THE STRAINED FORCES
THE ARMED FORCES STEP UP IN THE WAR AGAINST THE VIRUS, BUT GIVEN THE THREAT OF A HOSTILE BORDER THEY MAY NOT BE ABLE TO SCALE UP FROM PRESENT TASKS
A hostile border hinders the efforts of the armed forces in the battle against Covid
The second wave of Covid hit India this April with a ferocity that led to a surge in infections and overstretched hospital infrastructure. In a matter of days, India turned into the second most affected country, triggering a wave of panic, despondency and high body counts. ‘Our nation is at war,’ as former army chief, Gen. V.P. Malik, described it in an April 18 tweet as the daily death toll surged past 1,300.
In the days that followed, the armed forces were brought in to plug the gaps in medical care and speed up delivery of medical infrastructure. The army has so far set up eight field hospitals with over 5,000 beds in some of the worst affected cities, including the national capital Delhi. It plans to roll out at least six more such field hospitals. Indian Navy warships have brought back ISO containers, oxygen cylinders and concentrators from the GCC (Gulf Cooperation Council) countries and Singapore. The IAF’s transport fleet, including C-17 heavy-lift aircraft that can carry nearly 70 tonnes of cargo, have flown over 400 sorties within the country and abroad, airlifting 5,669 metric tonnes of oxygen containers. (ISO containers are refillable, weigh 3.6 tonnes and can store over 21,000 litres of liquid medical oxygen or the equivalent of two tanker loads.)
The defence ministry’s research wing, the DRDO (Defence Research and Development Organisation), is installing 849 medical oxygen plants in hospitals across the country by July 31. It is also teaming up with pharma major Dr Reddy’s to roll out a drug which could hasten the recovery of Covid-19 patients and cut down oxygen dependency. “This has been declared a war,” Lt Gen. Madhuri Kanitkar, deputy chief of defence staff (medical) and deputy chairman of the Covid-19 crisis committee, told India Today TV on May 3. “In this war with the virus, doctors, healthcare workers, all of us are soldiers.”
As the pandemic devastated the world last year, some of the worst-affected countries turned towards their armed forces, repurposing their skills and equipment to confront a oncein-a-century pandemic. The military is a repository of skilled personnel with the logistic networks and platforms to speedily move large loads. It has a large medical corps which is trained to set up field hospitals completely staffed with doctors and medical assistants in a matter of hours.
The US, the country worst hit, has deployed over 60,000 defence personnel, including 4,400 doctors, nurses and medical personnel, to fight the pandemic (mostly from the National Guard, a reservist formation under its Department of Defense). In France, the military has bolstered civilian response in three areas—healthcare, logistics and protection. Turkey has used the military to set up field hospitals. The UK defence ministry
confirmed this January that their armed forces’ response to Covid-19 was the biggest ever homeland military operation in peacetime with more than 5,000 personnel involved. None of these countries, however, live with the kind of live security threats on their borders faced by the Indian armed forces. Last May, just two months after India went into a nationwide lockdown, the Chinese PLA (People’s Liberation Army) mobilised two divisions along the Line of Actual Control (LAC), leading to a nine-month standoff punctuated by a violent clash on June 15 in Galwan Valley, the first such incident along the Chinese border in 45 years. The PLA and the Indian Army mutually disengaged from areas north and south of the Pangong Lake on February 10, areas where troops, tanks and artillery were within sight of each other. A smaller number of PLA soldiers, however, continue to remain at the Gogra Post and Hot Springs, two areas north of Pangong Tso. In the past few months, the PLA has rapidly built up infrastructure and bases along the LAC in Xinjiang and Tibet, demonstrating their intention to permanently base troops close to the undemarcated boundary.
LAST YEAR, THE ARMED FORCES participated with gusto in mobilising resources, aircraft, manpower and field hospitals to combat the first wave of Covid. In the first week of May, there were much publicised flypasts by military helicopters showering petals on hospital staffers and health workers in Indian cities. This time around, with additional troops strung along the LAC and the PLA having sown the seeds of mistrust, there is considerably less enthusiasm to deploy additional resources in the fight against Covid.
“The vision at the highest level (of government) is for us to do everything that is possible (in the fight against Covid)… while maintaining operational preparedness,” a senior army official told india today. The army says it is stretched thin by the need to be ready for any eventuality on its two-and-a-half fronts—the Line of Control (LoC) with Pakistan and the LAC with China and counter-insurgency commitments in Jammu and Kashmir and the Northeast.
These commitments will impact the deployment of the most crucial life-saving assets a military can rapidly roll out— field hospitals. These 45-bed medical facilities with an operation theatre can be set up virtually overnight. Each has a team of 10 doctors and 150 staff and usually provides secondary care to troops wounded in conflict. A field hospital performs life-saving surgeries and treatments on them before sending them to a tertiary care centre. These facilities are also set up in remote areas where there is no possibility of speedy medical attention for soldiers. Each infantry division—around 12,000 soldiers—has two field hospitals and the army has around 100 such temporary hospitals. The deployment of two additional infantry divisions in the Ladakh theatre since last year has meant additional field hospitals have had to be set up in areas where no medical facilities exist. This is the anticipated ‘battle-surge’ which military medicos warn against disturbing because it is a capability which cannot be built overnight. The Army Medical Corps, which provides medical service to serving and retired military personnel, is around 70,000 strong. This includes some 10,000 doctors, 750 dental surgeons, 7,000 nurses and 40,000 paramedics, medical assistants and battlefield nursing assistants. Military-medical experts warn against overexploiting these resources and being dragged into extended ‘aid to civil authority’ commitments. “Sometimes you cannot tap the army beyond a certain level, especially when you have an exploitable situation like China on your borders. Our hospital strength is to cater for war, not for peace time,” says Lt Gen. (Dr) Velu Nair, former director general military services (DGMS), army. On May 3, Delhi deputy chief minister Manish Sisodia had requested defence minister Rajnath Singh for the army’s assistance in creating ‘10,000 oxygenated non-ICU beds and 1,000 ICU beds along with oxygen supply’. The military heaved a sigh of relief when the Centre told the Delhi High Court on May 6 that it could not ask the army to set up more field hospitals in the national capital. Military hospitals are already dealing with a surge in cases of families of serving personnel and veterans and have little spare capacity. To bridge the acute shortage of trained medical staff, the defence ministry has stepped in to add over 600 armed forces medical services doctors into service. It is also rehiring 400 recently retired doctors on 11-month tenures and extending the term of 238 short service commissioned doctors until year-end. Retired armed forces doctors are also on the eSanjeevani portal, a health ministry telemedicine platform, for online consultation.
WEAPON OF FIRST RESORT
Military analysts urge caution, stressing that the armed forces are a weapon of last resort, not the state’s tool of first recourse and say it should be used only as an interim measure. “Governments need not be criticised for employing the military’s multiple organisational skills as early responders as a stopgap measure until administrative gaps are suitably overcome,” says Lt Gen. Syed Ata Hasnain, ex-military secretary and now member, National Disaster Management Agency (NDMA).
“To marshal national resources on a war footing, the government should have activated the emergency laws such as the NDMA Act, Civil Defence Act, the Union War book, Defence of India Act, Epidemic Diseases Act etc. that authorises the mustering of not just doctors, paramedics and civil defence volunteers but also transportation, buildings
DEFENCE EXPERTS WARN AGAINST OVEREXPLOITING THE ARMY’S MEDICAL RESOURCES IN ‘CIVIL AUTHORITY’ COMMITMENTS “WHEN YOU HAVE AN EXPLOITABLE SITUATION LIKE CHINA ON YOUR BORDERS”
and other essential services and facilities. They would have also placed restrictions on the general public in the national interest. Sadly, these were not drawn upon in a crisis of this scale,” says Col. D.P.K. Pillay (retired), research fellow at the Manohar Parrikar Institute for Defence Studies and Analyses (MP-IDSA). This is possibly an outcome of there being no pandemic planning within the government. The NDMA was set up after the 2004 tsunami to coordinate efforts to deal with a single incident like a flood, cyclone or gas leakage—and not for events such as a pandemic. The National Health Policy of 2017 does not even mention the possibility of an epidemic.
Experts say the military could be used more effectively in creating mechanisms to tackle future waves of the pandemic or other such cataclysmic events which call for multiple arms of the government to coordinate relief and response.
Such a framework could create policy guidelines for integrating ministries like home, PMO, surface transport and civil aviation to coordinate strategies for everything, including moving people and relief material across the country. The once-in-a-century crisis could become an opportunity for building structures to tackle other such nationwide health emergencies without excessively relying on the armed forces. ■