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Everybody Counts

When India’s underfunded and fragmented healthcare system failed its informal workers during COVID-19, SEWA’s decades of community investment proved that member-centered care saves lives.

Installation

Everybody Counts

When India’s underfunded and fragmented healthcare system failed its informal workers during COVID-19, SEWA’s decades of community investment proved that member-centered care saves lives.

Historical Context
Do we not always find the diseases of the populace traceable to defects in society?
Rudolf Virchow, 1848

Rudolf Virchow (1821–1902) was a German doctor and scientist often called the “father of modern pathology.”

Virchow pushed for public health reforms, believing that preventing disease meant improving living conditions, sanitation, and access to care. He was also a politician and social reformer, unafraid to call out governments when poor social conditions made people sick. His belief that medicine is inherently political remains just as relevant to today’s health crises.
Rudolf Virchow portrait
Rudolf Virchow, known as the “father of modern pathology” and founder of social medicine.

In 2020, India’s health expenditure ranked 179th among all countries, at 2.96 percent of its GDP. Poor infrastructure, lack of accountability, and a fragmented healthcare system with little oversight resulted in gross mismanagement.

The differential access to care in India across class and caste divides could not be obliterated by the Herculean mobilization of oxygen cylinders and the rushed building of new hospitals and intensive care units. Pandemic-related excess mortality rates in India were among the highest in the world, but remain heavily contested by the government to date.

SEWA’s decades-long investments in their communities allowed them to mount a multi-pronged response to protect their members. Their guiding talisman “What do our members need? How will this benefit our members?” ought to be the lodestar that guides health systems everywhere.

Weekly Deaths in India (2020–2022)

This graph shows the weekly reported deaths in India from 2020 to 2022, based on World Health Organization (WHO) data. The chart reveals multiple waves of increased mortality, with a sharp spike in mid-2021 during the second wave of COVID-19.
Weekly deaths in India 2020–2022, WHO data visualization

Health Data & Medical Responsibility

Essential research highlighting the importance of accurate data and responsible healthcare practices during public health emergencies.

Why Every Body Counts — PLOS Global Public Health
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Why Every Body Counts

A critical examination of mortality ascertainment during the COVID-19 pandemic in India, emphasizing how accurate death counting after public health emergencies generates vital knowledge for future preparedness. The authors argue for documenting both direct and indirect deaths to understand the full impact of disasters.

PLOS Global Public Health Satchit Balsari, Caroline Buckee, Jennifer Leaning
Indian Express — Open Letter Against Unwarranted Interventions
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Open Letter: Appeal Against Unwarranted Medical Interventions

Thirty leading doctors issue a collective appeal against the inappropriate use of medications and diagnostic procedures during the pandemic, advocating for evidence-based practices that prioritize patient safety and responsible resource allocation.

The Indian Express 30 Medical Professionals

Health Services Access During Crisis

This visual represents the proportional distribution of SEWA health services accessed by households in India during the COVID-19 pandemic. The data reveals both the reach of community-based healthcare initiatives and the critical gaps that remain.

SEWA Health Services Distribution — 1000 Households

Proportional Distribution of Health Services Access

Visual representation of 1,000 surveyed households and their access to various SEWA health services during the COVID-19 pandemic period.

Key Insights

The distribution reveals a multi-layered approach: basic protective equipment reached three-quarters of households, while more specialized services like telemedicine and counselling reached roughly one-third. The gradient shows both the effectiveness of peer-to-peer distribution and the challenges of scaling specialized interventions to remote and marginalized communities.

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