With senior citizens being particularly vulnerable to Covid-19, 13.8 per cent of those aged above 60 infected by coronavirus have died in Mumbai, as opposed to the average fatality rate of 5.7 per cent for all age groups. While most doctors, who work as consultants, are practicing through tele medicine at home, some, despite being senior citizens, are walking into hospitals and clinics every day to treat patients.
Dr Hiren Ambegaonkar, CEO of S L Raheja Hospital, said most hospitals have advised their elderly doctors to not treat Covid-19 patients. But as the pandemic enters the fifth month in Maharashtra, many senior citizen medical practitioners have decided to continue their practice, risking their personal safety.
The Indian Express speaks to a few of them.
R B Dastur has been going to Bhatia hospital every single day since March. “My age is against me. But I cannot not go,” he said, adding that this is the time doctors need to step out, it’s their duty. “Just like when a fire starts, a fireman cannot say I can’t go inside because its too hot, it’s similar for us. This is the fire we need to douse.”
When the pandemic began, 51 staffers in Bhatia hospital got infected. The fear of infection led to multiple resignations, with nurses and ward boys refusing to join work. The staffers in canteen had also quit. Dastur had to go to hospital to negotiate with nurses, promising them accommodation and higher salary.
“Amid all this, I had to start taking interviews to appoint more staff. I have 12 beds in the Covid-19 suspected ward, I can get 12 more if there are more nurses and doctors,” he said. At present, of the 300 consultants, less than 15 to 20 doctors are coming to work regularly.
Every day, Dastur meets all head of departments to discuss the line of treatment and bed management. His wife and daughter have remained at home except for a recent salon visit. While Dastur tried social distancing in the early days, he said it is difficult to stay away from family and he eventually gave up. “How long can we stay away? We have to learn to live with the pandemic.” He has no illnesses, and counts on his immunity to take him through the pandemic.
Anil Pachnekar has been working in Dharavi for 35 years. Along with BMC, he has been instrumental in containing Covid-19 in five hotspots of the vast slum. He had mobilised 50 private doctors in April and started making door-to-door visits to detect cases of cough, cold and fever. The aggressive efforts helped in faster detection of Covid-19 cases.
In Dharavi, home to lakhs of people with low incomes, residents hesitate to interact with civic officials.
“But they open up to us. They listen to us as we have been treating them all these years. I realised I have to do my bit in saving lives. So, I let my junior doctors handle my clinic and have started going door to door to look for suspected cases along with BMC workers,” Pachnekar said.
The 60-year-old would do a door-to-door survey from 9 am till 3 pm, visiting over 300 houses daily. He has diabetes but “it is under control”. He had to ensure he does not put his children, both renal transplant patients, at risk. “I used to go home scared. I would bathe for an hour after returning,” he said.
Pachnekar said several private doctors shut clinics in Dharavi in March and April. The Mahim Dharavi Medical Practitioners Association agreed to help the government and together, they screened 47,500 people in the first eight days and found 83 positive cases.
“If we have the strong will to work, we forget everything else,” he said. Chief Minister Uddhav Thackeray has praised Pachnekar and the private doctors for their efforts.
The head of microbiology at Sion hospital did not take a single day off from March until June. From handling laboratory testing to coordinating the fever clinic, training staff on antigen test to conducting sero-surveillance and making policy decisions, she has supported BMC’s efforts.
The 62-year-old lives with her husband, aged 65. She cooks in the morning and leaves for the hospital, sometimes returning late at night. “He manages the house,” she said.
Baveja said she did not have to think for a second before deciding that she will continue working. “As the head of the microbiology department, I knew I had to keep working. How could I take a backseat due to fear of death? I thought either I will be history or become a part of history.”
She has been instrumental in handling fever clinics at slums and arranging doctors for them. She has taken multiple training sessions on the right method of donning and doffing for staffers and doctors.
She also manages Sion laboratory that tests 100 RT-PCR samples a day, has started antigen testing and will soon start CB-NAAT testing. She also advises BMC on infection control and testing policies.
Once she returns home, there are a series of zoom calls to handle. “We take all standard precautions. My colleagues sometimes buy vegetables for me. We are doing our bit,” she said.
Behram S Pardiwalla worked until Wockhardt hospital was forced to shut down fully in the first week of April after 82 doctors and staffers tested positive. The index case was a heart patient who later turned out to be Covid-19 positive. Aged 66, with hypertension, a childhood episode of polio infection and obesity, Pardiwalla decided to stay home and consult through video calls.
“But I realised I cannot consult through tele medicine forever. My family was not very happy when I decided to go back to hospital,” he said.
He visits the hospital three to four times a week. He wears mask, gloves, surgical gown and a face shield, and when he consults patients, he does not touch them. This week, the hospital will start regular out patient department services and Pardiwalla will start going daily.
He treats Covid-19 patients too, but indirectly. Junior doctors enter the isolation ward and report the patient’s condition to him and he directs the line of treatment. “This pandemic will change how we see patients. The personal touch is lost. I can’t touch a patient’s arm to comfort them, I have to remain at a distance. Social distancing and face shields are the new norm,” he said.
The IMA Maharashtra president kept his Pune clinic open even when several general physicians downed their shutters in March and April. He has diagnosed 50 Covid-19 patients in three months.
His only safety gear – an N-95 mask.
“After meeting each patient, I wash my hands. The mask is always on,” he said.
He works for eight hours a day. Once he reaches home, he keeps his shoe outside the house and immediately takes a bath. “Social distancing is not possible at home.”
Bhondwe has personally requested Public Health Minister Rajesh Tope to ensure that good quality personal protective equipment (PPE) are available in chemist shops.
On May 14, while an assurance was given by the department that chemist shops will have adequate stock of PPE, IMA is yet to found an easy supply of PPE.
“Doctors are willing to pay for PPE. But the government needs to ensure that general physicians like me get access to it. If we get infected, the government is to be blamed.”
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