Health workers risk their lives
Across the country, doctors, paramedics, nurses, technicians, ASHA workers, ambulance drivers and helpers, and other health workers have been working day and night to take care of patients suspected to have been infected with coronavirus. They have been risking their lives, having had to administer services to possibly infected patients without or with very inadequate personal protective equipment (PPE).
PPE consists of mask, eye shield, shoe cover, gown and gloves. However, according to news reports, shortages are forcing doctors to use raincoats and motorbike helmets, diluted sanitisers and cloth masks instead of the mandated protective equipment. Even in a big metropolis like Mumbai, the resident doctors said they do not have access to N-95 masks, and are forced to reuse the thin two-ply mask for three-four days each. In AIIMS, the premier hospital of the country located in the capital, medical experts are using hand sanitizers and plastic face shields, which they have made themselves, as makeshift PPE while they look after COVID-19 patients.
Even under normal circumstances, doctors and attendants in hospitals are expected to wear masks or goggles or face shields, gloves and coveralls when they attend to patients, both in the interest of maintaining sterile conditions for the patient, the public outside the ICUs and OTs, as well for their own protection. This level of protection is crucial in the context of an infectious virus.
However, in the context of the current pandemic, all government hospitals are facing a dire shortage of PPE and hence doctors and other health workers are obliged to treat and care for patients without protecting themselves. It is reported that in Bihar, 83 junior doctors have developed symptoms of COVID-19, but continue treating patients. Reports from Rajasthan, Karnataka, Uttar Pradesh, Bihar, and Kerala among other states point to doctors and other health professionals testing positive or having exposure to COVID-19 patients.
Besides the lack of PPE, health workers across the country are working long hours without respite. Even in the absence of such epidemics, health workers in India have to work long shifts, sometimes continuously for 36 hours at a stretch and for close to 80 hours a week. India has one of the lowest doctor-population ratios in the world, among the larger economies. The WHO says there should be one doctor for every 1,000 people. According to an estimate, India has shortage of about 6 lakh doctors, tens of thousands of critical-care specialists and some 20 lakh nurses, and an even bigger shortage of supporting medical staff.
In the present conditions of lockdown across the country, health workers have become vulnerable to harassment while commuting to work. There are reports of health workers being beaten up brutally by the police for “breaking the curfew” despite their possessing IDs as evidence of their profession. Further, people in the neighbourhood are fearful of being infected by the health workers and are evicting them from their homes. Some sections of health workers have not been paid their salaries for months.
Across the country, doctors and other health workers are demanding that they be given adequate PPE and protection for secure living and working conditions. They are demanding that they be paid salaries due to them. On 26th March, nursing staff at the Jhansi Medical College in Uttar Pradesh had to boycott work for a day to reiterate their demand for salaries pending since seven months. They resumed work the next day in response to the demand of COVID-19 patients. Doctors at the isolation ward at the medical college hospital had not yet been given PPE kits and hand sanitizers were not being provided either. The staff had been purchasing sanitizer for themselves till it was no longer available in the market. In Uttar Pradesh, drivers of around 4,700 ambulances that mainly serve government hospitals went on strike on 31st March, demanding proper safety gear and health insurance. In a state-run hospital in the city of Rohtak in Haryana, several junior doctors have been declining to treat patients unless they have adequate safety equipment.
There is an urgent need to making PPE available to all health workers who are on the frontline of the battle against this virus. Healthcare needs to be given the priority it requires, which means the care givers must be enabled to lead secure and healthy lives themselves.