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Return migration of labourers in the surge of covid-19 in India: multidimensional vulnerability and public health challenges

MOJ Public Health
SK Singh,1 Nandlal Mishra,2 Aditi2

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Background: The nationwide lockdown imposed in four phases incited by the spread of the COVID in India led simultaneous ramifications, the most rampant of them being the mass exodus of labor migrants to their native places enhancing their multidimensional vulnerability. This paper analyses five dimensions of the vulnerability of the migrant workers returning from high contagion zones in million-plus cities to low-risk rural areas, its contribution to the surge of COVID infections in their native places, and challenges to the public health system.
Data and methods: The SARS-CoV-2 attributable cases and deaths have been taken from the COVID19 India Org website (https://www.covid19india.org/). The total number of COVID cases per lakh population is computed using a district-level projected population as on March 31, 2020. The data on reverse migration has been collated from the Ministry of Railways. It deals with six states having the maximum share of reverse migration in the country. Indicators measuring vulnerability towards preventive practices of COVID at the household level are obtained from the fourth round of Indian DHS.1
Results: There was a sixteen fold increase in clusters of COVID cases once workers employed in the unorganized sectors distressed across the country started reverse migration in May 2020. The increasing number of COVID cases in the rural dominated districts of the migrant-receiving states overburdened their hitherto stressed public health system. States receiving the maximum share of return migrants during the lockdown was Uttar Pradesh, followed by Bihar, Madhya Pradesh, Rajasthan, Odisha, and Jharkhand. The two most unsettling vulnerabilities were their inability to follow social distancing norms and lack of water, soap, or detergent for ensuring hand hygiene. Massive unemployment and disadvantage for the urban economy in terms of shortage of workers were other components of the multidimensional vulnerability of labor migrants engaged in unorganized sectors. 
Conclusions: The spread of awareness among the returnees about precautions, ensuring norms of micro-level social distancing in their households and villages is the need of the hour. Public health’s response to COVID-19 should establish a COVID care center in each of around 700 district hospitals with all necessary infrastructures, including trained human resources, medicines, oxygen ventilators, etc. The governments at the origins and the destinations should ensure mechanisms to protect the migrants against multidimensional vulnerabilities that pose a threat to their entities during socio-economic and health emergencies.


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