The traditional Tamil treatise, Thirukkural, written over 2,000 years ago had defined a nations’ characteristics, “Pini inmai Selvam Vilaivinbam Emam, aniyenba Nattirkiv vainthu,” implying that, “the important elements that constitute a nation are: being disease free; wealth; high productivity; harmonious living and strong defence.” The nation is facing the gravest of national security crisis, the pandemic, with the second wave of the COVID-19 pandemic from March 2021 causing unprecedented devastation in India. The national health infrastructure is stretched to near-breaking point with very large shortages to combat the disease.
By Rakesh Sharma
The societal pain and anguish is gross and intense. In exactitude, prediction on the course this pandemic will take, is not feasible, with diverse forecasts and prognostications that the positive cases and death cases will double, or the curve will commence the drop within a fortnight, or that there would be a third wave later this year. The worst case scenarios in this national security crisis will have to be taken with all seriousness!
In the CLAWS Journal (Spring 2019), Gen VP Malik had stated that “despite the raising of disaster management organisations and forces, the armed forces are acknowledged as the most dependable rescue and relief organisation in such circumstances. They are effectively the nation’s chief rescue and relief forces. The people of India, the most important element in our nation, have looked at them (Armed Forces) as secular, positive and impartial. The armed forces are proud of this achievement and image, and I am certain that they will carry this spirit in the future too”. The Armed Forces are instruments of national power and have essential responsibility in national security.
The armed forces have their inherent strengths, hard-earned respect and faith of the peoples of India, and an unmatched pan-India presence. Being incessantly in crisis/ war-like situations, crisis-management systemic is well-honed, the organisational capabilities are immense, and the command and control is well charted out for the entire country, and have an efficient well-tested operational logistical supply chain and understanding. The decision-support systems for current and prospective operations are fine-tuned and practised. This is then the testing time for the armed forces to stand-up to their prime responsibility – well-being of the peoples of the nation. The medical set-up of the Armed Forces has already been dovetailed in the national effort towards pandemic amelioration, including establishment of ‘jumbo’ hospitals in many stations in the country. Additionally, transportation effort available with the Indian Air Force and Indian Navy has been put to intensive use, nationally and internationally.
Indeed, there is a serious situation on the borders with China since May 2020. In the current scenario case when India is stretched with the pandemic beyond compare, for China to take abnormal territorial advantage by aggression will greatly challenge its attempts to acquire a global status, and make it even a pariah nation. In any case, with the trust deficit on the LAC, the borders have forces deployed and prepared for eventualities. The armed forces in peace stations and in the hinterland are available and must contribute to this national cause and calamitous situation. There are three pathways that are immediately executable.
Firstly, the Army needs to establish National Crisis Command and Response Centre (NCCRC –name is immaterial and can be changed), based upon the operational-rooms infrastructure of Corps/ Divisional HQ, with specifically tailored and dedicated communication and data-links infrastructure. The NCCRC, manned 24×7, in addition to being main nerve centre, should have co-located, medical advisory centre, operational logistics centre, vaccination and testing centre, foreign aid receipt, distribution and despatch centre and information centre. All major, functional ministries should be represented at decision-making level, and take responsibilities. The location, in Delhi, should be sterilised, the staff duly vaccinated and regularly checked. Gradually, as the need arises the NCCRC can be further expanded. The staff for manning of computers and the communication infrastructure with decision-support software, collation of data management, and projection screens can be established the Corps of Signals/ experts from IN and IAF. Indeed expertise can be sought form Software-making specialist companies and educational institutions. Transparency, speed and precision of action, knowledge and innovation are mandatory to allay fears and panic, and to portray that we are on top of the crisis. Pandemic Information Dissemination, through briefings, press releases, social media, and the like will greatly facilitate to curb rumour-mongering.
Simultaneously, nation-wide armed forces formations like Area/Sub Area HQ/ units must establish immediately, in 15 States and 150 Districts maximally affected by positive cases and deaths, State and District Crisis Command and Response Centres, co-located with State and District Administrative Headquarters. There would be a requirement of specific last-mile delivery centres at States and Districts, like in/out patient treatment centre dealing with Hospitals and home-care patients. The data-base available with the States and Districts will have to be cleaned and reformatted into a singular national format, on one software and should be seamlessly available to all. This may take some time, but will be immensely helpful in retrieving information for effective decision-making at various levels. Decision makers at all echelons will hence have accurate, timely and credible information at their beck and call. Means to process, display and evaluate data for situational awareness will be the aid for decision support. Capabilities to transmit orders and decisions and follow up on implementation will be essential for pandemic management.
The pandemic is strongly entrenched in urban areas and is fast spreading to rural areas. The infection in now stated as aerosolised, hence the number of states and districts will have to be expanded gradually. The Crisis Response Centres must not be equated to call-centres or helplines, which also must be established separately by states and districts to dynamically respond to queries and needs of the citizenry. The Crisis Centres must have data of reserves and resources available country-wide like mobile field hospitals (tented mode with the Army) or CHCs, to be moved and deployed as situation develops. A clear cut charter of dynamic resource allocations contingent on the gravity of regional and locational pandemic pressures is a must, for National and State Crisis Response Centres.
Secondly, there are obvious serious flaws in logistical management of the resources where needy hospitals are not getting the required resources in time and in quantity. The Armed Forces have experts in logistics who, on daily basis manage projections, procurement, transportation and delivery, and with turn-around time envisaged create a continuous seamless supply-chain in most difficult terrains. Simultaneously there are experts who work the projections, who can plan for a surge or third wave and establish the systemic for creating locational reserves and future procurements.
This requires the current needs and future projections made by medical experts, epidemiologists, modellers and statisticians, to convert the same into quantities required, with time lines and locations. A detailed data base will be required of all medical establishments handling Covid-19, their holding of oxygen-supported beds and ICUs, their daily off-take of oxygen based on clear criteria, internal generation capabilities and projections for the need for increase as anticipated. To this must be amalgamated, requirements of home-care patients – which themselves are increasing sharply, and the sharp increase as evident in rural environments. Many States and cities administrations (like BMC in Mumbai) have already chalked out much of this data. It is the question of intelligent forecasting, knowledge of daily demand, need maintaining of regional reserves for a surge, transportation-management, and in-built dynamism in process that will take the country on top of the Pandemic.
It is stated that the country has credible oxygen-manufacturing capacities. The major ones should have Army liaison personnel placed in situ and linked with National Logistical Control Centre in Delhi. Based upon tailored software, oxygen-supply should be allocated nation-wide from the closest production centres, and transported by all available modes – rail, road, and air. A cycle of continuous delivery needs to be established. All transportation must be based upon GPS, controlled by checkpoints and any glitches in move be immediately rectified. There is also need for being transparent to the nation and all concerned, like the hospitals, etc on the registered data base, to be informed date wise, the supplier, details of Army liaison at the production centre, the mode of transport and expected time of arrival. This must be automated, and should not rely on nodal officers collating information and then sending requests to Central Government.
Once a complete database is available, new oxygen plants should be established in needy areas and very large hospital facilities, to a plan. Similar consideration must be done for critical medicines/ drugs and health care equipment, as necessary. At dire places with limited facilities, armed forces field hospitals can be deployed or local Community Health Centres (CHCs) converted into field hospitals for vaccinations and critical care.
Third, there are critical shortages of Medical staff – nurses, doctors, paramedics and medical waste-disposal organisation. Some very valid suggestions of increasing this work-force on war-footing, by enlisting fourth year students and the like with a long term view anticipating the third wave later this year, have already been put into effect. In the interim recall of retired Armed Forces Medical Corps (AMC) personnel, and tasking them to closest hospitals – military or civil, or CHCs is an excellent idea, and the AMC Records must push the envelope in contacting them.
There is also the issue of vaccination and testing, both which are critical to the operation. Though there is seeming shortage of vaccines currently, it is likely that the supply chain will get invigorated soon. It is apparent that vaccines have to reach doorsteps, in colonies and societies, small towns and villages. The armed forces can assist in vaccinating the population at large in distant far flung areas, and in villages using re-trained Battle field nursing assistants (BFNAs). This will relieve much wanted nursing staff for ward and patient management Vaccination campaign has to be on war-path, to protect the lives of the peoples of the country. Naturally, the armed forces personnel have to take due precautions to protect themselves too while discharging the newer responsibility.
The pandemic is a national calamity, a national security challenge that has not witnessed in life, and which is having far-reaching implications. As armed forces get involved nation-wide from districts to states, from production facilities to manufacturing plants, from oxygen-trains to oxygen-convoys, in construction of infrastructure including oxygen plants, the nation will feel relieved and the panic and fear will subside. There will also be serious check on leakages, and corrupt practices that are taking toll on gullible population. The well-being of the peoples of India is today the prime national focus and of utmost importance. Armed forces have the capacities to vigourously facilitate it.
This article first appeared in www.vifindia.org and it belongs to them. The author is a research associate with VIF.