Crushing Dissent During India’s Lockdown

Cuba, like every other country on the planet, is struggling with the impact of COVID-19. This small island of 11 million people has created five vaccine candidates and sent its medical workers through the Henry Reeve International Medical Brigade to heal people around the world. Meanwhile, the United States hardens a cruel and illegal blockade of the island, a medieval siege that has been in place for six decades. In April 2020, seven United Nations special rapporteurs wrote an open letter to the United States government about the blockade. “In the pandemic emergency,” they wrote, “the lack of will of the U.S. government to suspend sanctions may lead to a higher risk of such suffering in Cuba and other countries targeted by its sanctions.” The special rapporteurs noted the “risks to the right to life, health and other critical rights of the most vulnerable sections of the Cuban population.”

On July 12, 2021, Cuba’s President Miguel Díaz-Canel told a press conference that Cuba is facing serious shortages of food and medicine. “What is the origin of all these issues?” he asked. The answer, he said, “is the blockade.” If the U.S.-imposed blockade ended, many of the great challenges facing Cuba would lift. Of course, there are other challenges, such as the collapse of the crucial tourism sector due to the pandemic. Both problems—the pandemic and the blockade—have increased the challenges for the Cuban people. The pandemic is a problem that people all over the world now face; the U.S.-imposed blockade is a problem unique to Cuba (as well as about 30 other countries struck by unilateral U.S. sanctions).

Origin of the Protests

On July 11, people in several parts of Cuba—such as San Antonio de los Baños—took to the streets to protest the social crisis. Frustration about the lack of goods in shops and an uptick in COVID-19 infections seemed to motivate the protests. President Díaz-Canel said of the people that most of them are “dissatisfied,” but that their dissatisfaction is fueled by “confusion, misunderstandings, lack of information and the desire to express a particular situation.”

On the morning of July 12, U.S. President Joe Biden hastily put out a statement that reeked of hypocrisy. “We stand with the Cuban people,” Biden said, “and their clarion call for freedom.” If the U.S. government actually cared about the Cuban people, then the Biden administration would at the very least withdraw the 243 unilateral coercive measures implemented by the presidency of Donald Trump before he left office in January 2021; Biden—contrary to his own campaign promises—has not started the process to reverse Trump’s designation of Cuba as a “state sponsor of terrorism.” On March 9, 2021, Biden’s spokesperson Jen Psaki said, “A Cuba policy shift is not currently among President Biden’s top priorities.” Rather, the Trump “maximum pressure” policy intended to overthrow the Cuban government remains intact.

The United States has a six-decade history of trying to overthrow the Cuban government, including using assassinations and invasions as policy. In recent years, the U.S. government has increased its financial support of people inside Cuba and in the Cuban émigré community in Miami, Florida; some of this money comes directly from the National Endowment for Democracy and from USAID. Their mandate is to accelerate any dissatisfaction inside Cuba into a political challenge to the Cuban Revolution.

On June 23, Cuba’s Foreign Minister Bruno Rodríguez said that the Trump “measures remain very much in place.” They shape the “conduct of the current U.S. administration precisely during the months in which Cuba has experienced the highest infection rates, the highest death toll and a higher economic cost associated with the COVID-19 pandemic.”

 

Costs of the Pandemic

On July 12, Alejandro Gil Fernández, Cuba’s minister of economy and planning, told the press about the expenses of the pandemic. In 2020, he said, the government spent $102 million on reagents, medical equipment, protective equipment and other material; in the first half of 2021, the government spent $82 million on these kinds of materials. This is money that Cuba did not anticipate spending—money that it does not have as a consequence of the collapsed tourism sector.

“We have not spared resources to face COVID-19,” Fernández said. Those with COVID-19 are put in hospitals, where their treatment costs the country $180 per day; if the patient needs intensive care, the cost per day is $550. “No one is charged a penny for their treatment,” Fernández reported.

The socialist government in Cuba shoulders the responsibility of medical care and of social insurance. Despite the severe challenges to the economy, the government guarantees salaries, purchases medicines and distributes food as well as electricity and piped water. That is the reason why the government added $2.4 billion to its already considerable debt overhang. In June, Cuba’s Deputy Prime Minister Ricardo Cabrisas Ruíz met with French Minister of Economy and Finance Bruno Le Maire to discuss the economic consequences of the COVID-19 pandemic. France, which manages Cuba’s debt to the public creditors in the Paris Club, led the effort to ameliorate the debt servicing demands on Havana.

Costs of the Blockade

On June 23, 184 countries in the UN General Assembly voted to end the U.S.-imposed blockade on Cuba. During the discussion over the vote, Cuba’s Foreign Minister Rodríguez reported that between April 2019 and December 2020, the government lost $9.1 billion due to the blockade ($436 million per month). “At current prices,” he said, “the accumulated damages in six decades amount to over $147.8 billion, and against the price of gold, it amounts to over $1.3 trillion.”

If the blockade were to be lifted, Cuba would be able to fix its great financial challenges and use the resources to pivot away from its reliance upon tourism. “We stand with the Cuban people,” says Biden; in Havana, the phrase is heard differently, since it sounds like Biden is saying, “We stand on the Cuban people.”

Cuba’s Prime Minister Manuel Marrero Cruz said that those who took to the streets on July 11 “called for foreign intervention and said that the [Cuban] Revolution was falling. They will never enjoy that hope,” he said. In response to those anti-government protests, the streets of Cuba filled with tens of thousands of people who carried Cuban flags and the flags of the Cuban Revolution’s 26th of July Movement. Cruz said, “The people responded and defended the revolution.”

This article was produced by Globetrotter.

Manolo De Los Santos is a researcher and a political activist. For 10 years, he worked in the organization of solidarity and education programs to challenge the United States’ regime of illegal sanctions and blockades. Based out of Cuba for many years, Manolo has worked toward building international networks of people’s movements and organizations. In 2018, he became the founding director of the People’s Forum in New York City, a movement incubator for working-class communities to build unity across historic lines of division at home and abroad. He also collaborates as a researcher with Tricontinental: Institute for Social Research and is a Globetrotter/Peoples Dispatch fellow.

Vijay Prashad is an Indian historian, editor and journalist. He is a writing fellow and chief correspondent at Globetrotter. He is the chief editor of LeftWord Books and the director of Tricontinental: Institute for Social Research. He is a senior non-resident fellow at Chongyang Institute for Financial Studies, Renmin University of China. He has written more than 20 books, including The Darker Nations and The Poorer Nations. His latest book is Washington Bullets, with an introduction by Evo Morales Ayma.

Last month, U.S. Special Presidential Envoy for Climate John Kerry visited India in an effort to bolster the United States’ bilateral and multilateral climate efforts ahead of the 26th Conference of Parties (COP26), which will be held in Glasgow in just a few weeks. Countries that signed the United Nations Framework Convention on Climate Change (UNFCCC) will attend the conference to deliberate as well as negotiate actions needed to combat the climate crisis.

Kerry’s visit to India also marked the launch of Climate Action and Finance Mobilization Dialogue (CAFMD). CAFMD is part of the U.S.-India Agenda 2030 Partnership Indian Prime Minister Narendra Modi and U.S. President Joe Biden announced in April at the Leaders Summit on Climate. The talks took place within the context of India’s membership within an alliance colloquially referred to as “The Quad.” The alliance comprises Australia, Japan, India and the United States, and is aimed at countering a growing China in the Indo-Pacific region.

Soon after Kerry’s visit to India, Quad leaders met at the White House for discussions on a host of issues, including climate change. They agreed to work on climate targets aimed at 2030 and pursue enhanced actions in the 2020s.  

But what tools are available to India—and other developing countries—to support them as they face climate-change impacts like eroding coastlines and droughts? And how will such tools be made available? 

Mobilizing finance is considered key to helping developing countries meet their emission-reduction targets and adapt to climate-change impacts. At COP15 in Copenhagen in 2009, developed countries committed to a goal of jointly mobilizing $100 billion per year by 2020 to address the needs of developing countries.

But while COP15 set a clear target of $100 billion, it allowed flexibility in terms of what forms of financial support qualify as climate finance. The Paris Agreement, the successor to the Copenhagen Accord, reiterated the $100 billion per year commitment, but it also allows a wide range of financial instruments.

Developing Countries’ Perspective

Developed and developing countries have different perspectives on climate finance. Chandra Bhushan, a public policy expert and founder/CEO of International Forum for Environment, Sustainability & Technology (iFOREST), explained when developing countries speak of climate-finance requirements, they largely mean public grants from developed countries. But when developed countries talk about climate finance, they mean “everything from loans to grants to bilateral and multilateral funding,” Bhushan said. 

Bilateral funding refers to financial support from one country to another. Multilateral funding involves agencies such as the World Bank, which derives its source of funding from multiple countries.

India’s official position on climate finance is only grants and grant-equivalent elements of other instruments, like loans and guarantees, ought to be recognized as climate finance. For example, in a recent interview to CarbonCopy, Rajni Ranjan Rashmi, a former principal negotiator for India at the UN climate change negotiations, said it is “logical” to include only the grant portion, or the concessional part, of the loans in the definition of climate finance.

Publicly available information about CAFMD does not reveal what exactly “financial mobilization” would entail. This reporter filed a Right to Information (RTI) request with the Ministry of Environment, Forests and Climate Change (MoEFCC) for minutes of meetings held between Kerry and the ministry. However, the request was denied.

Bhushan also expressed skepticism, noting how pre-COP launches of dialogues, like CAFMD, are not uncommon. But he said their progress is rarely tracked to ascertain achievements.

Unpacking “Finance Mobilization”

In general, “finance mobilization” can happen on both concessional and commercial terms. Arjun Dutt, program lead at Council on Energy, Environment and Water (CEEW) said concessional capital typically is channeled through grants and soft loans to market segments that are not commercially viable to catalyze investment. And as for finance on commercial terms, Dutt noted it typically flows into sectors that have achieved commercial viability and large-scale deployment, such as utility-scale renewable energy.

Elaborating on what India needs, Dutt said if the world wants India to decarbonize at an accelerated pace and commit to net-zero goals, the country “would likely require greater international [climate-finance] flows on both concessional and commercial terms.”

Through financial instruments such as guarantees, concessional capital could help lower the risk of loan defaults with new clean-energy technologies, which could catalyze more private-sector investments, Dutt explained. And as for commercial international capital, it would be needed because of the sheer scale of India’s decarbonization requirements.

Pays to note, in her meeting with Kerry, Indian Minister of Finance and Corporate Affairs Nirmala Sitaraman also underscored a need for enhanced climate finance for developing countries, or funding beyond the $100 billion commitment made at the Copenhagen summit.

Recently, even African nations called for a 10-fold increase to the $100 billion climate finance target.

Climate Finance’s Track Record

Developed countries have largely failed in fulfilling their climate finance obligations, a September 2021 report shows. Out of 23 developed countries that have a responsibility to provide climate finance, only Germany, Norway and Sweden have been paying their fair share of the annual $100 billion goal. More specifically, it states that the United States has the biggest shortfall in paying its fair share of climate finance, based on historical emissions and national income.

And closer examination of delivered climate finance reveals other issues. According to a report by Oxfam, the share of grants in global public climate finance was only 27 percent in 2019, whereas loans—both concessional and otherwise—totaled 71 percent. The remaining 2 percent comprised finance mobilized from private sources. Oxfam referred to this reliance on loans to fulfill climate-finance obligations “an overlooked scandal.”

Recently, a climate negotiator from a developing country, who anonymously wrote for The Guardian, pointed out how climate finance in the form of loans is creating a debt trap for countries in the Global South, where the COVID-19 pandemic has hit economies.

Interest rates on concessional loans are unequal, too. “The rate of interest in developed countries is around 2 percent and in India, it is around 14 percent,” said Bhushan of iFOREST. “So, if the United States gives a loan for 6 percent, will you consider it as a loan given on concessional terms?”

Funding Mitigation Versus Adaptation

Climate finance usually aids two solutions: Mitigation and adaptation. Mitigation refers to efforts aimed at reducing greenhouse-gas emissions like investments in renewable energy technologies or even making existing energy generation more efficient. Adaptation means remodeling and reorganizing society and the physical environment to address risks posed by climate change. Climate adaptation includes enhancing the resilience of coastal communities with nature-based solutions like restoration of mangroves and providing food security with climate-resilient agricultural practices.

Here, too, disparities exist between the needs of developing countries and what the developed world actually delivers.

Little doubt remains that climate change disproportionately impacts the Global South, given pre-existing conditions like food insecurity and lack of adequate healthcare. And so, countries in this region need as much financial support, if not more, for adaptation as they do for undertaking mitigation measures to arrest the global temperature rise. Even the Paris Agreement recognizes developing countries need equal amounts of funding towards mitigation and adaptation. But funding flows largely towards mitigation.

Oxfam points out 66 percent of global public climate finance supported mitigation while only 25 percent went toward adaptation. “Profitability drives the flow of money,” Dutt said, noting how climate finance goes toward mitigation efforts—like enhancing deployment in the renewable energy sector—and not to adaptation. But this is where public finance—or that which is provided by taxpayer money—can flow.

It also is unclear if developing countries have undertaken climate-change impact assessments and drafted clear policies aimed at mitigation, which could then be implemented using international climate financing.

Developing Homegrown Climate Technology

Article 4.5 of the UNFCCC states developed countries have undertaken a commitment to 

“take all practicable steps to promote, facilitate and finance, as appropriate, the transfer of, or access to environmentally sound technologies and knowledge to other Parties, particularly developing country Parties, to enable them to implement the provisions of the Convention.” 

But little clarity is available on what “practicable” entails, what “as appropriate” means and what “environmentally sound technologies” encompass.

More rudimentary questions exist about whether developing countries like India need technology transfers.

“Renewable energy technologies like modules and inverters are produced at a mass scale across the world and even in India. These technologies are well-understood,” Dutt said. The only challenge, Dutt added, is India has not been able to produce renewable-energy equipment at globally competitive rates.

Expressing similar concerns, Bhushan spoke of how technologies like solar photovoltaic (PV) panels have hundreds of parts and algorithms that could have hundreds of intellectual property rights (IPRs). “Many of these IPRs are from developing countries themselves,” he noted. These IPRs are then packaged together and sold to companies to manufacture solar PV modules and panels. “Technology transfer is not like giving a formula to someone to produce a chemical. It is a combination of hundreds of formulas, many owned by Indians themselves,” Bhushan said. “The bottomline is, if you have money, you can buy whatever technology you want.” And so, the issue is not about freeing technology, like with the COVID-19 vaccines.

India has largely handled its own mitigation pathway because the country has access to renewable-energy technologies—both imported and domestically produced. Bhushan said talk of technology transfer is largely rhetoric without substantive demands detailing what exactly developing countries need.

Rishika Pardikar is a freelance journalist in Bangalore, India.

Hasina Hajukhan never imagined that returning to her maternal house would turn into a near-death experience. In April, the 28-year-old was seven months pregnant, and her medical parameters were normal. “I was taking extra care to ensure no complications during childbirth,” she told Toward Freedom.

As is customary in many parts of India, pregnant women return to their parents’ homes to give birth. When Hajukhan first reached her mother’s house in Ganeshwadi village of the western Indian state of Maharashtra, she felt nauseated. “It was April’s final week, and I couldn’t even breathe properly,” she recounted. A heat wave had taken hold. “The climate was the stark opposite of what it was in my husband’s village.” In Ganeshwadi, things kept getting complicated with the rising heat. “Every day, I was breathless and would feel dizzy.”

Using a desk fan at the highest speed didn’t help, as it just circulated more hot air. An air conditioning system was something her family could not afford. The tin sheet roof would get extremely hot. During this crucial time, Hajukhan needed rest. However, she spent most of her day stepping out to gasp for cold air. In May’s final week, things got worse. “I felt as if I was going to die,” she recalled, teary-eyed.

Immediately, her mother dialed Ranjana Gavade, an accredited social health activist (ASHA worker), part of a community of 1 million women healthcare workers appointed for every 1,000 people in India’s villages. ASHAs are responsible for more than 70 healthcare tasks, with a particular focus on maternal and child health.

“I was worried looking at her rapidly deteriorating health and informed my colleagues.” Upon their instructions, Gavade called a government ambulance and swiftly took her to the district hospital, 33 kilometers (20.5 miles) away. Hajukhan gave birth to underweight twins. Her troubles still hadn’t ended when she was discharged after three days. For a month since then, Hajukhan has been trying to ensure her twins gain weight, but all efforts have failed. As a result, they weren’t administered the necessary Bacillus Calmette–Guérin (BCG vaccine used against tuberculosis), Hepatitis B, and Polio vaccines.

The Kolhapur district, where Hajukhan lives, has been reporting recurring floods, heat waves, incessant rainfall, and hailstorms triggered by climate change. She said everything would have been normal had she not returned to her parents’ home to give birth in the heat waves. “My children wouldn’t have had to live such a dangerous life,” she said.

Like in the village of Ganeshwadi, climate change impacts have been delaying children’s immunization schedules throughout India, making them vulnerable to diseases. Research has found that if a child belonged to a district highly vulnerable to climate change, the odds of stunting rose by 32 percent, low weight by 45 percent, anemia by 63 percent and acute malnutrition by 42 percent. An analysis by global nonprofit Save the Children found that, globally, 774 million children are living in poverty and at a high risk of climate-related disasters. Weather disasters ranging from floods to droughts prevent children from obtaining nourishment, causing low weight, and these disasters put a break on children receiving vaccinations on time. Their weakened immune systems, as a result of a lack of proper nourishment in crisis times, make them vulnerable to other diseases. Being sick can halt the necessary immunizations, and these delays have led to a rise in epidemics and diseases.

How Floods Impact Universal Immunization

Snehal Kamble, 24, a resident of Maharashtra’s flood-prone Arjunwad village, remembers the year 2019 in meticulous detail. “A day before the floods, I was preparing to go to my parent’s house.” Five months pregnant, she was looking for iron folic acid tablets. “Instead, all of us went to a flood relief camp,” she recounted. From there, she moved to another relief camp within a few days, as the water rose further. “During this time, I was worried about my house and belongings,” she said. She fell sick and was away from home for 15 days. “Those were the most difficult days of my life,” she shared. Then in January 2020, she gave birth to a boy named Sangarsh, who has often fallen sick. “When I went to my maternal house, he just couldn’t bear the heat there,” she said. The dehydration and spells of fever he experienced affected his immunization schedule. “His Pentavalent vaccine was delayed by several months because of health ailments,” said ASHA worker Shubhangi Kamble (no relation to Snehal), who has been monitoring this child since birth.

Further, his Measles-Rubella vaccine and Vitamin A dose were also delayed, making him vulnerable to diseases. “Vaccines need to be administered on time,” said Sachin Kamble, a nursing officer at the district women’s hospital in Maharashtra’s Osmanabad district. “Otherwise, it affects a child’s immunity, making them more vulnerable to diseases.”

He pointed out how the lack of vaccinations led to 2,692 cases in 2022 in Maharashtra, which reported the highest measles count in India. That was an eight-fold increase from the previous year. During this time, India reported 12,773 cases. India’s National Family Health Survey (NFHS) said only 31.9 percent of children ages 24 months to 35 months had received a second dose of measles-containing vaccine in 2019-21.

Another healthcare worker, Kavita Magdum, from flood-affected Ganeshwadi village, said that children in her surveying area never fell ill so frequently. She started noticing such stark changes only in the past five years. Upon inspecting this, she found, “Stress caused by the changing climate is leading to this.” For instance, Magdum sees that many children aren’t drinking breast milk, which has impacted their medical parameters. These drastic changes reflect in Indian government statistics, as well. During 2015-16, 58.6 percent of children ages 6 months to 59 months (just under 5 years old) were anemic in India. By 2019-20, this number rose to 67.1 percent. In addition, 32 percent of children nationally remain underweight.

After a year-and-a-half, Snehal’s son started getting better, thanks to Shubhangi’s consistent visits, when she monitored every parameter and ensured the best possible treatment by working hours beyond her duty. “Once the vaccination schedule started falling in place, his health, too, began improving,” Shubhangi shared.

Untimely Administration of Vaccines

While climate change is making it difficult for these healthcare workers to complete universal immunization, another challenge is the untimely vaccine administration.

“There are many instances, where vaccines in several villages are just not available,” said Netradipa Patil, leader of more than 3,000 ASHA workers and co-founder of Deep-Maya Foundation, a non-profit that works for women and children. “During such times, it becomes extremely challenging for us healthcare workers to manage everyone.”

Patil has observed that the workload has increased tremendously for all the ASHA workers because of the delay in vaccination. This is because ASHA workers are responsible for immunization, and in case of any discrepancy or error, they are held accountable. Research published in 2016 concluded, “Lack of timely administration of key childhood vaccines, especially DPT3 (the three doses of the Diphtheria, Tetanus and Pertussis vaccine) and MCV (measles-containing vaccine), remains a major challenge in India and likely contributes to the significant burden of vaccine-preventable disease-related morbidity and mortality in children.” Another paper published in 2019 inferred, “The proportion of children with delayed vaccination is high in India.”

In 2021, the World Health Organization found that 25 million children around the world under the age of 1 didn’t receive vaccines, a figure not seen since 2009. “Many children never get the Vitamin A doses on time. These doses are just not available when required,” Patil said, suggesting the Indian government should consult local healthcare workers to arrange vaccination. “We need to reach more and more people, and, currently, looking at the changing climate, we aren’t prepared to do this,” she shared. Patil made simple suggestions like identifying vulnerable children and their locality and monitoring them from the earlier stages, even before the disaster strikes. “Just by proper identification, we can save so many children,” she said.

Rising Undernourishment

Fed up with feeding medications and tonics that didn’t seem to help increase his weight and prevent him from continually falling ill due to the changing weather conditions, Rashi Patil, 23, quit taking her son to the doctor every month after 18 months. “My son just wouldn’t eat anything,” Patil said.

Moreover, the changes in local climatic patterns affected her son’s health, and he often fell sick. Last year, he was hospitalized for a week as his platelets fell and a fever intensified. What followed next were recurring illnesses that delayed his immunization schedule. Because of the fever in March, he wasn’t administered the Pentavalent 1 vaccine (it protects from five life-threatening diseases: Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib [Haemophilus Influenzae Type b]). Her son soon became weak and began recovering only after the vaccine’s administration. All this while, her son struggled with good eating habits. After several trials and errors, Rashi and her husband, Rajkumar, discovered the climate affected their son’s health and eating habits.

“Now, their son makes it a point to eat only outside the house, where he gets some cold air,” says Rashi. “Contrastingly, this was never the case with my elder daughter.”

Toward Freedom reached out to Ganeshwadi’s community health officer, Dr. Prajakta Gurav, regarding what steps her team was taking to deal with delayed immunization. Gurav hasn’t replied as of press time.

The impact of poor diets is more obvious at the national level. For instance, just 11.3 percent of children between the ages of 6 months and 23 months receive an adequate diet. Plus, in 2022, India ranked 107 out of 121 countries on the global hunger index. These numbers further reveal how climate change is exacerbating the existing faultlines.

The problem is not restricted to India. Of the countries at severe risk of being adversely affected by climate change, the report by Save the Children says, “Burundi has the highest rate of stunted children (54 percent), followed by Niger (47 percent), Yemen (46 percent), Papua New Guinea (43 percent), Mozambique (42 percent) and Madagascar (42 percent).”

Research published in PLOS Medicine found that in 22 sub-saharan African countries, drought led to lower chances of completion of BCG (Bacillus Calmette-Guérin), Polio and DPT (diphtheria, tetanus, and pertussis) vaccines. “We took vaccines to the last mile. Now, climate change is eroding progress.”

For Komal Kamble, 30, vaccinating her 2-year-old daughter remains challenging. Her remote mountainous village of Kerle, in Maharashtra’s Kolhapur district, remains inaccessible most of the year.

For the village population of less than 1,100 people, the nearest healthcare facility is 15 kilometers away. Last year, within a week of October rains, the road that connects her village to the nearest hospital was completely under floodwater.

Komal’s daughter couldn’t get proper medical care for two days, worsening her health. Her chest was full of cough, and the fever rose, making things difficult for the agrarian Kamble family. This wasn’t restricted to heavy rainfall, though. Since her birth in 2021, Komal has taken her daughter to a private doctor at least 20 times, spending over Rs 15,000 ($182). Last year, she was feverish and wasn’t given the crucial Japanese encephalitis vaccine, a Vitamin A dose and the Measles-Rubella vaccine. This made her vulnerable to more diseases, challenging the Kamble family.

Healthcare worker Shubhangi Kamble from Arjunwad says that instances of children missing their vaccination are rising rapidly. When she went to find out why this was happening in her village, Arjunwad, she saw that children fell sick during floods and heat waves. “This was the time that coincided with their vaccination schedule, and so many couldn’t get the vaccines,” she shared.

However, a delay in vaccination has caused more problems than she had anticipated.

“Almost every day, at least one parent dials me asking where they should get their children hospitalized,” she said.

Now, every rainfall brings a health issue for Komal’s daughter. “I am tired of going to the healthcare center to hear that my daughter is underweight or sick and can’t be given the vaccine,” Komal said, with frustration in her voice.

Meanwhile, with every climate disaster, it will become increasingly difficult for many families to complete the immunization in time. “I’ve been vaccinating children for over a decade, but things never got this difficult. We took vaccines to the last mile. Now, climate change is eroding progress,” said healthcare worker Kavita Magdum.

Sanket Jain is an independent journalist based in the Kolhapur district of the western Indian state of Maharashtra. He was a 2019 People’s Archive of Rural India fellow, for which he documented vanishing art forms in the Indian countryside. He has written for Baffler, Progressive Magazine, Counterpunch, Byline Times, The National, Popula, Media Co-op, Indian Express and several other publications.