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Sunday, June 07, 2020

KEM Hospital: Through the night, in Mumbai’s Ground Zero ward

At the frontline of Mumbai’s battle against the pandemic, the 95-year-old hospital, where nearly 400 of 1,800 beds are reserved for Covid patients, is swamped by patients with all kinds of other health complaints and illnesses.

Written by Tabassum Barnagarwala | Mumbai | Updated: May 19, 2020 2:42:38 pm
Mumbai coronavirus patients, Mumbai news, Mumbai's KEM Hospital, Coronavirus maharahstra deaths, Covid 19, Mumbai coronavirus cases, containment zone, Indian Express Outside KEM Hospital, which is at the frontline of Mumbai’s Covid battle. (Express photo by Tabassum Barnagarwala)

It is past midnight, but the three dozen men and women on the pavement outside the KEM Hospital are wide awake. From beneath the banyan tree, they fix their gaze on the emergency ward, waiting for beds to empty.

At the frontline of Mumbai’s battle against the pandemic, the 95-year-old hospital, where nearly 400 of 1,800 beds are reserved for Covid patients, is swamped by patients with all kinds of other health complaints and illnesses.

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Not only does it draw people from neighbouring districts, it also caters to a huge slum population, including Worli, the first containment zone in the city. One of the few hospitals treating both Covid, non-Covid patients, it is the choice of many because private hospitals are too scared to admit them.

Dr Hemant Deshmukh, Dean of KEM Hospital, says, “Most patients start coming evening onward. And at night, they have no means to go home, so they stay back, hoping a bed will get free.”

The crowd of patients has thickened after the nearby Nair Hospital, a municipal facility, converted into a Covid hospital. All non-Covid patients are referred to KEM. With private hospitals running skeletal OPD services, KEM has become the final port of call.

“As a policy, we have decided not to refuse treatment to anyone. If we don’t take them in, who will?” says Deshmukh. But the challenges at night are different — there are fewer staffers to deal with desperate families.

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An intern at the front desk of the emergency medical services (EMS) says from the time his shift began at 8 pm, he had taken down names of 53 people until midnight. All with Covid-like symptoms. Most people, he says, were given medication and sent home since beds are not available.

Patients sitting outside KEM hospital. At KEM hospital, nearly 400 of 1,800 beds are reserved for Covid patients, is swamped by patients with all kinds of other health complaints and illnesses. (Express photo by Tabassum Barnagarwala)

A bedsheet her only comfort on the stone ground, Khatoon Shaikh, a heart patient, has been waiting to get hospitalised since 10 hours. After four hospitals turned her away, she reached KEM. “I filled various forms, went to this department and that. She was made to sit next to it is a suspected Covid-19 patient. How can I risk my mother?” son Rafiq says. So they decided to wait outside for a bed. Whenever Shaikh feels uneasy, she goes inside the emergency ward, a doctor gives her some medicine and she returns outside to her usual spot.

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“Hospitals are behaving as if there is no illness other than Covid-19,” the old woman says, “All they want to know is if we have cough, fever or breathlessness.”

Next to her sits Pradeep Rajbhar, a migrant labourer from Uttar Pradesh who has earned no wage since two months. His friend Sonu Rajbhar is inside, “feverish and breathless” and undergoing a CT scan. He too awaits a bed for his friend. The two have not eaten since 20 hours. They spent entire day travelling from one hospital to another, covering 60 kms from Vasai in neighbouring district to Parel, Mumbai, looking for a hospital willing to treat. “They say he may have Covid-19. If he has it, all of us have it. We are 8 people living in one room,” Pradeep says. Opposite them wife and son of a 62-year-old Covid-19 patient try to get some sleep. The senior citizen got a bed after waiting for 26 hours. There is no fan, and he keeps sweating, but they say they can’t complain under given situation. “We both are high risk, we have to quarantine ourselves but hospital asked us to wait if they need help,” the son said.

Inside the emergency ward, doctors are wearing blue personal protective equipment, only their eyes visible behind glasses.Upon entry, each patient is asked, “Do you have fever, cough, cold or breathlessness?” These are Covid symptoms. Suspected cases are transferred to two wards, with 50 beds each. They are full, so patients sit in the corridor as they await test results. Once the corridor fills up, people move outside. Shireen came to KEM hospital four days ago, her father is a high blood pressure patient who recently developed cough. The two have occupied a corner in corridor. He sleeps on floor and she guards him. Her burqa masks her face. “Doctors said once his report comes they will give us a bed,” she said.

A young resident doctor asks them to make way. It feels inhuman, he says, to send patients out, but the ward remains high-risk. Three of his colleagues have tested positive. The emergency ward is the most “dreaded posting”. “Earlier, the emergency ward used to be this crowded only on a Monday. Now it’s every day,” the doctor says.

One of the few hospitals treating both Covid, non-Covid patients, KEM hospital is the choice of many because private hospitals are too scared to admit them. (Express photo by Tabassum Barnagarwala)

Another doctor, attached with gynaecology ward, says wearing a personal protective equipment makes them feel sticky, they have to speak louder and communication with patient has become difficult. “Before this pandemic, we did 15-20 deliveries a day, now the number is 30. All private hospitals are scared to admit patients,” he says. A day before he delivered 16 women in eight hours shift.

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Around 1 am, a car pulls up outside the emergency ward. Four men place an elderly man on a wheelchair and wheel him up the ramp. The intern asks the man if he has fever, cough or cold. He does not reply. The intern checks his pulse. “He is, I think, no more. Please take him to that counter,” he says.

The counter has three doctors, all seated behind a rope, two feet away. The shocked family insists that they treat him: “How can he suddenly die?” The man is identified as Shankar Chaurase. “We brought him at 7.30 pm, the doctor gave medicine for fever and asked us to go home. As soon as we reached home he started breathing heavily so we rushed back,” a relative says. No Covid-19 test was conducted on him, although he had all symptoms.

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As paper work begins for Chaurase, two dead bodies, sealed in a black cases, are wheeled out by men in PPE. Outside Sangeeta More weeps as she looks at the bodies. Her husband Subash More (60) is gasping and half conscious on a stretcher. His is diabetic. Her son Umesh storms out of emergency ward, “They are all wearing those PPEs. The ward is full of corona patients. Lets go to another hospital, we will catch infection here,” he says and starts making calls for an ambulance. The intern follows him. “You have to let us check him, stabilise him,” he tells the son. When the man refuses, the intern makes him a sign a form of discharge against medical advice. “We try to counsel, but there are so many patients,” says the intern.

The night shift is far from over. Around 3 am, there are three ambulances and two taxis outside the emergency ward. No ward boy is available to wheel them. Few patients and their family had just fallen asleep, they wake up and stare as another family rushes to find a stretcher.

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