Non-functional ventilators, not enough beds & a high patient load: What ails Safdarjung Hospital’s biggest dept

“I was told there was no ventilator available, which is why we were given this device. But operating it was hard,” said Prakash.

He once again requested a ventilator and Ashok was finally given one — only for the family to find that the screen, which shows the parameters, was not working.

Later that night, Ashok passed away due to dengue complications.

Distraught by the turn of events, Prakash said it was better for a patient to die peacefully in the comfort of their home than take them to a hospital where there are no beds and machines are non-functional. “In just that night, almost 40-50 new patients occupied a single room; 20 patients were occupying 10 beds… the rest found space where they could… on the floors and corridors,” he said.

This is not a one-off case at the Central government’s largest hospital in Delhi which is struggling with defunct ventilators, a shortage of beds and staff, and a huge patient flow.

Due to lack of functional ventilators, families of patients were given ambu bags to help them breathe (Express Photo by Ankita Upadhyay)

Generally, the Department of Medicine is considered to be the backbone of any hospital as it deals with patients suffering from various health conditions. At Safdarjung, the department — which sees 180-220 new admissions in a week — is equipped with 85 ventilators for 168 beds across three wards. Of these, only 33 are functional. It also has one ECG and four ECHO machines.

The Indian Express spent three days at this crucial department to understand the problems.

Spot check

As one entered wards 11, 12 and 13, the lack of space was glaring as stretchers with patients rushed past for admission, and others with bodies — and inconsolable family members — were wheeled out.

Patients were seen lying on the floor even as resident doctors inspected them. The space between two beds was also occupied by patients, sleeping on mattresses or bedsheets they brought or borrowed from the hospital. Their relatives, meanwhile, were seen holding up the drip bottles. Some were undergoing blood transfusions lying on the floor while the drip hung from a knob of the electricity board.

For those lucky enough to get a bed, the situation was no better. One of the patients was lying on a bed that was wet from the urine of another patient.

Patients seen lying in the corridors as no beds were available (Express Photo by Ankita Upadhyay)

According to a staff member, oxygen supply is connected to each bed. But with two patients usually occupying a single bed, only one can avail of a ventilator.

A senior resident doctor said many ventilators have not working since 2019 but nothing has been done so far. “There is no annual maintenance contract (AMC) or comprehensive maintenance contract (CMC),” the doctor added.

The hospital also has a policy of not refusing admission to any patient.

“We see patients with brain stroke, chronic heart failure, COPD, liver and kidney failure, and those with viral and bacterial infections,” said another senior resident doctor, adding that most of them are from Uttar Pradesh, Haryana and Rajasthan.

High footfall

The department also sees the highest patient load as compared to other departments.

According to data provided in a reply to an RTI filed by The Indian Express, the medicine ward saw more than 2,000 patients a month in 2023. September alone saw more than 33,000 patients admitted to its wards. In contrast, patient load in departments like neurology and cardiology were less than 200 and 1,000 respectively.

According to hospital sources, a patient generally remains admitted for a period of 4 to 5 days, which means only 6-8 patients can be admitted against every bed per month. There are around 30-40 beds in one ward.

However, an analysis of data from the RTI report shows that on average, there were more than 15 patients on a bed throughout the year in the Medicine Department. September saw an average of 199 patients. Doctors said these were mostly patients with dengue fever and meningitis.

According to a senior doctor, almost 180-200 patients are admitted every week, including those who are critically ill. Most remain at the hospital for at least 5-7 days.

The doctor further said facilities have not been upgraded considering the rise in patient load in the medicine ward: “It is the same as it was 20-30 years ago.” He said a demand was raised to provide more wards with a minimum of 100 more beds, but no action has been taken so far.

In this year’s interim Union Budget, Safdarjung Hospital witnessed a decrease in fund allocations. In 2023-2024 it was granted Rs 1,853.34 crore, which was revised to Rs 1,933.07 crore. This year, Rs 1,834.00 crore has been granted to the hospital and its associated medical college.

Staff crunch

In January, 54-year-old Ratan Singh from Mangolpuri was admitted to the hospital for three days after he suffered a stroke and missed his BP medication. Sitting next to him, his daughter Smita claimed there were no doctors or staff on call and she was taking care of him. While Singh managed to get a bed, he was sharing it with another patient.

Smita further claimed patients were not even provided with blankets despite the winter chill. “We brought our things from home. I saw patients lying on the floor in such cold weather,” she added.

The authorities concerned have now taken up the matter with the hospital administration.

On January 8, the Head of the Medicine Department, Dr YC Porwal, wrote to the hospital’s medical superintendent on the staff shortage and asked that nursing orderlies, OT assistants and safai karamcharis be provided from other departments on an urgent basis to meet the patient load.

According to the doctor, the average number of multi-task workers deployed in a ward, where more than 100 patients are admitted, is six — which is not enough. He said despite many letters and reminders being sent, no action has been taken.

The department has 14 consultant doctors, who are permanent employees, and 70 junior and 20-25 senior residents. Around 4-6 doctors are also from the CGHS wing, but are not full-time employees and are not regularly posted in the department. There are also 20 nursing orderlies, 15 safai karamcharis and three OT assistants assigned to the wards.

Dr Porwal further mentioned that super-speciality departments, except cardiology, do not have emergency units, and sometimes even patients requiring surgery are shifted to medicine wards on the pretext that no surgical intervention is required while critically ill patients are also admitted here.

When asked what was being done to upgrade the department’s ventilators and beds, the hospital’s PRO told The Indian Express that 25 more beds would be added in the H Block extension (part of the medicine department). However, when asked if this would suffice to meet the patient load, there was no response. The PRO also did not respond to whether the number of ventilators would be increased.

Doctors too said they were under constant pressure to tackle the patient load. “Many of our resident doctors are under immense stress and have been suffering from mental health issues due to the workload and hurdles related to patient care,” said a resident doctor.

He added that when faced with such a heavy workload, the chances of errors also increase. “How will the doctors give their 100% to each patient? This only results in compromised patient care,” he said, adding that these patients were among the poorest of the poor.