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The world has sent India millions of Covid aid. Why doesn’t it reach those who need it most?

Updated 0948 GMT (1748 HKT) May 5, 2021

When India’s Covid-19 crisis passed its breaking point last month, dozens of countries pledged crucial aid.Last week, plane loads of fans, oxygen supplies and antivirals started arriving, with photos showing huge packages being unloaded at the New Delhi airport.

There’s just one problem: for days, much of the cargo was in airport hangars, while hospitals on the ground argued for more commission. Medical workers and local officials continue to report the same devastating shortages that have been straining the health care system for weeks – raising questions even among foreign donors about where aid is going.

In a newsletter from the US State Department on Friday, a reporter asked where US aid was and demanded “accountability for US taxpayers’ money,” the briefing transcript said. “Is something being done to control how it is distributed, the aid we are sending?” the reporter asked.

A military plane carrying relief supplies from the US arrives in New Delhi, India. The Indian government vigorously denied any delay on Tuesday evening, saying it had installed a “streamlined mechanism” for allocating aid.

Nearly 4 million donated items across 24 categories have already been distributed to 38 healthcare facilities across the country, the health ministry said in a statement.But in the field, many state and local authorities argue that there has been little to no communication from the central government about how and when they would get help.

“We have sent delegations to (the government) for clarification on the supply of (oxygen), drugs and vaccination, but there was no clarity spoken by the Union government,” said Raghu Sharma, health minister of Rajasthan State.

, Tuesday. “Regarding import or foreign aid, no information or delivery details have been shared with the state government.” The central government has “kept states in the dark during the pandemic,” he added, calling for a “more transparent environment.

” The health ministry said on Tuesday it had provided aid to two hospitals in Rajasthan, in the cities of Jodhpur and Jaipur. There are a number of possible reasons for the delay: unnecessary bureaucracy, human error or time-consuming protocol.

But for those on the ground, such possible explanations do little; all they want is for the government to act more quickly and bring the aid to their ICU units, where thousands die every day.

According to the Ministry of Health, India reported 382,315 new cases of coronavirus and 3,780 virus-related deaths on Wednesday. The country has now registered more than 20.6 million cases since the start of the pandemic.

Oxygen shortages are especially pronounced in Delhi’s union territory, which does not produce its own oxygen and relies on the central government to direct allocations from various manufacturers and states.

“It is the government’s duty to provide us with oxygen,” said Dr. S.C.L. Gupta, director of Barra Hospital in the capital New Delhi. At least 12 patients, including a doctor, died in Barra Hospital on Saturday after the oxygen ran out.

Gupta said hospital staff told authorities throughout the day that they had only a few hours of oxygen left; by the end they had to rely on oxygen from the patients’ families. “Patients die before our very eyes,” said Gupta. “I’m sorry we can’t save you.”

A logistical nightmare

A distribution problem highlighted by the Indian media is simply that the government had no protocols before receiving the aid, and needed to quickly merge allocation and coordination guidelines.

It took the government seven days to create a mechanism to distribute supplies to states, the health ministry said in a press release on Tuesday. They started working on the plan on April 26 and did not publish their Standard Operating Procedure (SOP) guidelines for distributing aid until May 2.

The release did not specify the day the aid distribution began. In those seven days, more than 23,000 Indians died from Covid-19.

Relief supplies from Covid from Thailand and the United Arab Emirates will arrive in New Delhi, India on April 29. Even with the SOP issued, the distribution process is complex, with room for further delay.

Once aid arrives in India, it is received by the Indian Red Cross Society, which works closely with the government. The Red Cross is working with Customs to approve the goods, the Health Ministry said, adding that Customs “is working 24 x 7 to expedite and clear the goods upon arrival.

” Once released, the items are handed over to the Ministry and a government-run health product manufacturer called Hello Life Care, who will arrange transportation of aid to its final destination. But it is a huge logistics venture because “the materials from abroad are currently arriving in different numbers, specifications and at different times,” the ministry said in its Tuesday release.

A number of problems could arise, it said: “in many cases” the type or number of relief supplies does not match the inventory provided by the foreign donor.

Authorities must then waste precious time on “reconciliation (discrepancies) at the airport” while aid is idle, the release said. Only when the paperwork has been updated with the correct details can the authorities proceed with the distribution.

Foreign relief supplies will be unloaded from planes at New Delhi Airport, India on April 29. India is a huge country of 1.3 billion people, and most of the foreign aid is flown to New Delhi – meaning much of it has to be redistributed to distant states.

The military has been deployed to assist in this process, with the Air Force flying supplies to various cities as well as overseas flights. States with high caseloads, or those that are regional medical centers, will be prioritized, the Health Department said Tuesday.

Donations are also allocated to states with fewer resources or in remote areas. It’s unclear how much aid is still being processed, but this week images began to emerge of supplies finally arriving on the ground. According to city customs, the Air Force shipped the “first batch” of 450 oxygen bottles from the UK to Chennai on Tuesday.

Meanwhile, 350 oxygen concentrators from Hong Kong will be sent to Mumbai on Wednesday. However, these stocks will only provide a little relief.

As of Tuesday, Chennai had more than 32,000 active cases, while Mumbai had more than 56,000. Hospitals in both cities are so low on resources and the situation is so dire that dozens of patients are dying.

Desperate patients wait for oxygen

While the government is working to get back aid to desperate states, it is also working to increase domestic oxygen production. And again and again, federal authorities claim they have enough supplies to meet the states’ demands.

“The (daily) production of oxygen in the country was 5,700 metric tons (6,283 metric tons) on August 1, 2020, which has now increased to about 9,000 metric tons (9,920 metric tons),” a Ministry of Health spokesman said at a news conference on Monday.

Last month, the ministry said it had 50,000 tons (55,115 metric tons) of oxygen surplus. On Monday, the ministry spokesman claimed again, “There is plenty of oxygen available in the country.”

A military aircraft with emergency assistance arrives from the US in New Delhi, India. But doctors, officials and desperate patients tell a completely different story.

At a hospital in Meerut, a town in Uttar Pradesh, a family has worked around the clock to care for their 55-year-old mother in intensive care. The family told CNN this week that they had been hospitalized for six days before getting a ventilator, and that they had to bring their own oxygen bottle.

At some point her vitality began to decline dangerously; her sons desperately pumped her chest, screaming and clasping her hands while relatives wailed beside the bed. A doctor was able to help stabilize the woman, but later she flattened again.

This time it could not be revived; her body was in the ICU for almost an hour before it was moved. The same scenes take place in almost every major city. In New Delhi, the situation has deteriorated so badly that India’s Supreme Court has ordered the central government to address the oxygen deficiency there by the end of Monday.

Similar hearings have taken place in the Delhi Supreme Court. “Are you saying we close our eyes to the people dying in Delhi?” the court told the central government on Saturday.

As India breaks another global Covid-19 record and hospitals run out of oxygen, countries promise help and aid Some government agencies have also come under fire for tackling the oxygen crisis.

A Supreme Court in Uttar Pradesh demanded “immediate remedial action,” noting specific cases of patients who died from oxygen deficiency.

“The death of Covid patients simply because they are not supplying oxygen to the hospitals is a crime and nothing less than genocide by those entrusted with the task of ensuring the continuous procurement and supply chain of the liquid medical oxygen”, said the court. Tuesday.

The central government has responded by stepping up emergency measures. Two of the five on-site oxygen plants destined for hospitals in Delhi are said to be operational Wednesday, the health ministry said on Twitter.

According to a statement from the ministry, the government plans to set up 500 factories across the country within three months. This week, some of this increased oxygen supply is being sent by rail to several severely affected states in what is called the “oxygen express.

” But until these supplies arrive, either from domestic plants or from foreign donors, patients have no choice but to wait, terrified for their lives.