Future Tense

How Missed Calls Became a COVID Lifeline in Parts of Rural India

Men wearing masks stand in a queue.
Migrant workers wait to get a COVID tests before boarding a bus in New Delhi on Aug. 18. Photo by Prakash Singh/AFP via Getty Images.

Baldeo Paswan, 40, died less than 24 hours after testing positive for COVID-19. In his small home village of Muradpur Bangra, in the east Indian state of Bihar, his wife and children were devastated by his sudden death and did not know how to begin the cremation procedure. Paswan belonged to the historically oppressed caste community called “untouchables,” and lingering prejudice, coupled with the fear of the coronavirus, made it difficult for them to find anyone to help move the body to the crematorium grounds several miles away. And the family members themselves, mostly uneducated, struggled to find support. They reached out to a COVID-19 assistance call center run by the local government, but no one answered or called them back.

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“The family was worried, and they don’t even have a son—only daughters,” their neighbor Harindar Paswan, a bricklayer by profession, told me about the incident that took place on April 30 during the peak of the second COVID wave in India. “No one was willing to even come close to their home.” That’s when Paswan (who is unrelated) gave a “missed call”—the practice of hanging up the call before the receiver picks up—to a service called Mobile Vaani. Within a minute, he had received a call back with an automated menu. He pressed the number 3 on his basic feature phone and left a voice message explaining the family’s predicament. A volunteer on the other end heard the recorded message, called Paswan back, and arranged a vehicle to take the body to the crematorium as well as provide a PPE kit.

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Mobile Vaani is tapping into an old culture of Indians of giving missed calls to their family and friends. Every day, more than 10,000 Indians from the villages within Bihar, Jharkhand, and Madhya Pradesh use their phones to make calls they know won’t be picked up. Mobile Vaani is an intelligent interactive voice response. People dial Mobile Vaani’s number, and the call goes unanswered. Within a minute, Mobile Vaani calls back, giving the person the option to leave a message or listen to promos, hyperlocal news, updates and messages left by others. SOS messages are heard by volunteers and handled depending on the level of urgency.

The benefit here is that in India, people don’t get charged to receive calls. So people only need to have a very small amount of their prepaid minutes to make the initial call, which itself won’t cost them any minutes. It’s also accessible for people who aren’t as literate: Dial a number, hang up, get a call back, press a few digits, and leave a voice message. Another advantage is that the user doesn’t have to wait on hold, something that could prompt them to hang up out of impatience. Mobile Vaani has become a lifeline during the pandemic, particularly in parts of India where internet access and smartphones remain scarce. Think of it as a local radio service or a voice-based social media network that works without the internet.

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Unlike during the first wave of COVID-19 in India, when infections in the rural parts of the country spread at a slower pace, this time Indian villages have been heavily affected at a much faster rate, with half of the country’s COVID infections and deaths coming from rural areas. While urban India turned to Twitter and other social media platforms in April and May to crowdsource resources for COVID-19 aid, rural Indians—many of them without smartphones or internet and facing a weak health infrastructure—didn’t know where to turn to for help during this devastating pandemic. (India has nearly 700 million internet users, but that means almost half of its 1.36 billion population isn’t online.)

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Mobile Vaani was started in 2013 by a social tech enterprise called Gram Vaani, to help rural Indians without the internet stay connected with local updates. During the first wave of the pandemic in 2020, India’s migrant workers used Mobile Vaani’s missed call services to receive help while stranded on highways, after a nationwide lockdown forced them to return to their villages on foot. In mid-April, Mobile Vaani began focusing on COVID-19-related services. Mobile Vaani’s volunteer network is based in the community it serves, which helps build trust and understanding. About 25 moderators listen to the voice messages left by people every day and pass them on to relevant volunteers from an active network of 300 spread across multiple districts in the northern and central parts of India.

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Mobile Vaani has helped people in these villages receive health care, teleconsultation services, and oxygen cylinders. In many cases, its prerecorded messages have helped people get over their fears or doubts. “In villages, people don’t want to accept that they have COVID and don’t even want to get tested,” says Sultan Ahmad, director of media and governance at Mobile Vaani. “So we started giving information—that if you have symptoms of cough and fever, you should immediately get tested. And then many people actually got themselves tested after listening to us because of the awareness created through the voice promos.”

There is also a Mobile Vaani app for the rare user who has a smartphone in these locations. For example, Rakesh Kumar, a public elementary school teacher at a village in Bihar, has a smartphone, but he usually has to go to the rooftop of his place for proper internet connectivity. He’s also been a regular listener of Mobile Vaani for almost a year now. When he was unable to book a vaccine slot through the government’s online booking portal, CoWin, he decided to turn to its services to help book a vaccine slot. It worked. “I wasn’t able to book for my wife and me, so Mobile Vaani was helpful with that,” he says Kumar. They have now been vaccinated.

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Mobile Vaani is also helpful with the vaccine hesitancy that currently plagues rural India, due to misinformation and a low literacy rate. Several people in Bihar—a state that has had almost 9,500 deaths to date—who had scheduled their shots with the help of Mobile Vaani backed out of getting the jab at the last minute. “They were scared they would lose their lives,” says Ahmad. “So our volunteers called them regularly—some four to five times—and explained that they also got vaccinated, had a fever for a day and then they were fine. That helped build trust and they agreed to get the shot.” So far, the team has been able to help 200 people register, of whom about 80 have been inoculated. This number may seem small, but with 60 percent of people in rural areas not knowing how to enroll for vaccination, these numbers are promising.

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Public health experts say that even as local volunteer groups and services such as Mobile Vaani are coming together to help people in India’s rural areas, it shouldn’t be up to them. “Local networks can only have so much reach,” says Sulakshana Nandi, national joint-convener of Jan Swasthya Abhiyan or People’s Health Movement–India. “It’s important for the government to undertake these tasks to have a higher impact. It’s also the government’s duty to provide these services. This includes not only circulating the right information but also providing enough resources and services—from testing facilities and treatment to vaccines.”

More than a month has passed since Paswan’s death. His wife and nine daughters (four of whom are married) continue to mourn his death while also figuring out ways of bringing food to the table, having lost their sole breadwinner to COVID-19. Mobile Vaani volunteers are currently assisting the family in procuring official IDs to be able to claim some of the government benefits they are entitled to.

Future Tense is a partnership of Slate, New America, and Arizona State University that examines emerging technologies, public policy, and society.

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