Indian migrant workers at risk of being left out of vaccine drive

New Delhi, India – In the past year, Jagdev Pandey has lived three lives.

Last summer, the 37-year-old migrant worker lived in a one-room rented house in a working-class neighbourhood in the eastern part of India’s capital, New Delhi. He had a stable marketing job with a company manufacturing aluminium foil paper.

In July, during the monsoons, the company shut down due to the COVID-19 pandemic and a nationwide lockdown imposed to check the virus.

Pandey was forced to go back to his village 700km (435 miles) away in the Siddharth Nagar district of Uttar Pradesh, India’s most populous state.

After months of unemployment, he returned to Delhi in the winter only to find himself at a homeless shelter, living off the money he can make by painting walls. He now shares a sleeping hall and a common washroom with 12 strangers.

“My life changed like seasons,” said a masked Pandey, sitting outside the shelter, not far from a rented room he had called home last year. The proximity is a constant reminder of all he dreamed of when he migrated to the city six years ago.

Before this year’s lockdown in Delhi, he was painting walls for about 10 days a month, earning a daily wage of 500 Indian rupees (less than $7).

Pandey feels that migrant workers like him, who travel back and forth – his wife and two children live in the village – and whose livelihoods have been hit by lockdowns should be prioritised for vaccination. But there is one big problem.

“I have no idea where and how to get vaccinated,” he told Al Jazeera.

Experts say many of India’s 140 million migrant workers run the risk of being left out of the ongoing COVID-19 vaccination drive either due to a lack of awareness, want of a targeted strategy, or a severe shortage of doses.

The trend is sharper for adults below 45, the age group that most migrant workers are in. Vaccination for this group started on May 1.

S Irudaya Rajan, chairman of the International Institute of Migration and Development (IIMAD) in Trivandrum, Kerala, said migrant workers were stigmatised as carriers of the disease and their vaccination should be prioritised.

“Migration-prone age group, especially inter-state migrant workers, are mostly less than 30 years. They should be prioritised for vaccination because they are the ones moving and so their risk factor is much more compared to others,” he told Al Jazeera.

Rajan’s observation came against the backdrop of India crossing two grim landmarks. Last week, it became the second country after the United States to record more than 25 million coronavirus cases. On Monday, it became the third country after the US and Brazil to report more than 300,000 virus-related deaths.

Vulnerable, mobile population

On March 24 last year, Indian Prime Minister Narendra Modi announced a nationwide lockdown on four hours notice. Days later, more than 11.4 million migrant workers, rendered jobless overnight, tried to go home, many walking on foot for hundreds of kilometres.

When a deadly second wave of the virus intensified last month, many workers again left big cities, boarding trains and buses as states announced lockdowns. Thousands of workers went home, highlighting the need to vaccinate them in the cities they work in to prevent COVID from travelling back to their hometowns with them.

But the vaccination drive has slowed recently, with many states reporting a severe shortage. India, the world’s largest vaccine maker, has fully vaccinated just over 41.6 million people with both doses, or only 3.8 percent of its nearly 1.35 billion population.

Dr Shri Prakash Kalantri, director and professor of medicine at the Mahatma Gandhi Institute of Medical Sciences in Maharashtra state’s Sevagram, said migrant workers should be vaccinated with priority as their risk of acquiring the infection is “pretty high”, while acknowledging that this would be “challenging” due to limited supplies.

“It is both our moral responsibility and ethical obligation to protect them but how to do so when the vaccine supplies are short. I cannot answer that question,” said Kalantri.

The need to prioritise shots for this transient population is more urgent because of continued lockdowns in a dozen states.

A recent study (PDF) showed that domestic travel bans imposed by the governments of developing countries to control virus spread can be counterproductive, especially in the medium term, as they confine migrant workers to an area where cases are rising, thus increasing their risk of getting infected.

Several other studies have pointed out how the year-long pandemic and repeated lockdowns affected both lives and livelihoods of migrant workers.

Predicting the long-term impact on India’s migratory patterns, a December 2020 report by the International Labour Organization (ILO) observed that the pandemic could increase distress migration from rural to urban areas.

In the queue

While Pandey’s struggles highlight how India’s digital divide and lack of awareness make it almost impossible for migrant workers to access vaccines, there are others, like Sukanta Mandal, who have managed to register but are still unable to get a slot.

Mandal, a power-loom worker in the western state of Gujarat’s Surat city, comes from Gopinathpur village in the Ganjam district of Odisha. Surat and Ganjam are on opposite coasts, 1,600km (995 miles) away from each other.

He registered himself on CoWIN – the federal government’s website keeping track of all vaccinations. For more than three weeks now, he has been checking the website for a vaccine slot.

“But each time, I only see red. It has never been yellow for me.” Red signifies filled up slots while yellow indicates limited availability.

A set of queries sent by Al Jazeera to the federal health ministry seeking comment on vaccinating migrant workers remained unanswered.

Anhad Imaan of Aajeevika Bureau, a non-profit that works for migrant workers, said his organisation observed in the last few weeks that the virus has spread to “households in very remote areas” of Rajasthan, a northwestern state.

“There are so many hurdles to get vaccinated. It is difficult for them to register as most do not have smartphones. Even if they do, they are expected to help others but that is not the viable way of doing this,” said Imaan.

Mandal says he has encouraged and helped his friends in Surat above the age of 45 to get vaccinated but, with rising cases, he is concerned about his safety before taking others to vaccination centres.

Controlling the spread

To put the predicament of Mandal and millions like him into perspective, they are part of the migration corridor between Ganjam and Surat.

Studies estimate that Surat hosts 600,000 to 900,000 migrant workers from Odisha, more than 80 percent of whom are from Ganjam.

In high-mobility migration corridors, and with infections surging in rural areas in the second wave, there are concerns over lack of vaccination among migrant workers in urban hotspots like Surat directly impacting rural source districts like Ganjam.

There are other such corridors, as identified by India’s finance ministry which mapped routes in its 2016-2017 economic survey by analysing railway ticketing data. These included Gorakhpur in Uttar Pradesh to Mumbai and Delhi, and Kutch in Gujarat to Chennai in Tamil Nadu, among others.

Dr DCS Reddy, former head of community medicine at the Institute of Medical Sciences at Banaras Hindu University in Uttar Pradesh, said the migrant workers in Delhi and Mumbai decided to go home at the start of the second wave after what they experienced last year experience.

“They have travelled to areas with low prevalence of the disease which means higher susceptibility of the local population. Some were likely to be infected and could spread the disease unless there is adequate COVID-19 behaviour and healthcare access in place,” Reddy told Al Jazeera.

At the homeless shelter in Delhi where Pandey is staying, workers said they would try to get vaccinated before going home again.

The youngest among them, also one of the most eager to get a vaccine, is Sanjeev Kumar Thakur, a 27-year-old labourer from Muzaffarpur in the eastern state of Bihar.

With a mix of hope and confusion, Thakur announces that the only one among them who could visit home soon is 53-year-old Surendra Kumar Prasad, who got his first vaccine shot on April 2.

“He has got it, I would want it too but I guess it will take a while,” said Thakur.

For the young man, however, the wait for the vaccine could be tied to the wait for a new job. Last year, he risked his life delivering food orders at the peak of the pandemic as most of India’s middle class locked themselves up at home.

He has been jobless for months now and takes up day jobs to sustain himself. “I don’t know what I want more, a job or a vaccine,” he said.