India’s social inequalities were reflected in coronavirus care

India's social inequalities were reflected in coronavirus care

NEW DELHI (AP) – When Pradeep Kumar’s wife was admitted to a government-run hospital in the capital of India for the treatment of COVID-19, it took her two days to see a doctor.

“There are six other women in her room and everyone is frustrated,” he said outside the LNJP hospital in New Delhi. “They act like they are leprosy patients.”

Kumar’s wife had just given birth when she found out she had the virus. She was told she would have to change hospitals and be admitted to one of the institutions to treat coronavirus patients, an exhausting process of waiting in an ambulance until 3am as her husband completed paperwork.

While Indian leaders have promised coronavirus testing and care for everyone who needs it, regardless of income, treatment options are as layered and uneven as the country itself. The care ranges from crowded wards in public hospitals that some will worry if they get sicker than if they stay at home, to spacious suites in private hospitals that only the wealthy can afford.

Under India’s health care system, depending on their income, everyone in those public hospitals should be able to receive free or highly subsidized care. But the system is chronically underfunded, meaning government hospitals are overloaded and patients often have to wait days for even basic treatments.

World Health Organization data shows that the Indian government spent $ 63 per person on health care for its 1.3 billion people in 2016. By comparison, according to the WHO, China spent $ 398 in 2016 on each of its 1.4 billion people.

While India has cut its poverty rate in half over the past 15 years, about 176 million people still live on less than $ 1.90 a day, and experts say the pandemic is the country’s major inequality in everything from labor rights to healthcare, in the spotlight. .

“Epidemics are usually good mirrors of society and the country,” said Pratik Chakrabarti, a professor of science history at the University of Manchester, adding that it “showed how uncertain people’s lives are” in India.

With over 450,000 registered coronavirus infections across the country – and the actual numbers believed to be much higher – the healthcare system in India is facing one of the biggest tests. So far, hospitals still have the capacity to handle all virus cases, but if that changes, there are backup plans that include treating patients in repurposed train wagons.

But there are also shortcomings.

At the RML Hospital in New Delhi, a government-run facility that offers free COVID-19 testing, dozens of people waiting for a recent day to be registered for a test stood in line or lay on metal benches in the shade in a blazing summer heat. A small covered triage room had been converted into a crowded waiting room for confirmed COVID-19 cases.

Manoj Kumar, a personal trainer who fears he has the coronavirus, was queuing outside another public hospital to enter. He said he saw some people give the guards money to skip the line.

“The rich people get their jobs done pretty easily,” he said. “People who don’t have money for the guards have to queue for several hours.”

In another public institution’s AIIMS hospital in New Delhi, more than 600 employees are infected with the virus, which union leader Dr. Blamed Srinivas Rajkumar T. for poor hygiene and sanitation protocols, including “biohazard use, reuse of face masks and face shields”. ‘

Private hospitals generally have higher standards of care, but most people cannot afford it.

At Max, one of the largest private hospital chains in India, daily rates of coronavirus treatment range from about 25,000 rupees ($ 333) for a general ward bed to 72,000 rupees ($ 960) for an intensive care bed. with a fan.

Delhi’s own health minister, Satyendar Jain, reported to a government-run hospital earlier this month after testing positive for COVID-19, but transferred to a Max hospital when his condition became critical.

Other private health care providers sell home care packages for people with mild or moderate symptoms, including about $ 25 per day twice daily remote monitoring by a nurse, drug deliveries, and a guaranteed ambulance if needed.

For those in need of isolation – say a virus patient’s husband – the Delhi government has ordered a large number of hotels to remodel rooms for the job. Room rates, including daily care, cost around 10,000 rupees ($ 132) per night – again, an amount unattainable for most people.

Dr. UK Paul, the head of a governmental committee for medical emergency preparedness, said the perception of private hospitals as better was “over-generalization”.

“Some of our best COVID care facilities are in the public sector,” he said, adding that “it was not possible to meet this challenge” without private hospitals, which have many of the intensive care and ICU beds in India to have.

The dual hospital system has an impact even beyond the corona virus.

Vishnu Singh’s 14-year-old daughter has had a fever and has been unconscious every night for a month. But given the current situation in public hospitals, he wouldn’t dare to take her.

“The public hospitals are full of people with the virus,” he said, “you can get infected if you stand in line.”

Instead, he spent 10,000 rupees ($ 132) – two-thirds of his monthly income as an office manager – to have exams and tests done in private hospitals and labs. It is still not clear what causes his daughter’s illness.

The pandemic has hit the poorest in India the hardest, from the disease itself to the economic and social consequences of a recently lifted nationwide freeze, said Ramanan Laxminarayan, an epidemiologist and economist who leads the Center for Disease Dynamics, Economics and Policy in Washington.

“The closure mainly protected the wealthy because they could afford to stay at home. The poor could not bear the heavy burden of the disease, “he said.” This is simply an extremely unfair situation. ‘

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Associated Press journalists Aniruddha Ghosal, Rishabh R. Jain and Shonal Ganguly contributed to this report. Follow Emily Schmall at twitter.com/emilyschmall

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