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When Mumbai’s Dharavi, Asia’s biggest slum; reported its first COVID-19 case, the city was in jitters. Home to 1 million people all residing in an area of 2.85 sq. km, Dharavi is one of the most densely populated places in the world. It is well known that the most important measure to contain the pandemic is social distancing. But this is nearly an impossible task in this labyrinth where 7-8 people live in a 100 sq. feet hutment. The whole locality, present at the heart of Mumbai, divided into several crooked roads and narrow paths not wider than 2 metres, sees thousands of people each day. It is impractical for them to be apart from each other.

The crisis in Dharavi began on April 1, when COVID-19 spread its venomous tentacles to this environ. A 56-year-old man succumbed to the virus. Although the virus had taken away 9 lives and infected 181 people in the city as on that date, the virus in transmission in Dharavi meant alarm bells were ringing. It is a very well known fact that if the spread of the virus is not curbed then it would take the lives of lakhs and lakhs of people. Before the curve started to rise exponentially it had to be flattened.

Kiran Dighavkar, assistant commissioner at Mumbai’s municipality, and his team have managed the effort against COVID-19 in Dharavi so well that now Dharavi’s victorious model has turned out to be a paradigm for developing and highly populated countries all across the world. An intellectual and well-determined man, Mr. Dighavkar constituted a group of people who were the frontline warriors in this battle. He believed in working proactively rather than reactively. His strategies were easy yet effective in fighting the pandemic. Once the virus had set its foot in Dharavi, a team of Mahim Dharavi Medical Practitioners Association and members of Indian Medical Association (IMA), together with 25 doctors, patrolled the area for 10 days in the major hotspot areas of Dharavi, testing thousands of residents. The task force began their 360-degree strategy for Dharavi, that of 3Ts – Testing, Tracing and Treating. The door-to-door testing covered nearly 47,500 people in the hotspots. The ones who tested positive were immediately quarantined in facilities. These facilities soon started becoming full, which forced the government authorities to convert schools, colleges, sports complexes, gyms etc into institutions for isolation and treatment. Thousands and thousands of beds were put up. All clinics that had initially been shut once from March, were made to reopen whilst providing the doctors and nurses with personal protective equipment kits (PPE), sanitisers, disinfectants, sufficient masks etc and instilling in them the confidence to work.

In the initial phase, the number of positive cases did rise but not exponentially. Although it seemed to be a bad sign superficially, it simply indicated the fact that more people were being tested, quarantined and isolated. There were also situations where sufficient test kits weren’t available. In the absence of such kits, doctors effectively used oximeters to check oxygen levels. A healthy human being has an oxygen level of 98%-100%. People with oxygen levels lower than the given range were quarantined and isolated until they were tested. Lockdown and social distancing cannot be a norm in Dharavi, so ultimately the main goal was not to reduce the number of positive cases but to limit the number of deaths. Active testing helped doctors reduce the number of people contracting the disease. About 51% of Dharavi residents who tested positive eventually recovered, better than Mumbai’s 41% rate. Fresh infections were down to an average 20 a day from 60 in early May.

In April, it seemed that the disease would cause big problems. But Mr. Dighavkar turned this situation around. Word about the dangers lurking in the streets of Mumbai due to COVID-19 was rapidly shared among the residents. Video clippings were made by social workers and celebrities, to educate people about the virus. People who felt they had symptoms were institutionally quarantined and tested. People volunteered to be quarantined rather than hiding away in fear. Localities were taught to how to fight the virus and how exactly should they lead their life forward.

The government took a lot of steps to ensure the Lockdown was followed. Meals were provided to the residents. Nearly 19,000 lunch packets and 19,000 dinner packets were distributed among people living in hotspots. Several NGOs and others helped the people of Dharavi survive this catastrophe. Unfortunately this outbreak took place during the holy month of Ramadan. People in isolation centres were worried about following rituals. The government ensured that these people received sufficient fruits, dates, and other meals at required times so they would not have to break the rules of the fast. Contact tracing was also one of the strategies implemented. People who came in contact with COVID-19 positive people were immediately quarantined. A concerning issue was the use of public toilets. Approximately 80 people use one toilet. There were people bought in to clean them regularly and undetachable sanitisers were placed. Sanitation improved by leaps and bounds. Each person who tested positive and had used the toilets in one particular area in Dharavi was traced and other residents living in that vicinity using that public toilet were tested as well. As per contact tracing, the pandemic team working round the clock has isolated areas that were identified as high-risk zones and till date, 1.25 lakh people are confined to their homes, with essential services operational.

The third step involved in the strategy is treatment. Dharavi has CCC1, CCC2, and DCHC facilities which are in place and being utilised to isolate and quarantine patients. Several preventive medicines are also being distributed among workers to improve their immunity. These steps have sufficiently reduced the number of cases. Dharavi has proved to the world that the virus can be contained if people and the government work together and adhere to all rules and regulations, regardless of population density. Today, Dharavi is not only recognised for contributing to the GDP of the Indian economy but also for successfully curbing the spread of COVID-19.

By Sai Lakshmi Suresh


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