Over the past three months, ever since a medical student in Kerala tested positive to corona virus, the performance of the state in preventing and treating the infections to its citizens has become popular subject of webinars, talk shows, academic articles and media reports, national and globally.

There is no doubt that the people and government of Kerala responded to deal with the growing Covid-19 pandemic in a systematic, planned and effective manner—from screening arrivals at airports to delivering food and medicines to the elderly living alone. It has been successful, so far, in containing the spread and providing medical and welfare relief to its people.

  • Most analysts have highlighted three key principles underlying the Kerala model:
  • Strong and effective local panchayats and urban bodies
  • Widespread network of vibrant community organisations and civil society (like Kudumbsree)

Efficient and accountable health and social welfare departments of the state government

In praising the success of this model, there is a strong message being conveyed that Kerala model should be adopted by other states, especially the ‘BIMARU’ ones. This is an unsustainable and infeasible recommendation for states like Bihar, MP and Uttar Pradesh, right now. Why?

The three features noted above underlying the success of ‘Kerala Model’ have evolved in the society and government of Kerala over a couple of centuries. Kerala has the best social indicators in India continuously since independence. It now has 94% literacy rate, female literacy at above 92%. Nearly all girls complete highschool today, and more than half proceed to post-secondary education. Nearly two hundred years of investment in learning and education in Kerala has provided such outcomes today. The Library Movement began in Kerala in 1829 when first public library opened in Travancore. By 1925, Kerala had a movement in support of public libraries in each city and village, resulting in formation of Kerala Grandshala Sangham in 1945. By 1970s, Kerala had more than 5000 functioning public libraries in the state.

Second feature of Kerala’s efficient social welfare system owes greatly to social reform movements around 1900s when education of lower caste communities and their political emancipation occurred parallely. Land reforms were initiated before independence; workers’ organisations inspired by Marxist leaders raised consciousness of rights and dignity of labour since early 20th century. Investment in public health began in Kerala in mid 19th century when princely state of Travancore invested in creation of western system of medicine and hospitals, to complement strong network of Ayurveda system of indigenous health care already widespread in the region. Vaccination was made compulsory in Kerala in 1879. Since independence, and formation of the state of Kerala in 1956, successive governments, be they led by Congress or Communist parties, invested substantially in public health infrastructure till 1980s. The reader may wonder why most nurses in India and internationally are young women from Kerala? When western hospitals were set up in Kerala in the 19th century, the missionaries gave opportunity to widows and other excluded women to become trained as nurses; the trend has continued since then.

The third feature that distinguishes Kerala model is strong and effective local governments. First democratically elected panchayat took office in Kerala in 1953. Over the next four decades, several rounds of elected panchayats had already functioned in the state when 73rd & 74th constitutional amendments received presidential nod in 1993. Since then, successive governments in Kerala have been devolving substantial local self-governance authority—functions, funds, functionaries—such that most basic services to citizens are provided under the governance and administration of these local bodies in urban and rural areas. Citizens participate actively in Gram Sabha and other local decision-making bodies, and hold elected leaders and appointed officials accountable. Kerala has a vibrant network of community-based civil society organisations and an independent media. People’s Science Movement (KSSP), for example, has been propagating scientific awareness amongst citizens for more than half century.

Therefore, the three sets of features that distinguish Kerala’s response to Covid-19 are rooted in its long history of active citizenship and responsive governance.

In the so-called ‘BIMARU’ states of India, especially Bihar, MP and UP, the social and institutional infrastructure does not have the current capacity to demonstrate these Kerala-type features. These three states comprise of nearly half of the total number of poor households in the country today; nearly 60% of all migrant workers currently walking helplessly on country’s roads come from these states. Female literacy rates in Bihar are lowest in the country and these three states have less than 60% female literacy today. The per capita income in UP is half and in Bihar one-third of the national average today (while that of Kerala is twice the national average). The system and pattern of agricultural land-holding in Bihar shows extreme marginalisation and landlessness, with feudal zamindari culture and exploitation still widespread. Eastern UP has 84% of households with landholdings below one hectare, highest in the country.

The poor governance culture, systems and practices in such states is largely responsible for continued neglect of effective delivery of public health and social welfare services to all citizens in these states. It is not that new investments have not been allotted to these states, but they have failed to utilise them effectively. Danish government supported primary health care programmes in MP and Tamilnadu since 1978; the dramatically different responses of the two states during the current pandemic indicate differential returns from that investment. In early 1990s, US government supported a massive public health programme in UP (called SIFPSA). Result?

The culture of citizenship and governance in UP, MP and Bihar needs to be transformed, no doubt. The principles practiced by Kerala are relevant in these states too. But, the people and leaders of these states have to invent their own models which are rooted in their soils. Citizens of these socio-geographies have to become active, engaged, demanding and supportive for inventing locally appropriate models for effective local governments on their local soils. Associations and coalitions of citizens have to nurture their own variety of social capital; they have to invent & build their own models, if they want to improve the situations in their own communities. The political, economic and social elites of these states have to demonstrate inclusive approaches to the wellbeing of all, and invest in building local institutions which citizens can trust. When the police in UP, MP and Bihar bring food to the homes of the poor during lockdown (as they do in Kerala), instead of beating them when they come out to beg for it, we will know that conditions are emerging for decades of renaissance in UP, MP and Bihar!

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Views expressed above are the author's own.

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