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India, patients are turned away as Covid-19 causes healthcare collapse

India struggles to keep its crumbling healthcare system afloat amid the drastic rise in coronavirus cases, making it the third worst-hit country globally.

India had 200,000 active coronavirus cases on the 2nd of June. It took just over a month to more than triple the figure and reach 700,000 patients in the first week of July.

India in third position for Covid-19 cases

The total positive cases in India stands at over 878,000 including over 300,000 active cases, 23,000 deaths, as well as 550,000 people treated and discharged on as of the 13th of July, according to the Indian Ministry of Health. The massive rise in cases has brought India to the third position globally for number of Covid-19 patients, overtaking Russia and behind only the US and Brazil.

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A doctor examines a patient in an area set aside for possible coronavirus cases in New Delhi, India © Yawar Nazir/Getty Images

The major spike in cases at super speed has led to a harrowing time among India’s citizens as they facing difficulty in getting treatments due to the crumbling of health infrastructure coupled with strict protocols that make it difficult even to dispose of the dead.

Poor ranking in global health chart  

In the 2019 Global Health Security Index, which measures pandemic preparedness of countries based on their ability to handle crises, India ranked 57th, lower than the US in first position, the UK in second, Brazil in 22nd and Italy at 31st, pointing to its higher vulnerability to the pandemic compared to countries that have seen a high number of fatalities so far.

Heart-wrenching reports of patients being turned away from both private and government hospitals seem to have become part of daily life as the pandemic continues to scale new heights, claims corroborated by the relatives of those dying at home due to shortage of hospital beds. This puts the Indian government’s claims of having made adequate arrangements to deal with the invisible enemy in doubt.

In May, when the country was under complete lockdown, the government had asked all states to earmark hospitals only for the treatment of Covid-19 patients and ramp up their capacity to manage the increasing number of cases. Hospitals were sternly instructed not to turn anyone away, including private health ones, which have a major role to play as most of government hospitals suffer from lack of adequate facilities.

The alarming situation, however, has exposed the lacuna behind the supposed preparedness. Health experts say that the government has been caught unaware by the super spread of the virus and the lockdown hardly brought any major changes other than delaying the inevitable.

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A Covid-19 mobile testing van in New Delhi, India © Yawar Nazir/Getty Images

Collapsing health infrastructure

In a fresh instance, a 52-year-old man in southern Indian state of Bengaluru passed away after being refused treatment by 18 hospitals in the last week of June. The patient was experiencing shortness of breath for over a period of 24 hours prior to his death. The tragedy led to a widespread outcry, forcing the government to order a high level inquiry. Yet this is far from being an isolated case.

Indian states like Maharashtra, Gujarat and Delhi, which are facing the severe wrath of the pandemic, are already running out of beds entirely. Worse, videos have gone viral where patients complain of being kept in isolation wards that are unfit for human habitation and sometimes even among dead bodies.

In a recent study, the New Delhi and Washington DC-based Centre for Disease Dynamics, Economics & Policy and Princeton University in the US say the country currently has over 710,000 beds, including 35,000 in intensive care units, as well as a little under 18,000 ventilators for 1.3 billion people.

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Disinfecting an ambulance © Yawar Nazir/Getty Images

Shortage of health staff

The problem aren’t just beds. The severe shortage of health staff is another issue the country has been grappling with for a long time. Health workers complain having been denied wages and protective equipment, as well as being muzzled, persecuted and forced to work overtime. They’ve also been contracting the virus at an alarming rate due to negligence.

In June, hundreds of nurses hailing from northeastern states and who were working in private hospitals in Kolkata in eastern India resigned from their jobs. They complained of having forced to work for longer hours with low wages coupled with allegations of racism, such as being referred to as Chinese because of their similar facial features.

“I’d been living in Kolkata for over 2 years and was working as a nurse in a private hospital,” commented a nurse from Imphal, who preferred to remain anonymous. “We used to work in three shifts but since the pandemic broke out, this was reduced to two shifts. We had to work for twelve hours and without proper PPE kits. Hospital management didn’t increase our pay but deducted our salaries because of the reduction in the number of non-coronavirus related patients being admitted to the hospital. It wasn’t our fault but we were punished despite working extra hours”.

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People’s temperature is checked before entering a Hindu Temple © Yawar Nazir/Getty Images

Healthcare: just one per cent of GDP

There is one doctor for every 11,082 people in India according to the Health Ministry data released in October last year, which is 10 times worse than the World Health Organization (WHO)’s recommendations: the doctor to population ratio should be 1:1,000. In rural areas, this doctor-patient ratio is as low as 1:10,926 as per the National Health Profile 2019. India spends just over 1 per cent of its GDP on public health, ranking 170th out of 188 countries on this count. A Lancet study estimated that 4,300 Indians die every day due to the poor quality of healthcare in non-pandemic times.

“The need of the hour is to train grassroots level health workers to identify the primary symptoms of suspected coronavirus patients and then refer them to the nearest hospital for treatment,” says Doctor Sajal Biswas, general secretary of Indian medics association Service Doctors Forum. “It would ease off a lot of burden from doctors that are already short in numbers. We’ve been repeatedly urging the government to ramp up existing health facilities by increasing the paramedics and doctors at the ground level, but no attention has been paid. Coronavirus has clearly exposed how ill-prepared the health sector is to deal with the virus, which has been on a spree to build fresh records every day”.

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