Delhi’s battle: A day in the life of a dengue ward

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On the ground floor, nurses and doctors have queued up outside the changing rooms near Ward No. 1 and 2, to get ready for their shifts that begin at 2 pm. The guard at the entrance to the wards decides not to wait and slips on his blue uniform shirt in the corridor itself. Inside, both the wards — general fever wards which now take in dengue patients too — are teeming with people, majority of them ‘suspected dengue cases’. Each bed has at least two patients, with relatives and friends crowded around them.

Around 2 pm, the senior resident doctor on the shift rushes to take his place at the main desk at the reception area, where scores of patients are waiting. He first examines a patient who has been complaining of high fever, studies his reports in detail and then calls out to a nurse to take his blood samples. As the anxious patient asks him “Do I have dengue?”, he says flatly, “Lets see”, and moves on to the next patient.

“We cannot invest ourselves emotionally in all cases. The numbers are large, time is limited and every patient is important,” he says, as he attends to the patients. Dr Babasaheb Ambedkar Hospital is only admitting patients with a platelet count of below 50,000.

The hospital has made a number of changes to tackle the rush. The surgery department has been shut, while the casualty department is also handling dengue patients. Beds and doctors from the other departments, even orthopaedics and gynaecology, are being diverted to handle the mass of patients. Of the 200 doctors at the hospital, 50 have been specifically assigned to dengue cases. The other 150 doctors are also being roped in from time to time to attend to the patients.

Yet, nothing seems enough. “Every doctor, every nurse is working beyond his shift, the patients just keep coming, even the private hospitals are referring their patients to us,” says another doctor.

On the fifth floor, in the Emergency wing of the hospital, over a 100 relatives of dengue patients have stationed themselves outside Ward No. 51, 52 and the Disaster Ward — all wards with ‘confirmed dengue’ patients. Sitting on bedsheets spread out on the floor, their luggage serving as pillows, they have been waiting here for days. A junior resident doctor tears through the visitors and makes his way towards the rooms in the Disaster Ward.

Vijay Pandey, a driver, and his wife Bhagwati have been at the Disaster Ward for the last three days, after their 11-year-old son Sonu was admitted with dengue. “He studies in Muzaffarpur in Bihar and had come here for a vacation. He hasn’t eaten a morsel in three days,” says Vijay, who lives in a one-room flat in Sector-3 in Rohini. His son is sharing his bed with a 25-year-old. The doctor examines Sonu and gives quick, sharp instructions to the
male nurse. “It’s a wait-and-watch case. Keep giving the fluids and ORS,” he says, before moving to the next bed.

The doctor only examines the “urgent” cases — the nurse in charge of the ward had briefed him about these cases at the beginning of the shift. He soon gets a call on his phone, asking him to move to the counter on the ground floor, where the rush of suspected dengue patients has picked up. “I will return to check the other patients later… There is just no system in place,” he says.

It’s a little after 3 pm and airconditioners in the ward do little to cool rising tempers. A woman is arguing with an attendant, asking why her son should be kept in hospital “when he looks perfectly fine”. Her 14-year-old son is sleeping through his mother’s outburst, lying next to another dengue patient. A male nurse pacifies the woman, telling her that her son needs to stay because his platelet count is 30,000 and that he can be discharged only if the count goes up to at least 50,000.

“This is a new problem. Most patients fight to get in; this woman wants to leave,” the nurse says later. There is another problem, he adds. “Most of the patients here are from villages like Narela and Bawana and it is very difficult to explain to them that we only treat the symptoms — there is no one solution.”

It’s 4 pm, time for the doctors to make another round. A nurse in Ward No 1. asks relatives to leave the wards. “Don’t crowd around. Doctor sahab aane wale hain,” she says. The patients move out reluctantly, but some ignore the nurse and stay on. “They don’t listen,” the nurse rues. “They will go now, only to return after an hour.”
As a senior resident enters the ward, some of the patients’ relatives sit up.

“There are about 500 beds in the hospital and close to 750 dengue patients. There is no option but to make them share beds. Some relatives come and plead with me for separate beds, but what can I do?” says the doctor, as he checks a patient who has been throwing up since morning.

Like in all hospitals, the nurses are the workhorses. There are about four nurses in a ward for each shift and they rush from one bed the other, besides keeping a track of the inventory — food, fluids, injections, drips. “Sometimes we end up consoling patients’ relatives and at other times, we are just trying to locate cleaners to mop the wards,” says a nurse.

“Locating cleaners” has been hard, agrees Soni Sharma. Her 13-year-old daughter, Shivangi, has a platelet count of 7,000 and has lost 6 kg in four days, but Soni’s immediate concern is one of the toilets in Ward No. 52. “My daughter has refused to use the toilet because it is very dirty. A helper came and said the cleaners will come at night and asked us to give them some chai-paani (bribe). What do we do until then?” says Soni.

In the adjoining Ward No. 51, a nurse is consoling Kusum Maurya. The previous night, she says, the doctors had asked her to arrange for four bottles of B+ blood for her husband, Ram Asrey Maurya, who has been admitted for three days. “When I went to the blood bank, the man there scolded me and kept my ID card. He says he won’t return it till the blood is replaced,” she says. Her blood group doesn’t match her husband’s and now, she will have to find donors. “Where do I go looking for them?” she asks.

Babasaheb Ambedkar Hospital is the only hospital with a blood bank in the area and relatives of patients in other hospitals come here, making this one of the busiest areas in the hospital.

The pathology department on the second floor is feeling the crunch too. “The machines can only test 50 samples in one hour. How fast can I go?” says a lab assistant. “When the platelet count of a patient is below 40,000, we need to make slides and I have to examine each one of them under a microscope. After 20 slides, my eyes start hurting. I am afraid I will make a mistake,” says the senior resident doctor on duty in the lab.

At 6.10 pm, back at the main counter on the ground floor, 27-year-old Sunil Kumar, a driver from Sonipat, is engaged in a bitter argument with a nurse. He insists that he needs to be admitted. “I have such high fever, but they are saying that my platelet count is stable,” he says.

The doctor on duty shakes his head in disgust. “The problem in our country is that the patient decides the treatment. If we try and explain things to them, they say government doctor ne hamein naa bol diya (the doctor turned us away).”