A year on, Indian media is still to tell the full story of the lockdown

Broken News

Published in Newslaundry on March 18, 2021

Link: https://www.newslaundry.com/2021/03/18/a-year-on-indian-media-is-still-to-tell-the-full-story-of-the-lockdown

 

As anniversaries go, we are on the cusp of one that the government is unlikely to mark but the ordinary people of India will remember for years to come. On March 24, 2020, at 8 pm, the prime minister appeared on national television and, without prior warning, announced a national lockdown that would come into effect in four hours.

Even the shock of his demonetisation announcement on November 8, 2016, also at 8 pm, did not compare to this. The common factor in both announcements, three and a half years apart, was that the poor were the ones who paid the price.

As we approach March 24, 2021, the poor in India are still paying the price for that fateful decision.

The lockdown was necessitated, we were told, to curb the spread of coronavirus. But despite the cruel and often heartless implementation of the lockdown, the virus continued to spread over the next six months. Today, the cases are lower than at the peak, but the crisis has not ended. In all, the virus has afflicted at least 1.14 crore Indians and killed more than one and half lakh.

What have we in the media learned from our coverage of the pandemic, including the impact of the lockdown?

Let us remember that two days before this announcement, Narendra Modi and some of his ministers had met with media owners and editors. According to this report by Sagar in Caravan magazine, "The prime minister’s website reported that the journalists committed to 'work on the suggestions of the prime minister to publish inspiring and positive stories' about COVID-19. After the interaction, some owners and editors who were present in the meeting took to Twitter to thank the prime minister for making them a part of the video conference and seeking their opinions, while others published reports on the meeting on the front page the next day, with photos of themselves and Modi on the television screen."

The tone of acceptable coverage was set. The government desired "positive" stories. But the fallout of the lockdown was anything but positive as lakhs of men and women, who had migrated to cities for work, fled on foot or with whatever they could find by way of transport to return to their homes thousands of kilometres away. That was the big story, one that no media house, however "positive" it wanted to be, could ignore.

It is the visuals of the great Indian exodus, perhaps one of the greatest that this country has seen since Partition, that will live on as the abiding memory of 2020, a year when the pandemic overwhelmed all else.

Yet, today, if we look at the media, we would be hard put to remember that this actually happened. We still do not have a clear picture of how many of those men and women returned; if they did whether they found work and shelter; if they did not whether they were able to eke out a living in their villages; and how many of them were afflicted by the disease that upended their precarious lives on March 24.

Many journalists did an exemplary job capturing the human tragedy unfolding across India. It was not an easy task. Even as they set out to report, their colleagues in the media were losing their jobs and media houses were unwilling to put the resources needed for such reporting. Despite this, we read stories that will be remembered.

An angle that was missed by most media platforms was that of gender. Migrants were mostly men, but there were also women. Some were part of families, but there were many women who had migrated to cities for work and were stranded without jobs or some place to live. Their stories were largely missing in the reportage.

This is one of the important findings of a study conducted by Population First and the Network of Women in Media, India on the gender perspective of the media coverage of the pandemic. Released last week, it is worth a closer look not just for the statistics but because it brings out a point that is relevant for the media at all times: that a gender perspective needs to be integrated into all reporting if we want to tell the full story. Without it, we miss out on literally half the population, particularly so during a crisis.

The study restricted its analysis to print media and looked at coverage from March to September 2020. It studied a sample of 12 mainstream newspapers in seven languages and found that only 4.8 per cent of the 6,110 news items analysed had "anything of significance with regard to women and/or gender issues".

That story, of how women and girls survived through this year of the pandemic, has still to be told in full. In fact, the Parliamentary Standing Committee on Home Affairs has found that there has been an increase in cases of domestic violence and trafficking. According to the report, "The female migrant workers and their children were trafficked and had gone missing during lockdowns.” But we have read little of this in the media.

Also, apart from domestic workers, about whom there have been some reports, there are thousands of women in the service industry who have lost their jobs. Where are these women? What are they doing? How have they survived? We also know little of what women faced when their men returned to the village without a job.

The other challenge that the media continues to face is how to cover the pandemic. After a while, the data means little to readers. They look at the daily numbers, which must be reported, but often fail to make the connections.

The media has been constantly challenged, not just in India but around the world, to find ways to keep on telling this story, of a virus that continues to spread, of health services breaking down, of growing fear and anxiety and of the lives that have been devastated by suffering and loss.

Currently, we also face the dilemma of how to report on the safety of the vaccines being administered. Initially, there was the controversy about the home-grown Covaxin that was cleared for emergency use even though its phase three trials were not complete.

And now we have controversies surrounding the AstraZeneca vaccine that has been rolled out as Covishield in India. Several countries in Europe have suspended its use. Yet, the World Health Organisation reiterates it is safe.

How do we in the media report this when several lakh people in this country have already received the first dose? Most people only read headlines. How can we ensure that what is reported is science-based and balanced?

The jury is still out on this but the dilemma is a genuine one. You cannot ignore these reports, or the adverse reactions to the vaccine reported in India, even if they are a handful. At the same time, as several experts have emphasised, the percentage of adverse reactions is so low that they ought not to undermine confidence in the efficacy of the vaccine.

Objectivity and balance is often a fine line that the media has to tread. As Marty Baron, who recently retired as editor of the Washington Post put it in this interview with the New Yorker: "The idea of objectivity – I should make clear – it’s not neutrality, it’s not both-sides-ism, it’s not so-called balance. It’s never been that. That’s not the idea of objectivity. But once we do our reporting, once we do a rigorous job and we’re satisfied that we’ve done the job in an appropriate way, we’re supposed to tell people what we’ve actually found. Not pretend that we didn’t learn anything definitive. Not meet all sides equally if we know that they’re not equal. It’s none of that. It’s to tell people in an unflinching way what we have learned, what we have discovered."

Can the Indian media report in an "unflinching way" given the attitude of this government towards it?

If we had any doubts about that, they have been firmly dispelled by what is perhaps the most significant story of this year, as far as the media is concerned. A group of ministers met last year and discussed how to make the media fall in line and "neutralise" those who do not, as reported in Caravan and elsewhere. The ministers also consulted a number of journalists, one of whom reportedly suggested colour coding journalists into green for the undecided, black for opponent and white for supporter. There has been no official denial of this meeting.

If we read the details of the meetings, now available in the public domain, and also consider the pre-lockdown messages from the government to the media, its strategy for media control is crystal clear. The latest move that will affect the few spaces that still remain for critical and independent coverage of events could be the Information Technology Intermediary Guidelines and Digital Media Ethics Code Rules, 2021 that will regulate digital news platforms.

The message is literally staring us in the face in black and white.

 

Making sure that consent is informed

My column in Mathrubhumi, published on September 13

 

 

Every day we wake up and hope that there will be some end in sight to this global pandemic that has killed thousands in India and around the world in a few months, and infected many more.  But that hope lies shattered as we continue to hear about more infections, and more deaths.  Even in states, and regions within states, where there was some success in dealing with the pandemic, Covid-19 has reappeared.

 

On top this, we have the recent news that the Phase 3 trials for one of the most promising vaccine candidates, the one being developed by AstraZeneca, has been put on hold temporarily.  Although politicians who want the vaccine to be delivered quickly, so that they can claim credit for it, are disappointed, people should in fact be glad that the problem has been detected. And trust that science will fix it.  As the Chief Scientist of the World Health Organisation, Soumya Swaminathan has said, "I think this is good. Perhaps a wake-up call or lesson for everyone to recognise that there are ups and down in research, and that we have to be prepared for those."

 

Coincidentally, the participant in the trial who developed adverse symptoms is a woman. This reminded me of the importance of "informed consent" before anyone participates in these trials.

 

The Covid-19 vaccine trials are high profile.  The whole world is watching, and waiting.  Here no one can afford to take shortcuts.

 

Unfortunately, this is not true of other such drug trials that have been conducted in the past.  And especially when it comes to the issue of "informed consent". 

 

There are examples that come to mind from not so long ago when women took part in clinical trials for vaccines without really knowing what this was all about.

For example, in 2009, a clinical trial to test the efficacy of the human papilloma virus (HPV) vaccine on young girls was conducted in Khammam district, Andhra Pradesh.

 

This vaccine held out the promise of preventing cervical cancer, something that afflicts and kills millions of women worldwide. So it was an important health intervention and its success would help women everywhere.

 

The problem was the choice of girls on whom this trial was conducted.  They were tribal girls, living in hostels away from their families. Neither they, nor their parents, understood what the trial was about. Yet, 14,000 girls between the ages of 10 and 14 were given three doses of the vaccine.

 

Things began to go wrong when four of the girls developed health problems after being given the vaccine and died.  It was not clear whether their death could be linked directly to the vaccine.  But what was clear was that these girls were not in the best of health and that they did not understand the possible complications of being injected with a live virus. The literature about the vaccine was in English, which neither they, nor their parents could read. In fact, even the health providers administering the vaccine could not read English.

 

Finally, due to the intervention of a women's group, the trials were suspended.  But they brought home forcefully the importance of respecting individuals, regardless of their social or economic status, if you put them through a human trial for a new vaccine.  One hopes that the fight to stop this trial is a lesson learned and that such a thing will not be repeated.

 

What we need to take home from such incidents is that the disempowered, including poor women and girls, often become the easiest choice for experimentation because they do not have the ability to object.

Uninformed Consent

https://www.thehindu.com/opinion/columns/Kalpana_Sharma/The-Other-Half-Uninformed-consent/article16123576.ece

The Hindu, Sunday Magazine, April 18, 2010

THE OTHER HALF

KALPANA SHARMA

What women need is basic healthcare. Not costly medical experiments involving vulnerable sections who don't know what they are getting into…

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Were they informed about adverse health impact and were these monitored and treated?

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Photo:G.N. Rao. THE HINDU

Controversial: Tribal girls treated with the cervical cancer vaccine interact with Brinda Karat.

Marie Antoinette told her people to eat cake when they needed bread. Our government encourages people to buy cars — from Rolls Royce to the Nano — when they need affordable public transport. And when people, especially women, want simple, basic health care — and clean water and sanitation — they are being urged to inject their daughters with a Rs. 9,000 vaccine against cervical cancer. If some of us conclude that the priorities of our decision makers are more than slightly skewed, we should not be blamed.

The recent controversy over the use of the Human Papilloma Virus (HPV) vaccine on tribal girls in Andhra Pradesh has once again brought into focus several ethical and gender-related issues in the arena of public health that need to be openly debated. In India, we have many recent examples of women, particularly poor women, being subjected to clinical trials for contraceptives, including injectable contraceptives. These women have suffered after-effects and not known fully what was happening to them. It is only when women's groups and health groups raised an alarm about the way these trials were being conducted did the government intervene.

Goverment intervenes

Once again, the government has intervened and stopped, for the moment, the project in three districts — Bhadrachalam, Kothagudem and Thirumalayapalem — of Khammam district in Andhra Pradesh where 14,000 girls, mostly tribal, between the ages of 10 and 14 have been given three doses of a vaccine that is supposed to protect them from cervical cancer. The project is headed by a well-known international NGO and is supported by the Indian Council for Medical Research (ICMR). The official district health authorities and health personnel have been fully involved in every aspect of the project. So it is not something that has been done clandestinely.

The alarm bells first rang when four girls died after they had received the vaccine. Whether they died due to complications caused by the vaccine, or from other factors, has not been established. Perhaps it cannot be conclusively established. But the very fact that the parents of one of the girls believes that her problems arose after she was administered the vaccine suggests that it is an issue that has to be investigated further.

Of course, there is little doubt that cervical cancer is an important health risk that millions of women face. A quarter of all deaths due to cervical cancer worldwide occur in India. The infection can lie dormant in a woman for 20 to 40 years before it manifests itself as cancer. Hence the belief that if young girls, before they become sexually active, are administered a vaccine, they might be able to avoid getting infected by HPV and thereby lower their risk of getting cervical cancer.

The first HPV vaccine came into the market in 2006 in the United States. After trials, it was declared safe for use in young women, and men. While it provided women cover against cancer and genital warts, it protected men from genital warts. However, once you were infected with HPV — of which there are at least 15 strains that can cause cancer while the vaccine protects you against only two — the vaccine was of no use. Also its efficacy in the long run has not yet been tested because the infection takes such a long time before it shows up as cancer. So young girls who have received the vaccine in the last years would have to be followed for that length of time before we can be completely sure that the vaccine actually works. Meanwhile, the best protection against cervical cancer remains regular checks — with or without the vaccine — to catch any early signs of the cancer.

So what then is the basis of the opposition to the project being conducted in Andhra Pradesh?

SAMA, a Delhi-based women's health group, has done a detailed study of the problem in Andhra Pradesh. Its members have spent time speaking to the girls who received the vaccine, to their teachers, to the health workers, to the parents and the district authorities.

What emerges is a disturbing tale of young tribal girls who are not necessarily in the best of health in the first place, given their background of poverty and under-nourishment, being given this vaccine. The information provided to them is in English, which neither they, nor their parents, nor the health worker giving them the vaccine, can read. Even the exact age of many of these girls is not certain as births are not regularly registered in large swathes of this country. Hence how were these girls chosen for the project? Were they informed about adverse health impact and were these monitored and treated? And did they really give “informed consent” to be a part of the project when they could not read the literature? In fact, many of the girls did not know the meaning of the word “cancer” or “cervix” or even “uterus”. So did they know what they were being given and why? It would appear not.

Of course, the company providing the vaccine does not deny contra-indications. Its website states: “The side effects include pain, swelling, itching, bruising, and redness at the injection site, headache, fever, nausea, dizziness, vomiting, and fainting. Fainting can happen after getting GARDASIL. Sometimes people who faint can fall and hurt themselves. For this reason, your health care professional may ask you to sit or lie down for 15 minutes after you get GARDASIL. Some people who faint might shake or become stiff. This may require evaluation or treatment by your health care professional.”

But how do you deal with all this when the girls live in a tribal hostel, or in areas where the health facilities are abysmal? In the case of 13-year-old Sarita, who is one of the four girls suspected to have died from complications connected to the vaccine, by the time her parents managed to go to the nearest big hospital in Bhadrachalam, she was dead. This is what they said to the team from SAMA:

“Our child was active and happy. We lost our child, and we know the pain and the agony of that loss. We don't want any other child to die. We don't want any other parent to suffer. Care should be taken for other children who received vaccination. Even though some girls are suffering from side effects like severe stomach pain, teachers are not letting them go home… We want the government to take immediate action. This is our only appeal. This is why we are speaking out.”

Exposing vulnerability

Fortunately, this appeal has been heard and for the moment the project has been suspended. But it has brought into focus once again, the dangers of exposing poor women, in particular, to this kind of medical experimentation. By all means, efforts should be made to try out a new technology. But not at the cost of the health of the woman. And certainly not on the basis of exploiting her ignorance. What is more important? Women's health or promoting a new vaccine? If it is the former, then there is much more that can be done at a fraction of the cost — starting with ensuring that primary health centres have gynaecologists available at all times. Women in this country urgently need basic health care and nutrition, not necessarily advanced medical interventions whose efficacy has yet to be proven.

(To read the original, click on the link above)