Ailing villagers struggle to access treatment

WEAKENED by fever and gasping for breath, 47-year-old Vinod Kumar died in an ambulance more than 60km from his home in India’s eastern Bihar state, far from the big cities at the centre of the nation’s devastating Covid19 crisis.

His death last week followed a frantic journey and dozens of phone calls by desperate relatives in search of a hospital bed and oxygen supplies, as a nationwide surge in coronavirus cases exposes the limitations of health facilities in the countryside.

“We admitted him where we found a bed. It was a nursing home but wasn’t functioning like one. Patients were getting their own oxygen,” said Kameshwar Kumar, Vinod’s brother.

“The hospital was rationing its oxygen supply to patients and my brother was sinking so we were forced to rush him to another hospital but he didn’t make it,” Kumar said, crying as he spoke.

India’s Covid-19 crisis has been most acute in the capital, New Delhi, among other cities, but in rural areas – home to nearly 70% of India’s 1.3 billion people – limited public health care is posing particular challenges.

Ill-equipped hospitals, staff shortages and long journeys to dedicated Covid-19 wards are making it harder for village patients to access treatment as a second wave pushed India’s total coronavirus cases to more than 20 million this week.

Less extensive testing and public awareness about the disease’s symptoms, especially in the countryside, mean the actual number of infections could be five to 10 times higher than reported, medical experts say.

“The situation has become dangerous in villages,” said Suresh Kumar, a field co-ordinator with Manav Sansadhan Evam Mahila Vikas Sansthan, a human rights charity.

In some villages where the charity works in the northern state of Uttar Pradesh, home to about 200 million people, “there are deaths in almost every second house”, he said.

“People are scared and huddled in their homes with fever and cough. The symptoms are all of Covid-19, but with no information available many think it is seasonal flu.”

In the Uttar Pradesh village of Kodai, which lies in Prime Minister Narendra Modi’s constituency, emergency facilities set up during last year’s first wave of infections were dismantled earlier this year when cases dropped. “The quarantine centres set up for returning migrant workers were closed and so are the fever camps,” Vijay Kumar, a village resident, said.

“Returning migrant workers are going home, falling sick and there is no one keeping track.”

Elsewhere, local activists warned that pre-monsoon agriculture activities mean more farm workers are on the move – increasing the in rural districts.

In Bihar’s Bikram district, about 200 000 residents of 15 villages have one primary health-care centre (PHC) equipped for Covid-19 care, with a stock of 12 oxygen cylinders and one ambulance.

As cases multiply from one week to the next, such stocks were woefully inadequate, officials said.

In Patna, Bihar’s capital, nearly 40 of 100 test samples are testing positive and local hospitals are overrun.

“I get calls for beds every day. But where are the beds? Our in-charge of a primary health-care centre died last night in a private nursing home as we couldn’t find him a bed in a proper hospital,” said Krishnakant Singh, who oversees two PHCs in Patna district.

“Just oxygen won’t help, we need ICUs and ventilators. Just breathing has become difficult here,” he said.

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