IT’S 10 pm, near pitch dark. In the middle of the road at the Rarah border between Rajasthan and Uttar Pradesh is a barricade and three policemen. To the left, hanging from an electrical wire overhead, are three temporary stage lights. Under them is a table — a jug of water and a bottle of hand sanitiser on it — and a doctor in a chair, with hairnet, mask and gloves.
Meet Dr Rajveer Singh, the last line of defence against the coronavirus entering Rajasthan, and among the first responders if and when the infection slips through. For the last two days, from 8 pm to 8 am, he has been screening hundreds of migrants returning on foot who are trying to beat a national lockdown enforced with four hours’ notice.
And across 800 km in four states, Singh, his work station and his work are emblematic of a healthcare system creaking under the weight of an unprecedented crisis, propped up by doctors and health workers in the field, overwhelmed but committed to the cause.
After a quick dinner break, Singh’s gloves are back on. He is ready to check a group of three men, with bags slung across their shoulders. His questions are calm, his tone patient: “Where are you coming from? Where are you going? Do you have any symptoms of fever and cough? Have you met anyone with symptoms of fever and cough?” Finally, he asks: “Have you by any chance travelled to Bhilwara or Jhunjhunu?”
Bhilwara, he knows, has emerged as a worry spot, after six persons working in a private hospital, including doctors, tested positive. Of the 93 cases in Rajasthan, 26 are from Bhilwara — 13 have since tested negative — and the district’s population of more than 24 lakh is under surveillance, the town locked down.
Based on the answers, Singh decides his next course of action. In every case, he jots down the person’s name, address, contact number and where they were coming from. “But for instance, if they are from Bhilwara or Jhunjhunu, or have fever or contact, I will send them to the district hospital. From there, they could be sent to home quarantine or institutional quarantine. This is what we have done for the last three days,” he says.
Last Thursday, the first day of the border checks, they marked people with quarantine stamps. But then, says Singh, there was a shortage of stamps. “So we either sent them to the district hospital or, based on our lists, sent health workers to homes to paste quarantine stickers,” he says. For instance, he says, “over 240” people needed either home or institutional quarantine between 8 pm on Sunday night and 8 am the next morning.
Singh has also watched instructional videos of doctors and nurses in Hazmat suits, peeling off and on different layers. The only layers he has, though, are a pair of extra gloves in his coat pocket, and an extra mask. “Yeh toh jung hai. Har jung mein kami hoti hai (This is war. There are shortages in every war)… At least, there is a doctor here,” he shrugs.
Across Madhya Pradesh, Haryana and Rajasthan, doctors have been besieged by the numbers. But at entry points to UP — Mathura from Bharatpur, Noida from Delhi, and Agra from Dholpur — there were no doctors Sunday, just one police jeep.
Singh is also battling another — time and sleep. He is posted at the Rarah Community Health Centre, with two colleagues. But now, from 8 am to 8 pm, two of them sit at the border. By night, it is left to one. Even through the day, there is work to do. The CHC itself may be shut, but Singh does his bit to spread awareness “every morning”. “I tell people to wash their hands, and not to mingle. So far, there are no cases in Bharatpur, but if it spreads to the villages, God knows what will happen…,” he says. Yogendra Singh, the local patwari who is giving the doctor company, completes the sentence: “There are three doctors. The CHC covers 15 villages, all with populations of over a thousand each. Sochke dekhiye (Think about it).”
At the District Hospital in Bharatpur, 15 km away, there is a queue of people, spread reasonably apart “for social distancing”. Outside, there is anger and confusion. “They brought me from the border and took my name down. Can I go home now?” one asks. Another complains: “No tests are taking place.” A third says: “They put a stamp my hand and told me to stay at home. But how will I get home now, my village is 50 km away?”
At one end of the queue are two doctors behind a table, and a cloth screen. The questions are the same. “Depending on what they say, we recommend isolation, or institutional quarantine, or home quarantine. The government has set up quarantine stations in hotels across the city,” says the lead doctor, who does not want to be identified. Over one hour, from 6 pm to 7 pm, as the light begins to fade outside, the doctors never stop, and the people too, most of them returning migrants.
Inside the room, there are six doctors. Only two have full body protection, transparent and flimsy. Not one patient undergoes a temperature check in that hour. Four other doctors wear only gloves, a mask, and a white jacket. “Like the government, we are doing the best we can,” the doctor says.
Outside the section closed off for possible COVID-19 cases, a building stands alone in an open field. The paint on the walls is coming off, and the cement ceiling is chipped. The blue poster in front reads: “Isolation Centre.” The building is in the eyeline of Mahendra Rathore, standing in queue. “Looking at that building, I have half a mind to run away. What if I have the virus? They say they give food and water and a place to sleep. Lekin woh toh jail mein bhi dete hai (But that they give in jail, too).”
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