Building trust, breaking myths: How sehat aapas helped health officials win over Nizammudin basti

New Delhi: Just over a month ago, when the Tablighi Jamaat markaz in Nizammudin basti emerged as a Covid-19 hotspot, the Delhi police took the Jamaatis to quarantine centres after cordoning off the basti and declaring it a containment zone. But the Delhi government health officials had a challenging task at hand –– to know who among the over 13,000 residents of the basti had been infected, and more importantly, who could convince them about coming out in the open about their symptoms, if they had any.

It was then that the Delhi government health officials and World Health Organization roped in a trusted group of 40 health workers –– all female residents of the basti, fondly called Sehat aapas who work with the Aga Khan Foundation, and are funded by the Tata Trust, to gain the confidence of the basti residents, and get them to agree to declare their health conditions and travel histories.

These women went to each of the 1,700 families in the basti, and also facilitated 150 COVID-19 tests in the last few days, for those with severe symptoms.

No resident was detected Covid-19 positive for a month. However, three days ago, a female resident with co-morbidities passed away here and was detected to be COVID-19 positive.

"Results of her second test are pending. It is strange because she was unwell and confined to her house," a resident of the basti said.

Nizammudin basti was among the first places in the city the health officials wanted to check for community transmission, given its proximity to the Markaz.

Like they do during any other health crisis, they wanted the residents to declare the travel history, symptoms of cough and fever, and if they had come in touch with a Covid-19 patient.

The women associated with the community health programme in the basti maintain a health register of every family here, and help with important interventions such as pregnancies, menstrual health, child nutrition, and track morbidities in every household.


The basti was mapped into eight clusters –– ten full-time women, the sehat aapas, who were given three to four assistants, sehat sahelis, and a cluster each. Two bigger clusters were divided into two. On March 30, the door-to-door screening of the basti residents began.

Jyotsna Lall, director (programmes), Aga Khan Trust for Culture (AKTC), told ET that the women were selected because of the “rapport they shared with the community” and had a willingness to learn.

“We called over 60 women for training sessions, and observed them.

Among them, the best was a 70 -year-woman who couldn’t join us because she fractured her leg. ...The rest went to 1,852 houses in two days, explaining to people what this was all about. It is easier for people to believe when someone from their own socio-economic background tells them what to do.”

This exercise met some hurdles as on the first day, it provoked some unrest in some areas of the basti where people refused to share details with the officials, citing the data collection exercise as a “threat to their citizenship”. The foundation heads had to call Arshad Madani, the leader of the influential Jamiat-e-Ulema here, to convince people to allow the work to be carried out.

For Safina Ansari (33), a sehat aapa since the past seven years, and also mother of four, going out for this exercise was more challenging as relatives and even some family members had warned her against it.

“My sister-in-law said I should not visit their house if I am exposing myself to such risk. But basti ko badnaami se bachaana tha (we had to protect the basti’s reputation). And, I thought it is something I can do.”

In December and January, the basti had witnessed prolonged anti-CAA and NRC protests, and was reeling under deep unrest following the media coverage of the Tablighi Jamaat incident.

“There was deep anxiety and hurt. But we did not force anyone to give out details. In fact, a woman told me the first day that I as a Muslim should not be doing this to other Muslims, but she rang me up the next day saying she was ready to talk about it,” Safina said.

According to Safina, three of the large clusters were closest to the dargah. “Dildar nagar, nizam nagar and Khusrao nagar have a significant number of migrants living in them in cramped spaces. The dargah receives many pilgrims every day. There are lodges and kothis where people work.. it was important to reach out to them and get details. The familiarity really helped as I have been here all my life.”

The women point out that though not even one resident was infected with Covid-19, the basti was sealed as a hotspot. Mehrunisha said there was anxiety in people when the exercise began, and a lot of anger that all exit points had been sealed, and there was problem in even procuring basic essentials. “Plus, there was police everywhere. What helped was that we took a very genial approach, mindful of all that had happened here. We could cover 500 houses the first day. People were more willing to talk to us after that."

Shabnam Roohi, a single mother of a twelve-year old, also a sehat aapa said when she went to screen people in mohalla which had mostly houses of maulanas, it was the women of the house who came out and supported their efforts. “The maulanas were not convinced with what we were doing..But the wives made them understand..”

For almost eight years now, the sehat aapas have been giving training programmes for women in different age groups in the basti telling women about menstrual hygiene, and the importance of both, pre and post natal care.

“We used to find a lot of women were restricted from taking baths for a month after birth, infants would be fed honey and water,and sometimes even biscuits. The infants were only given the BCG vaccine, and nothing else..We slowly started working with senior women of the basti too, as they had more power to make decisions in the household,” Mehrunissa said.

“In fact, men would earlier be very dismissive of us, as to why we are talking to women about periods, but now they come to the clinic, ask for condoms themselves,” Roohi said, adding that the immunisisation was only 30% but now, it is 70%, and the institutional deliveries have gone up to 90%.

Ratish Nanda, who heads the Aga Khan Trust for Culture, said “the fallout of the Tablighi Jamaat Covid breakout – the hatred focussed at Nizamuddin Basti was shocking and hurtful for most residents”.

“It was obviously not clear to many that the Tablighi Jamaat has no relationship with the Dargah. In-fact their belief system is on opposing poles from the sufi traditions of the Dargah. Over six weeks after the Tablighi Jamaat event, there is still not a single case reported in the basti – though two families were suspected and quarantined -they later tested negative," Nanda said.