In Part 1, we saw how those who cannot negotiate the digital world are severely handicapped in accessing COVID care. In this concluding part, we examine how the digital divide is impacting the immunisation drive, and explore how it can be bridged.
Experts are equating digital handicap with vaccine hesitancy. They believe the digital divide is mystifying and complicating the vaccination process.
Social technologist Kiran Jonnalagadda observes, “You can combine misinformation and unavailability and create hesitancy out of it. Imagine if you are told that there is no chance getting the vaccination, that slots are full and so on; then I am going to find a way to justify not being vaccinated. That allows me to then assume that somebody else who got vaccinated is a fool because there are so many problems with it; that I am better off not having one.”
That’s precisely what’s happened with Manju, a street vendor, does not want to get vaccinated. Most others he knows are afraid, he says, apparently after one street vendor died the day he got vaccinated.
The digital divide has further lead to panic and insecurity amongst communities, who then have to rely on their employers or relatives for information.
Wait for the free vaccine
A majority of workers, Dalits, Bahujans, and Adivasis, completely rely on public healthcare facilities. A report titled Workers and the Pandemic, released in May 2021 by All India Central Council for Trade Unions (AICCTU) in collaboration with Garment and Textiles Workers Union (GATWU) and Domestic Workers Rights Union (DWRU), states that more than 50% of the workers prefer going to government centers for healthcare. That’s mainly because it is free of cost.
Radha, a domestic worker, echoed this: “I will get vaccinated when the government vaccination drive starts in my area. It will be free.” She is 35 years old and cannot walk in for vaccination. Her only source of information is her relatives and family members. Like most domestic workers, she has no idea about the CoWIN app where she has to register herself.
Some domestic workers on their employers or, in the case of domestic workers, on vaccination drives in the apartment complexes where they work. This dependence passes on accountability to employers, RWAs, and Apartment Associations. Their vaccination is left to the employer’s discretion rather than the State, which is supposed to take responsibility for universal vaccination.
Shashikala, a 36-year-old domestic worker, was registered on CoWIN by her employer. She says, “The domestic workers who are not vaccinated are not being allowed to work. If we want to be allowed inside (homes), we have to take the vaccination now, whether we want to or not.”
Working around the digital divide
While technologists are suggesting more inclusive ways to leverage technology, activists are petitioning against CoWIN. And NGOs are finding ways to plug these gaps in real time.
One example of such an initiative is Haqdarshak, a for-profit social impact enterprise that aims at connecting citizens and MSMEs to welfare and financial schemes created by the government. It ensures last mile service delivery of these schemes to the communities they are designed for, through trained support agents on the ground.
This organisation also created a COVID Resource Center, where it provides support for welfare programs, vaccine registration and insurance coverage. As lack of information has been identified as a major issue, they also have a helpline (+91 886 072 3233) and a WhatsApp chatbot (+91 93073 05995) which provides multilingual support and detailed information.
“We now know that more and more people are going to get infected. This is why we are also pushing for people from the marginalised communities to have access to some sort of healthcare or life cover as they don’t have any private insurance,” says Aniket Doegar, CEO and Co-Founder of Haqdarshak.
Haqdarshak has been receiving a lot of calls on its helpline primarily because Aarogya Setu and CoWIN are English-based and digital-first (Meanwhile, CoWin is about to transform into a multi-lingual platform soon). Aniket points out that the calls are of three types. First, about vaccines. There is a lot of stigma around vaccination in rural areas. People feel like it can lead to infertility because adults are not used to mass immunisation programmes anymore.
Second, those who are interested in getting vaccines but do not know where and how to get it, whether it is free, where the government centers are located, and if any documentation is required. Vaccination requires Aadhar and many people do not have it. These are the bottom 30-40 crore people who will be the last to get these vaccines, says Aniket.
Third, to find slots. Aniket’s team has also received calls regarding government health insurance.
Haqdarshak has been registering people on the ground on CoWIN and helping them find a slot in their locality. They are currently focusing on the 45+ and the 60+ age group because they can still walk-in to public health centers.
While Internet Freedom Foundation has filed a petition asking to make CoWIN non-mandatory, people on the ground have their own ways of navigating through digital exclusion. Technologist and public policy researcher Rohini Lakshané notes, “Those who don’t have access to CoWIN are paying Rs. 50-150 to other people with the skills to just check if an appointment is available. They are doubly disadvantaged; they have to leave what they are doing for a living and go and check the availability of walk-in appointments or pay somebody else to do this for them.”
Lakshane points out that that this happens every time a digital initiative is started. Even in the case of train ticket bookings on the IRCTC website, she says there is a whole industry of middlemen and supporting services because it is so difficult to get tickets online. There are travel agents who will book it and a part of this service is that they will check schedules and availability. They will book tickets in advance and they will sell them ahead. There is a whole industry around digital government services for people who can’t access those directly, Rohini notes.
Aniket cautions: “What we are seeing now is that cases in urban areas are plateauing and those in rural areas are spiking. This will lead to the creation of two Indias.
If there’s will
As an alternative to CoWIN, Kiran suggests a system where one can call a number, go through an IVRS or a human operator, reveal where one is calling from and register. As soon as vaccines are available, the registered person gets an SMS saying that there is a slot available. “Based on how early you register or by a system of lottery, some of us get this notice while others do not ,and you have a certain time period, say an hour, to respond with a Yes or a No. If we don’t respond Yes in that time, somebody else is sent the same message,” Kiran says.
This system also does not require any advanced website and can work for those who have phones that are not smartphones. While this system does exclude those who do not possess phones at all, this is just an example to show that better systems can be imagined and built if enough thought and energy is put into it, notes Kiran.
There was an assurance from Health Minister Harsh Vardhan on May 17 that the CoWIN website will be available in Hindi and other regional languages soon. This announcement, made four months after the first vaccination administration began, is yet to be implemented.