To prevent a surge in Covid-19 cases in March 2020, the Central government abruptly locked the country down, limiting the movement of the nation’s 140 crore people. Lakhs of suddenly unemployed construction, migrant and other informal workers – many of whom reside in urban slums – suffered over the ensuing months, both from the pandemic and from its devastating social and economic ripple effects.

The response to this unprecedented health and humanitarian crisis galvanised collaboration between government, non-governmental organisations and the marginalised communities they serve.

The official response to Covid-19 relief was hampered by a long-standing trust deficit between government and NGOs, and between government and slum communities. Yet, governments at national, state and local levels realised that the pandemic could be controlled only if they had the trust and cooperation of communities.

This was critical to ensure last-mile delivery and uptake of disease prevention and treatment information, emergency food and water rations, cash transfers and other essential relief measures. Out of necessity, the government turned to NGOs with strong grassroots organisations and social capital in slum communities.

When Covid-19 struck, these organisations had the knowledge, ability, large volunteer base and support of community groups to bridge the gap between government policy and intentions and the health and subsistence needs of slum residents. Before the pandemic, NGOs often sought government support to scale their programs. The pandemic flipped the script, with government agencies now relying on NGOs for service delivery.

“We are seeing across the country that the distrust between the government and the social sector has definitely declined,” said Vanessa D’Souza, CEO of the Society for Nutrition, Education, and Health Action. “It is not hunky-dory, but the government has realised that there is a big role for NGOs to play.”

Migrant workers line up to get food given by a non-governmental organisation during the nationwide lockdown in Chennai. Photo credit: Arun Sankar/AFP

Partnerships and pandemic

During the 2020 lockdown, government health and public service agencies found themselves overwhelmed with demand and unable to reach people in need, especially in slum communities. Given the urgency and magnitude of the communities’ needs, government agencies asked NGOs for help, said Sushma Shende, a Society for Nutrition, Education and Health Action programme director in Mumbai. “They asked, ‘Do you have any volunteers who can help us with [Covid-19] screening? Or who can help us in conducting awareness activities in the area?’”

The lockdown hit migrant workers particularly hard. One estimate put the number of suddenly unemployed internal migrants who returned to their home states at 1 crore. Jan Sahas, an NGO that works to eliminate sexual violence and forced labour, led the formation of the Migrants Resilience Collaborative in August 2020 to aid millions of disenfranchised migrant workers.

Among its early accomplishments, the collaborative worked with multiple state governments, civil society, and a number of donors to provide aid for more than one million migrant workers across 19 states. It also coordinated government entitlement delivery for upwards of 58,000 workers.

The lockdown also triggered a rise in domestic violence and abuse cases involving children, especially those from poor and marginalised areas. Even before the pandemic, Youth for Unity and Voluntary Action had championed the formation of functional child protection committees in every ward of Mumbai, as mandated by a largely unimplemented 2014 Maharashtra government resolution.

In November 2020, Youth for Unity and Voluntary Action and Bal Adhikar Sangharsh Sangathan, a children’s collective, launched a campaign – My Ward My CPC – to demand the formation of active child protection committees in every ward of the city. The campaign received a significant boost when a key Mumbai government official declared that by the end of 2020, child protection committees should be formed and activated across Greater Mumbai.

Reaching slum communities

To help lakhs thrown out of work to obtain food and pay for basic necessities, the Union government enacted relief measures, including direct cash transfers, free rations of wheat and rice, free gas cylinders for household cooking needs and financial support for construction workers. There was one catch: access to the programs required official documentation that many slum residents could not produce.

To address the problem, the Society for Nutrition, Education, and Health Action began educating community volunteers to help slum residents access the government relief program. Tata Institute of Social Sciences pursued a similar approach.

“People did not know what they were supposed to get,” said Mahesh Kamble, a TISS assistant professor of social sciences. “So even though there were many schemes of public distribution, they were not really effective because people were excluded from the system, the system was not running properly, and people lacked the required documentation.”

A similar dynamic played out in early 2021 when the national government laid out a staged plan to vaccinate adults – but vaccine recipients had to present identity cards in order to receive the shot. Again, NGOs stepped up to assist the government to deliver vaccines to slum residents who lacked ID cards.

When India’s second Covid-19 wave arrived in March, it quickly overwhelmed the country’s health system. In early May, the national government responded with a directive opening the door for people who lacked IDs to get vaccinated. However, overcrowding at several Mumbai vaccination centres prompted the municipal government to suspend walk-in vaccinations; people had to book an appointment online. Now, slum residents faced new barriers to getting the vaccine.

Again, several NGOs stepped forward to help slum residents. For example, Youth for Unity and Voluntary Action set up 12 vaccine help desks to identify those who qualified, answer questions, distribute accurate information to overcome vaccine hesitancy and register people online for shots.

Lessons for future

The pandemic established that NGOs play a critical role in helping government deliver health and humanitarian aid to vulnerable populations, especially over the last mile, as the examples we have documented illustrate. Without NGOs, many government initiatives would not have reached and been adopted by the populations most at risk and in need.

“This was such a big task, one entity cannot handle it alone,” said Shobha Shelar Kadam, a child development project officer in the Women and Child Development department, Suburban Mumbai. “Now we understand each other’s value and work, which represents a mindset change emerging in the government.”

Pritha Venkatachalam is a partner and Head of Market Impact – South Asia, Niloufer Memon a manager and Umang Manchanda is a consultant in The Bridgespan Group’s Mumbai office.