インドの巨大スラム街に希望の光、積極策でコロナへの勝利目前に

【ムンバイＡＦＰ＝時事】インド・ムンバイにあるアジア最大規模のスラム街ダラビでは、新型コロナウイルスによる初の犠牲者が確認された際、対人距離の確保や接触者の追跡がほぼ不可能だとして、狭く密集した通りが墓場と化すのではないかと多くの人々が懸念した。（写真はインド・ムンバイのスラム街ダラビで、戸別訪問しながらスクリーニング検査を行う医療関係者）
　だがそれから３か月を経て、ダラビには珍しく、希望の光が差し込んでいる。市当局者のキラン・ディガブカール氏によると、「災難を待ち構えるのではなく、ウイルスを追いかける」ことに焦点を当てた積極的な戦略が功を奏し、新規感染者が減少しているという。
　無秩序に広がるこのスラム街は、インド経済の中心都市ムンバイにおける厳しい所得格差を象徴する。推計１００万人の住民たちは、工場で働いたり、裕福な市民の下でメイドや運転手として働いたりしながら辛うじて生計を立てている。
　十数人が一つの部屋で眠るのが当たり前で、数百人が同じ公衆トイレを使う現状の中、標準的な感染対策がほとんど役に立たないことに当局は早々に気付いた。
　「対人距離の確保は実現不可能で、自宅隔離は選択肢になり得ない。しかも、大勢が同じトイレを使う現状では、接触者の追跡はとてつもなく大きな問題だった」と、ディガブカール氏はＡＦＰの取材でそう振り返った。
　戸別訪問でスクリーニング検査を行うという当初の計画は、ムンバイの焼けつくような暑さと湿気の中、防護服を何枚も重ね着し、感染者を探して狭い路地を歩き回る医療関係者が息苦しさを訴えたことから取りやめになった。
　だが感染者が急速に増え、検査を受けた人が５万人に満たない現状を踏まえ、当局は迅速かつ独創的な対応をする必要に迫られた。
　彼らが編み出した方法は、その名も「ミッション・ダラビ」。医療関係者は毎日、スラム街の異なる場所に簡易検査施設を設置し、住民らがスクリーニング検査や、必要ならばウイルス検査を受けられるようにした。
　学校や結婚式場、スポーツ施設は隔離施設として代用され、無料の食事やビタミン剤が提供された他、「ラフターヨガ（笑いヨガ）」のクラスも開催された。
　１２万５０００人が暮らすウイルスのホットスポット（局地的流行地）では、ドローンも駆使して人々の移動を監視し警察に通報するなど、厳格な封鎖措置が取られた。その一方、住民らが空腹とならないよう、大勢のボランティアが食料を配給するなど、迅速な対応に当たった。
　また、ボリウッドスターや経済界の大物らが医療装備の購入用に資金を提供し、建設作業員らはダラビ内の公園に病床数２００の野外病院をあっという間に建設した。
　こうして６月下旬までに、スラム街の人口の半数超がスクリーニング検査を受け、約１万２０００人がウイルス検査を受けた。
　ダラビでこれまでに報告された死者数はわずか８２人で、４５００人超を数えるムンバイ全体の死者数のほんの一部を占めるにすぎない。
　コロナ危機のピーク時に自身の小さな診療所で毎日約１００人の患者を診察していたアブヘイ・タワレ医師（４４）は、「われわれは勝利を目の前にしている。私はとても誇りに思う」と話した。
　２児の父親であるタワレ氏はＡＦＰに対し、４月に新型コロナウイルスに感染して自身も闘病生活を送らなければならなかったが、職場への復帰を「まったく疑っていなかった」と語った。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/07/06-12:24）

When coronavirus claimed its first victim in India's largest slum in April, many feared the disease would turn its narrow, congested streets into a graveyard, with social distancing or contact tracing all but impossible.
But three months on, Mumbai's Dharavi offers a rare glimmer of hope with new infections shrinking, thanks to an aggressive strategy that focused on chasing the virus, instead of waiting for disaster, according to city official Kiran Dighavkar.
The sprawling slum has long been a byword for the financial capital's bitter income disparities -- with Dharavi's estimated one million people scraping a living as factory workers or maids and chauffeurs to Mumbai's well-heeled residents.
With a dozen people typically sleeping in a single room, and hundreds using the same public toilet, authorities realised early that standard practices would be of little use.
Social distancing was never a possibility, home isolation was never an option, and contact tracing was a huge problem with so many people using the same toilet, Dighavkar told AFP.
An initial plan to conduct door-to-door screenings was abandoned after Mumbai's searing heat and humidity left medical workers feeling suffocated under layers of protective equipment as they combed the area's cramped alleys for cases.
But, with infections rising fast and fewer than 50,000 people checked for symptoms, officials needed to move quickly and get creative.
What they came up with was coined Mission Dharavi.
Each day, medical workers set up a fever camp in a different part of the slum, so residents could be screened for symptoms and tested for coronavirus if needed.
Schools, wedding halls and sports complexes were repurposed as quarantine facilities that offered free meals, vitamins and laughter yoga sessions.
Strict containment measures were deployed in virus hotspots that were home to 125,000 people, including the use of drones to monitor their movements and alert police, while a huge army of volunteers swung into action, distributing rations so they didn't go hungry.
Bollywood stars and business tycoons paid for medical equipment as construction workers built a 200-bed field hospital at breakneck speed in a park inside Dharavi.
By late June, more than half the slum's population had been screened for symptoms and around 12,000 tested for coronavirus.
So far Dharavi has reported just 82 deaths -- a fraction of Mumbai's more than 4,500 fatalities.
- 'Brink of victory' -
We are on the brink of victory, I feel very proud, said Abhay Taware, a doctor who saw around 100 patients daily in his tiny clinic at the height of the crisis.
The 44-year-old father-of-two also had to fight his own battle against coronavirus when he contracted the disease in April, but told AFP he had no doubts about returning to work.
I thought I could show my patients that a positive diagnosis does not mean the end, he said.
Although doctors like Taware worked to reassure worried residents, the stigma persists.
After an isolating 25-day spell in hospital and a fortnight in quarantine, Sushil -- not his real name -- said he now feared discrimination if people found out about his diagnosis.
The 24-year-old also struck a note of caution, warning of a potential resurgence in infections.
People need to take as many precautions as possible. The numbers might have come down but they can swiftly rise again, he told AFP.
- 'No escape next time' -
With Mumbai and Delhi struggling to accommodate coronavirus patients as India's cases surge past half a million officials are also wary of celebrating too soon.
It's a war. Everything is dynamic, said Dighavkar.
Right now, we feel like we are on top of the situation, he said.
The challenge will be when factories reopen, he added, referring to the billion-dollar leather and recycling industries run out of Dharavi's cramped tenements.
And some in the slum fear their community might not be as lucky next time.
On a blazing morning, as car salesman Vinod Kamble lined up to have his temperature taken, he recalled his terror when the virus landed in Mumbai.
I felt like Dharavi would be destroyed, and nothing would be left, he told AFP, describing the near impossibility of avoiding infection in the slum.
We need better infrastructure, the 32-year-old said.
Otherwise the next time a disease like this emerges, I don't think Dharavi will be able to escape.