Coronavirus: 인도의 가장 큰 빈민촌,Dharavi에 퍼지고있는 Covid-19방역전쟁, S.Africa의 Soweto는 무사할까?

드디어 터지고 말았다. 이재앙을 어떻게 해결해야 할까? 인도의 가장큰 도시 Mumbai시의 서쪽에 자리하고있는 Dharavi지역의 빈민촌에서 Coronavirus Pandemic이 발생, 인도를 비롯한 전세계를 발칵 뒤집어 놓고있지만, 정확한 방역대책이 세워질수가 없어,  당국자들을 더욱 방황케 하고 있다는 뉴스는 충격이다.

인도의 Mumbai의 대도시의 서쪽편에 있는, 한번 들어가면 찾아나올수없는 미로의 빈민가, Dharavi에 거주하는 56세의 한남자가, 지난 3월 23일, 의사를 찾아 진찰을 받았었다. 그는 몸에서 열이나고 기침이 심해서 의사를 찾은 것이다.

옷장사로 생계를 이어가던 이남자는 2.5 평방킬로미터의, 즉 1 평방마일보다 적은, 더러운 빈민촌에 500,000만명이상이 엉겨붙어 거주하는곳의 주민이었었다. 영국의 Manchester시의 거주인구보다 많은 사람들이, 버킹엄 왕궁앞에 있는 Hyde 공원과  Kensington공원보다 적은 공간에서 살고있다고 상상해 보면 이해가 될것 같다. 이주거촌이 얼마나 많은 사람들이 엉켜사는가를....
이빈민가는 Oscar상을 획득한 "Slumdog Millionaire"영화를 제작하게하는 영감을 준곳이기도하다. 세계각나라의 도시계획을 하는 Engineer들은 어떻게 해서 지역사회를 이루고 경제가 잘돌아가는지를 연구하는 모델이기도 하다. 

진찰을 마친 의사는 그환자에게 심한감기약과 해열진통제 처방전을 발급해 주었었다.  3일후에 다시 그는 집에서 가까운, 규모가 더큰 개인병원, Sion 병원을 찾았다.  그는 고열에 심한기침으로 상태는 더악화되고 있었다. 그의 설명에 따르면, 여행한적도 없었다고 했다. 그래서 의사는 더 농도가 짙은 감기약을 처방해주고 집으로 보냈었다.

3월 29일, 그환자는 숨쉬기 어려운 상태에서 다시 병원을 찾았었다. 의사는 그를 진찰후 Covid-19확진여부를 진찰하기위해 채취한 샘플을 실험실에 보냈다.  그로부터 3일후에 시험결과가 나왔는데, 양성판정이었다. 그의 상태는 계속 악화되여, 의사들은 Covid-19환자들을 치료하고있는 더 큰 병원으로 옮겼었다.  그러나 그의 상태는 치료받기에는 너무도 늦어 결국 그날 저녁에 사망하고 말았다.

사망한 옷장사는 Dharavi 빈민촌에서는 첫번째 환자였었다. 물고기의 아가미처럼 다닥다닥 붙어 살아가는 주민들은, 인구밀도가 가장높은, Mumbai시의 고통거리인 설사병과 말라리아  질병이 수시로 발생하는 곳에 인접해 살아가고있는것이다.

그러나 개인간의 거리유지가 지켜질수없는 이런 빈민촌에서 간격유지를 바라는것은 사치스러운 말장난으로밖에 여겨질수없는것이다. Coronavirus가 쉽게 번질수있는 이런곳은 금새 공중묘지로 변할수있는 악조건이기에 이도시의 주민건강관리 시스템에 큰 경종이다.  이방역대책을 세우고 치료하기에 바쁜 담당자들의 고충을 실질적으로 이해할수있는 사람들은 없다고 해도 과언은 아닐것 같다.

Dharavi의 빈민가에서 첫번째 환자로 알려졌던 그남자는 여덟명이 함께 살고 있었다. 즉 그의 부인, 4명의 딸 그리고 2명의 아들이, 빈민가의 다세대 주택의 420 스퀘어피트의 좁은 한칸 방에서 살고있었다.

"가족들에게 근황을 물었을때, 사망한 아버지는 최근에 다른곳에 여행간적도 없었고, 그지역에 있는 모스크에 간적이 있었을 뿐이다."라고 이지역을 담당하고 있는 부책임자, Kiran Dighavkar,씨가 설명한게 다였었다.  그러나 그얘기속에는 좀 헷갈리는게 있었다.


사망한 그남자는 같은 지역에 같은 사이즈의 방이 또하나 있었다. 그곳에서 그는 Delhi에서 방문한 5명을 이곳에 머물게했었다. 그방문자들은 지난 3월에 Tablighi Jamaat가 주최한 종교행사에 참석하기위해 Dharavi에 왔었던 것이다. 이종교행사에는 인도네시아, 말레이시아 그리고 미국에서온 사람들을 포함하여 8개국에서 신도들이 모였었다.

이런 참담한 Coronavirus Pandemic을 보면서, Dharavi와 삶의 조건이 거의 비슷한 남아공의 수도 요하네스버그에서 가까운곳에 있는 Soweto빈민지역이 번뜩 머리에 떠올랐다. 외형적으로 보는 그빈민촌의 모습이 너무도 똑같다고 느껴졌기 때문이다. 2019년도 3월초에 S.Africa전국 Tour를 하면서  Ghetto지역인 Soweto를 탐방했었다.제발 그동네에는 Coronavirus Pandemic이 침범하지 않았기를 바래는 마음이다.

https://lifemeansgo.blogspot.com/2019/03/s-africa-victoria-falls-adventure-tour4.html

On 23 March, a 56-year-old man living in a vast, labyrinthine slum in the western Indian city of Mumbai went to see a doctor. He was feeling feverish and had a bad cough.

The garment trader lived in Dharavi where more than half-a-million people are spread over 2.5 grubby sq km, which is less than a square mile. (Imagine a population larger than Manchester living in an area smaller than Hyde Park and Kensington Gardens.) The slum was the inspiration for the Oscar-winning Slumdog Millionaire film and city planners from all over the world have studied its throbbing economy and society.
The local doctor examined the man and he left with a prescription for cough syrup and paracetamol. Three days later, the man turned up at the private Sion Hospital close to home. His fever had climbed and the cough was getting worse. He said he had no travel history, so doctors gave him more cough syrup and sent him home once again.
On 29 March, the man returned to the hospital with signs of respiratory distress. Doctors admitted him, and promptly sent swabs for the Covid-19 test.
Three days later, the results arrived - he had tested positive. His condition deteriorated sharply and doctors tried to move him to a bigger hospital already treating Covid-19 patients.

It was too late: he died that evening.
That garment trader was the first Covid-19 patient from Dharavi. People living in this packed-to-the gills slum city suffer from all the common diseases afflicting Mumbai, one of the world's most densely-populated cities, from diarrhoea to malaria.
But an outbreak of coronavirus in a place where social distancing is an oxymoron could easily turn into a grave public health emergency and overwhelm the city's stretched public health system.
Nobody realises this more than the officials racing to track and contain the infection.
Patient No 1 of Dharavi lived with his eight-member family - his wife, four daughters, and two sons - in a poky 420 sq ft one-room apartment in a low-rise slum tenement ringed by squalid shanties.
"When we asked his family, they told us the man had no recent travel history and only went to the local mosque," Kiran Dighavkar, an assistant municipal commissioner in charge of the area, told me.
But there was a twist in the tale.
The man owned another apartment in the same complex. There he hosted five people who had reportedly arrived from Delhi after attending a conference in early March organised by Tablighi Jamaat, a religious movement that has followers in more than eight countries including Indonesia, Malaysia and the US.

Hundreds of people who attended the religious event in the capital set off several Covid-19 clusters across the country and are now linked to some 650 cases across 14 states.
The police believe the five men lived in the Dharavi apartment for two days - between 19 and 21 March- before they left for Kerala. "We are trying to trace these people," said Mr Dighavkar.

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"We have to find out the source of infection. How did this man get the infection and from whom? And we have to contain this infection by taking aggressive steps," he said.
The family of the deceased trader insists he didn't have a passport, something that the police are sceptical of. So they are trying to dig out his mobile phone records to find out more about his movements.
For the moment, the race is to ensure that the infection is contained. So 308 apartments and 80 shops in nine six-storey buildings in the complex where the trader lived have been completely sealed. Some 2,500 residents have been put under home quarantine. Food rations are being supplied. Health workers have disinfected the apartments with household bleach. Swabs of eight 'high-risk' occupants of the building - the trader's family and an acquaintance in the building - were sent for testing.
More than 130 residents above the age of 60 and another 35 who are suffering from unrelated respiratory diseases are being closely watched for Covid 19 symptoms.

Fearing an outbreak, authorities have taken over the 50-bed Sion Hospital, and quickly set up a 300-bed quarantine facility in a neighbouring sports complex. Protective gear has been given to doctors and nurses at the hospital.
Yet all this may not be enough to prevent an outbreak.
On Thursday, a 35-year-old doctor working with a private hospital and living in the slum tested positive for the virus. Municipality workers scrambled to isolate and seal 300 people living in the doctor's building. They have also identified 13 high-risk contacts in the building and sent their swabs for testing. The doctor told officials that two nurses in his hospital had tested positive for the virus. And at the weekend, a 30-year-old woman inside the same building complex as the trader, a 60-year-old man, who owns a metal fabrication shop and a 21-year-old male lab technician, tested positive.
"We are still able to try to contain the infection of the gated slum colonies. But there are the slums outside, and if we get cases there, we can't isolate them at home, and have to send even the high-risk cases to the sports complex quarantine centre," says Mr Dighavkar.
If that happens, the struggle to contain the infection will turn into a messy battle. The local hospital and makeshift quarantine will be easily overrun by cases.

Testing will have to be stepped up and results will have to arrive in time. After the first two cases - the trader and the doctor - 21 samples were collected from the slum. After more than 48 hours, the results of only seven have come in. The state-run hospital where the testing is being done says it is swamped by samples. Another 23 samples were picked up after the two new cases and sent to the lab on Saturday. It is not clear when the results will arrive.
"We are losing time because of the delay in results. It also delays shifting people who test positive into isolation," Virendra Mohite, the medical officer, who is leading the health teams in the slum, told me.
These are some of the real challenges to contain a massive outbreak of a disease in a unique, otherwise self-contained slum, which is home to fishermen, potters, furniture makers, garment makers, tailors, accountants, waste recyclers and even some of Mumbai's edgiest rappers. Dharavi, writer Annie Zaidi once observed, is a place full of "stories of desperation and grit, initiative and very, very hard work."
Now it faces its most daunting challenge of preventing a cataclysmic wave of contagion.




https://www.bbc.co.uk/news/world-asia-india-52159986