Did COVID-19 Helplines Help People During Lockdown? Here's an Insider Account

An insider’s account on district-level helplines in Ranchi – what worked and what failed – during the 2020 lockdown.

COVID-19 Helplines: Ad-hoc responses like helplines must be appreciated for working despite constraints, they are most effective in addition to having fundamental systems in place.

Image: Altered by The Quint

In the last two years, amid the COVID-19 pandemic, many of us found ourselves using government helplines like never before. We were familiar with the frustration, anticipation or relief in waiting for a response from them. But what, really goes, on behind the scenes? How are response systems designed, what makes them work? And, in what ways are they inadequate?

Prior to joining my current role as a researcher on health law and policy, I had the opportunity of working in the core pandemic planning and coordination team of the Ranchi district.

In March, I was asked by the then-District Magistrate (DM), Rai Mahimapat Ray, to draft COVID-19 guidelines for the district. I tried my best to make the guidelines as holistic as possible. It was crucial to go beyond preventive restrictions, quarantine, testing, and treatment—to aim for a larger ‘public health’ approach including food security, shelter, and empathetic social support.

Helplines as Part of Responsive Systems

In the weeks and months that followed, our team realised that to ensure proper public access to these measures, it was essential to create open channels of communication between the administration and the people of Ranchi. This was done in two ways – strengthening networks with local civil society organisations (CSOs), working with diverse communities (and ensuring continuity in their work even during the lockdown) and creating multiple helplines, apart from the primary COVID-19 helpline for the district.

Separate helplines were set up for telemedicine, mental health support and domestic violence counselling and assistance. Around the same time, reports from NCRB and different parts of the country suggested that (reported) instances of domestic violence were on the rise. We wanted to ensure that movement restrictions because of the lockdown did not

discourage women from reporting their experiences. India does not have any established emergency helpline to deal with such distress calls in a professional manner. Community spaces such as anganwadi centres, which play a crucial role in creating safe spaces for women, were not accessible during the lockdown. So, the point of the helpline was to create a comfortable space that one could access freely.

Different Lines for Different Needs

Apart from helping survivors register cases through the ‘mahila thana’ and protection officers, the helpline also offered to arrange home visits and counselling, and connect people with lawyers where possible. Since there was no ready team of trained responders, and the helpline also needed to be set up within a day’s time, I decided to contact a student from NUSRL, Ranchi, who put me in touch with a group of senior law students who were experienced in counselling and criminal law. We also connected with NGOs.

During the next two months, separate helplines were created for connecting people in hotspots to testing and ambulance facilities, ration delivery, household support kits, mobile ATM services, non-COVID medical emergencies, etc, and also for accessing basics such as food support, social and legal aid, etc.

A few months into the lockdown, when migrant workers were forced to take it upon themselves to resist state restrictions and return home, we tried to create a network of assistance, including resting areas, shelter homes, and buses plying to neighbouring districts and states. Apart from close coordination within the district, the team had to coordinate with other districts and states to take care of complex paperwork as per frequently changing rules from the Central government. They would then synchronise the operation of fleets of buses according to the requirements of the travellers (up to 2,000 per day).

What Differentiated These Helplines from the Rest?

Over time, the Ranchi administration became known for being extremely responsive, and we started getting calls from many other parts of the country as well. An important aspect of this response mechanism, which seems intuitive but is rarely observed in Indian governance, was the interconnectedness of distinct systems. Many of us have had the experience of going to a police station or government office in distress, only to be told that we haven’t come to the right place – and turned away. We needed to change this.

For instance, a woman from Raipur, Chhattisgarh, who was facing domestic violence and wanted to return to her parents’ home in Ranchi, had called the district's COVID-19 helpline. She was directed to the domestic violence helpline responders, who discussed her concerns and collaborated with the vehicle pass management system to ensure her return to Ranchi. They then continued providing legal counselling to her.

On a more personal front, the unlikeliest factors were sometimes the most influential. I remember a call from a daily wage-earning factory worker in Mumbai on one of the Ranchi helplines. He had been unable to reach any other avenue and requested us to arrange ration support for him and seven other labourers. They were stranded for weeks at a manufacturing unit, gradually running out of food and basic supplies.

When multiple efforts to reach out to the concerned local government and NGOs failed, it was his cell phone caller-tune that kept haunting me. It was a song called ‘Tujhe Yaad Na Meri Aayi’ from Kuch Kuch Hota Hai, which laments the abandonment by a loved one, and the regret of not doing enough in time. Over the next few days, I continued to ask multiple colleagues and volunteers for help. Finally, a colleague was able to reach out to another network of volunteers who ensured that supplies were delivered to him and his friends by the following week.

Faultlines Within Helplines

On paper, district administrations have the authority to take independent decisions during crises, tailored to local concerns. However, the paucity of human resources and lack of dedicated funds make this process complicated. The usual processes for setting up an ‘ideal’ helpline handled by trained professionals, engaging professionals or non-government organisations, or embarking on government projects, are heavily time-consuming. The prescribed procedure under the Disaster Management Act,

2005, is relatively quicker, but the process took a couple of months to be streamlined in practice.

Months of landline bill payments stuck in clogged administrative pipelines meant running to buy SIM cards and basic android phones whenever a new helpline was set up. Involving trained external professionals/organisations was not always feasible. Staff working in offices unconnected to health or emergency response—such as the election office, engineering departments, or other areas—had to be deputed on short notice to many of these helplines. Training on protocol, confidentiality and empathy was non-negotiable but had to be kept brief, and hence, was imperfect.

Working on these helplines helped me understand that they are only linkage and response mechanisms. They are useful in ad hoc assistance, but their effectiveness is curtailed by social inequities and deficiencies in underlying systems.

Partial Accessibility

Despite broadcasting the existence of the helplines through regional media, most of these helplines were used largely by urban callers who could communicate in Hindi or English. The hunger helpline had a 70-75% caller base consisting of women, illustrating the unequal burden on women in most households.

Also, those with greater access to resources were able to utilise the help provided by the helpline in better ways. For example, the survivor who sought help to return to Ranchi from Raipur, was able to do so with more ease because her parents had a car. The accessibility of these helplines was unintentionally limited to certain classes, castes, linguistic groups, and, mostly, urban communities.

Limited Efficacy of Ad-hoc Systems

Helplines can only function as connective tissues, not solve the underlying problems. A domestic violence helpline cannot holistically resolve issues in a largely patriarchal society. This is especially true since during the lockdown, the police had been directed to focus on counselling as opposed to investigation/arrest for domestic violence complaints. In many cases, traditional police counselling involves advising the survivor to “adjust”.

Similarly, a mental health helpline cannot solve the existing mental health crisis, and a migrant worker helpline cannot resolve systemic issues of unemployment. The large female workforce employed in informal or household workspaces found negligible space in migrant movements across the country during the lockdown. The migrant worker helpline was used largely by men – women were seen only as parts of families or larger groups led by men. Many female workers could not take to the streets in the first place due to relatively larger safety and financial risks compared to men.

(Justified) Lack of Faith in the System

Thirdly, the loss of faith of people in the government hindered them from accessing these helplines. A family of migrant labourers walking from Telangana towards West Bengal refused help from the administration – they chose not to rest in a shelter home because they were worried that they would be forced into a 14-day quarantine, and decided that they would prefer walking home. Such mistrust also prevented many women from seeking support from the domestic violence helpline.

Apart from some callers on the hunger helpline, the significant Adivasi population in Ranchi/Jharkhand rarely used any of the mentioned helplines.

Reflections and Learnings

Reflecting on the experience, I’m thankful to my colleagues and all frontline workers who tried to prevent important issues from falling through sarkaari cracks.

On the other hand, I wonder how much more could have been done if the district had more autonomy and control over funds; if every expense decision was not accompanied by months of approvals; if we had a more streamlined system where the Central, state, and local levels of governance had better-defined and coordinated roles; if the same set of people didn’t have to be pulled in a hundred directions to put out daily fires; if we could provide more meaningful training to responders.

It is important to recognise that while ad-hoc responses like helplines must be appreciated for working despite constraints, they are most effective in addition to having fundamental systems in place – and quite powerless without them. We must think about what needs to be done in “normal” times to better equip our systems for times of emergency.

(Shreyashi is a research fellow with the Health team at the Vidhi Centre for Legal Policy, New Delhi. Prior to this, she used to work as Project Officer (Health) in the District Mineral Foundation Trust PMU, Ranchi (Jharkhand) for around two years between 2018 and 2020. Her areas of interest include public health, gender and sexuality, impoverishment, and open science – and their intersections with the law.)