When a group of villagers in India's West Bengal state recently insisted that they would hold prayers in their local mosque in violation of social distancing rules amid the coronavirus pandemic, Mohammed Nizamuddin sprung into action. It helped that locals trusted Mr Nizamuddin. They called their wiry 54-year-old neighbour "doctor" and visited him for treatment and medicines whenever they fell sick. Except Mr Nizamuddin is not a qualified doctor. He is one of the state's estimated 100,000 informal rural health care providers. These unqualified doctors provide the first line of healthcare in tens of thousands of Indian villages. Often derisively described as "quacks", informal health care providers are typically male and in their forties, having spent a decade or more assisting qualified doctors before starting their own rural clinics. They also outnumber qualified doctors in India's heartland, where health care is spotty. Short of surgical operations - although they give jabs and stitch up wounds - they provide medical care and refer patients, in case they feel they require more care. Some states like West Bengal have taken steps to train thousands of such informal providers. They operate much like the "non-physician clinicians" in Africa - most rural healthcare in Kenya, for example, is delivered by nurses and clinical officers. They are also allowed to prescribe a wide range of medicines. Back in his village in Birbhum district, Mr Nizamuddin dissuaded his neighbours not to hold prayers inside the mosque. "There was a lot of pressure. I explained why it was wrong for public health. They listened and finally decided to hold smaller congregations in a number of open places," Mr Nizamuddin told me.