Diaspora doctors, professionals launch 'Project Madad' to combat COVID-19 spread in rural India

As the second wave of the COVID-19 pandemic batters rural India, a voluntary group of doctors and professionals from the diaspora in the US and from India has launched a unique initiative that will provide virtual time-sensitive information to healthcare workers in rural areas on treating COVID-19 patients, real-time details on hospital bed availability and counter vaccine misinformation.

Project Madad has been created with a mission that proper education and training of local healthcare workers and Registered Medical Practitioners (RMPs) will be fundamental in controlling COVID-19 spread in rural India.

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The Madad team is initially working with RMPs in rural Telangana and Andhra Pradesh and hopes that its model will be scaled in other areas and assist healthcare workers to recognise COVID-19 symptoms, treat mild cases at homes and provide advice on vaccination, dangers of overmedication, and other best practices.

At a time when medical infrastructure and capacities in urban and rural areas are already on the brink and doctors overwhelmed with increasing caseloads, Project Madad is focused on educating and training RMPs, sharing information in local languages and procuring access to vaccines, basic medical supplies such as masks, oximeters and oxygen concentrators for communities.

When the COVID-19 crisis initially started, we noticed that rural India was not getting attention at all, Project Lead Raja Karthikeya told PTI in an interview.

Karthikeya, who is based in New York, cited the example of Karimnagar in Telangana, where 70-80 percent of infection cases are from rural areas, a trend increasingly seen in other places.

To begin with, the team focused on capacity building for rural healthcare workers, especially RMPs, channelled medical supplies and created social media campaigns and flyers in vernaculars to spread awareness.

Minneapolis-based Dr Subbarao Inampudi, an eminent diagnostic radiology specialist, said, "Our goal is to address the majority of the population living in rural areas. We emphasised to RMPs that 80 percent of people who contract COVID-19 will do well. What you really want to do is decrease panic, take away people's fear and convert fear into carefulness."

Inampudi said a major focus for the team is to educate and counsel the RMPs on how they can prevent mild COVID cases from becoming moderate to severe and what to do when that happens.

That is the key. Simple techniques, not drugs.

With experience in COVID-19 treatment in the US garnered over the past year, we learned a lot, we made mistakes. We're not making those mistakes again. Hopefully, we can share our experiences of what we did, what worked and what didn't, he said.

The RMPs are enthusiastic that somebody is talking to them, Inampudi said.

The team connects with RMPs through the Zoom platform on two designated days and time slots a week, dubbed 'the Madad time', keeping in mind differences in time zones.

The team has connected with RMP associations at the mandal or Tehsil level in Telangana and Andhra Pradesh and so far has interacted with over 150 RMPs through sessions, where any number of healthcare workers can join. For the team, the focal points to reach local populations are RMP associations in the states, veteran medical practitioners through which it then connects with other micro-level networks.

All doctors associated with Madad participate in the interactions together as a team. Since the doctors come from different disciplines such as immunology, gynaecology, and paediatrics, they are able to provide advice on a range of medical issues.

Balaram Reddy, who has a chartered accountancy firm in the UAE and is the India Lead mobilising rural workers for the project, said he is seeing an impact of the project's efforts on the ground with the RMPs getting more confident in helping patients.

The 27-member Madad team has received requests from Uttarakhand and even Nepal. Karthikeya said the project aims to expand to include Sarpanches and Collectors. A hotline will be in place for RMPs to connect to the project's doctors in the US for advice at any time.

Hyderabad-based educationist Devishobha Chandramouli is leading the awareness component, Bengaluru-based consultant Kaivalya Gundu is managing vernacular outreach. The doctors' team includes immunologist Dr Rani Vatti, internal medicine specialist Dr Sailakshmi Tatikunta and palliative care specialist Dr Haritha Rachamallu from California.

The RMPs can act as a bulkhead against COVID-19 spread, Karthikeya said.

RMPs are trusted, they know the medical histories of patients.

They can also help in distributing medical supplies in a targeted manner to ensure appropriate utilisation of limited resources like oximeters.

The team has also developed an app, which will be launched next week, that gives real-time information on hospital bed availability and even identifies routes to get there quickly.

Online features also include live chat through which RMPs will be able to reach out to doctors for questions about treatments and symptoms and get access to necessary guidelines.

Washington-based Dr Rajesh Anumolu, the architect of MadadMaps, said, "Our goal is to provide a one-stop-shop that can get you from identifying to clarifying your misinformation, to hopefully not needing to use this service of finding a hospital. But if that's the last resort, we want to provide you a safe way to get there."

Dr Rewati Tepparti, a Minneapolis-based hospitalist, stressed that the right kind of knowledge needs to be percolated from top-down all the way as this will help combat panic.

That will keep these people out of the hospitals and prevent clogging of the already overburdened healthcare system so that beds are available for patients who genuinely need them," she said.

Karthikeya said the team encourages others to use its model to provide similar assistance in other rural areas.

Please, think about the villages. There's a whole lot of India outside our cities. This is an earnest effort to think about rural healthcare workers who may not be wearing a uniform but who are still out there saving patients.