India’s social inequalities reflected in virus care

NEW DELHI — When Pradeep Kumar’s wife was admitted to a governmentrun hospital in India’s capital for treatment of

COVID-19, it took two days before she was able to see a doctor.

“There are six other women in her room and everyone is frustrated,” he said outside New Delhi’s LNJP Hospital. “They’re behaving like they’re 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 at one set up to handle coronavirus patients, an exhausting process that took hours.

Though India’s leaders have promised coronavirus testing and care for all who need it, regardless of income, treatment options are as stratified and unequal as the country itself. Care ranges from crowded wards at public hospitals that some worry will make them sicker than if they stayed home to spacious suites at private hospitals that only the wealthy can afford.

Under India’s health care system, everyone should be able to receive either free or highly subsidized care at those public hospitals depending on their income. But the system has been chronically underfunded, meaning government hospitals are overburdened and patients often face dayslong waits for even basic treatments.

World Health Organization data show that India’s government spent $63 per person on health care for its

1.3 billion people in 2016. By comparison, China spent

$398 for each of its 1.4 billion people in 2016, according to the WHO.

Though India has managed to halve its poverty rate over the past 15 years, some 176 million people still live on less than $1.90 a day, and experts say the pandemic is shining a spotlight on the country’s vast inequalities in everything from employment rights to health care.

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

With more than 490,000 recorded coronavirus infections nationwide — and the actual numbers believed to be far higher — India’s health care system is facing one of its biggest tests. So far hospitals still have the capacity to handle all of the virus cases — though if that changes there are backup plans that include treating patients in repurposed train carriages.

But shortcomings are also on display.

At RML Hospital in New Delhi, a government-run facility that offers free COVID-19 tests, dozens of people waiting on a recent day to be registered for a test stood in line or lay on metal benches shaded by a green tarp in scorching summer heat. A small indoor emergency triage area had been converted into a crowded waiting room for confirmed COVID-19 cases.

A personal trainer who fears he has the coronavirus, Manoj Kumar was lined up outside another public hospital just waiting to get in. He said he saw some people give the guards money in order to skip the line.

“The rich people get their work done pretty easily,” he said. “People who don’t have money for the guards have to stand in line for multiple hours.”

At New Delhi’s AIIMS Hospital, another public facility, more than 600 staff have been infected with the virus, which union leader Dr. Srinivas Rajkumar T. blamed on poor hygiene and sanitation protocols, including “biohazard handling, reuse of face masks and face shields.”

Private hospitals generally uphold higher standards of care, but most people can’t afford it.

At Max, one of India’s biggest private hospital chains, daily rates for coronavirus treatment range from about $333 for a bed in the general ward to $960 for a bed in the ICU with a ventilator.