basket weaver Credit: Penny Vera Sanso and CLPHRS, Chennai

Female basket weaver
Credit: Penny Vera Sanso and CLPHRS, Chennai

Yet despite the diversity depicted this isn’t the whole story. Most pictures have been taken of people as they work in public view and during the hours of the day the general population are awake.

However, our research (2007-10, 2012-3) reveals that in the middle of the night the elderly are working. To our surprise we found that long before younger hawkers arrive on the first bus elderly wholesalers, porters, hawkers and rickshaw pullers are working these markets in order that everyday necessities are available in every neighbourhood at the start of the day. We also found that the elderly sell tea and hot food to late night workers and suspect that older people are working at many other things while the nation sleeps.

Our research also revealed that many elderly people work in hospitals, schools, banks, factories, restaurants and offices as cleaners, porters, security, peons, ayyas, gardeners and in many other roles, yet they have not appeared in the photo entries so far.

What are the policy implications of such widespread working of elderly people? First, that the working elderly are doing vital work for the country and family. This work needs to be recognised for what it is and fostered. Second, the vast majority of elderly workers clearly live precarious lives in or on the edge of extreme poverty and many are doing work that eats into body and soul. What elderly workers need is a meaningful pension that will enable them to choose whether and how much to work and will empower them to refuse the most onerous and demeaning work.

Taking kids to school  Credit: Penny Vera Sanso and CLPHRS, Chennai

Taking kids to school
Credit: Penny Vera Sanso and CLPHRS, Chennai

Photos can be seen at www.thehindushutterbug.com. Voting closes 28 July.

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