Photos show how one of the world's largest slums defied the odds and contained its coronavirus outbreak

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Photos show how one of the world's largest slums defied the odds and contained its coronavirus outbreak
  • The Dharavi slum in Mumbai, India, identified its first coronavirus cases on April 2. It is one of the world's biggest slums.
  • Onlookers feared that dire sanitation and extremely high population density there would let COVID-19 tear through its 1 million residents, who all live in one square mile.
  • But two months on from the first case, Dharavi has emerged as a success story in India's outbreak.
  • The slum recorded 491 cases in April and 1,216 in May. But thanks to mass testing and an ardent strategy of containment, only 274 cases and six deaths were reported by the third week of June.
  • Scroll down to see how Dharavi did it.
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This is the Dharavi slum in the city of Mumbai, India. It identified its first case of the coronavirus on April 2.

This is the Dharavi slum in the city of Mumbai, India. It identified its first case of the coronavirus on April 2.
The Dharavi slum in Mumbai, as seen in January 2006. Ritesh Uttamchandani/Hindustan Times via Getty Images

It is perhaps best known as the setting for the Oscar-winning film "Slumdog Millionaire."

One million people live in a one-square-mile area, with eight to ten people sharing a room often no bigger than 10 feet by 10 feet. Eighty percent of people there use communal toilets.

One million people live in a one-square-mile area, with eight to ten people sharing a room often no bigger than 10 feet by 10 feet. Eighty percent of people there use communal toilets.
Health workers on their way to conduct temperature and pulse-rate checks in the Dharavi slum on June 25, 2020. Satish Bate/Hindustan Times via Getty Images
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Fearing COVID-19 would tear through the slum, authorities in Mumbai and Maharashtra state enforced mass testing and a strict containment to slow the virus.

Fearing COVID-19 would tear through the slum, authorities in Mumbai and Maharashtra state enforced mass testing and a strict containment to slow the virus.
Thermal screening and pulse tests being carried out at Sant Rohidas Marg in Dharavi, on June 23, 2020. Vijayanand Gupta/Hindustan Times via Getty Images

The virus could "spread like wildfire" and "wreak havoc" in the slum, Babbu Khan, a municipal councillor in Dharavi, said at the time.

"For the slum-dwellers, it is very difficult to stay safe from a coronavirus-infected neighbor in this incredibly congested slum of Dharavi."

Source: The Guardian

Mumbai officials identified Dharavi as one of five danger zones in the city and sent an army of 2,450 health workers to oversee the response in the slum.

Mumbai officials identified Dharavi as one of five danger zones in the city and sent an army of 2,450 health workers to oversee the response in the slum.
A doctor checks the temperatures of local residents at a COVID-19 testing drive inside the Dharavi slum during a nationwide lockdown on May 29, 2020. Pratik Chorge/Hindustan Times via Getty Images

India enforced a nationwide lockdown on March 24 and relaxed some restrictions from early June.

Mosques located inside the slum used their loudspeakers, normally used to broadcast the call to prayer, to warn people to stay inside and be safe.

Source: Los Angeles Times, The Guardian

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So far, it has worked. The slum went from recording 491 cases in April and 1,216 in May to only 274 cases and six deaths as of the third week of June.

So far, it has worked. The slum went from recording 491 cases in April and 1,216 in May to only 274 cases and six deaths as of the third week of June.
A healthcare worker in the Dharavi slum on June 20, 2020. Satish Bate/Hindustan Times via Getty Images

"We can say so far, June is looking good, as the last two months were horrible," said Kiran Dighavkar, a municipal commissioner.

"Now we are are on top of the situation compared to what we were two months ago."

As of June 13, 77 people had died in Dharavi, but only six happened in June.

Source: The Times of India, The Economic Times of India, Bloomberg

Here's how they did it. Medics were proactive in their response: Testing people from 9 a.m. until dusk each day, and documenting the situation in minute detail.

Here's how they did it. Medics were proactive in their response: Testing people from 9 a.m. until dusk each day, and documenting the situation in minute detail.
A doctor takes a swab sample at a COVID-19 testing drive inside the Dharavi slum in Mumbai on April 16, 2020. INDRANIL MUKHERJEE/AFP via Getty Images

"Instead of people reporting it, we started chasing the virus," Dharavi said.

In early April, 47,500 people were tested for the virus in the city's most vulnerable areas. Twenty percent of them tested positive for COVID-19 and were quarantined right away.

"That gave us a head start," Anil Pachanekar, a private doctor and head of a local physicians' association, said. "If [those cases] had slipped through, it would have wreaked havoc."

Medics said that it took some time to convince people in Dharavi to come forward, as they feared repercussions, but once they noticed there was nothing to fear, the public responded very well.

Source: The Los Angeles Times, Bloomberg

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That Dharavi is a dense and bordered entity may have helped medics box in the virus and launch effective testing drives.

That Dharavi is a dense and bordered entity may have helped medics box in the virus and launch effective testing drives.
Police officers in protective suits with a woman in Dharavi on June 18, 2020. Satyabrata Tripathy/Hindustan Times via Getty Images

"It is possible that the compact geography enabled a greater level of coordination than in other places," Ramanan Laxminarayan, founder of the Center for Disease Dynamics, Economics & Policy in Washington, DC, told the Los Angeles Times.

"But it is still too early to declare victory."

Health workers also monitored people through door-to-door tests, mobile vans, and makeshift "fever camps," which made it easier to control the virus.

Health workers also monitored people through door-to-door tests, mobile vans, and makeshift "fever camps," which made it easier to control the virus.
A healthcare worker checks the temperature and pulse rate of a resident in the Dharavi slum on June 25, 2020. Satish Bate/Hindustan Times via Getty Images

At the camps, according to the BBC's Soutik Biswas, "health workers in protective clothing screen up to 80 residents every day."

People showing flu-like symptoms were also given COVID-19 tests on the spot, with those testing positive moved to makeshift quarantine facilities at places like schools, marriage halls, and sports complexes, Biswas reported.

Source: BBC

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The local government in Maharashtra state declared the "defeat" of the coronavirus in Dharavi on Wednesday.

The local government in Maharashtra state declared the "defeat" of the coronavirus in Dharavi on Wednesday.
A man has his temperature checked inside the Dharavi slum on May 29, 2020 in Mumbai, India. Photo by Pratik Chorge/Hindustan Times via Getty Images

However, cases are still trickling in slowly, with 11 new cases found on Thursday.

Source: The Times of India, Press Trust of India, Mumbai Mirror.

As of Thursday, no new deaths have been reported for more than a week.

As of Thursday, no new deaths have been reported for more than a week.
A butcher waits for customers at his meat shop in the Dharavi slum on June 24, 2020. INDRANIL MUKHERJEE/AFP via Getty Images
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