ON MAY 8, a 75-year-old man with “severe” symptoms in Madhya Pradesh’s Neemuch was referred to a Level-3 Dedicated Covid Hospital (DCH) in Indore, 250 km away. Four days later, the case was officially marked as the first Covid death in the district.
“Taking him there, finding out where beds were available, getting him admitted even though the test report was awaited… it was traumatic,” says the patient’s son, who is a doctor.
Nearly a month later, little has changed in Neemuch, near the border with Rajasthan. There is still no DCH, and critical patients continue to be referred to hospitals hundreds of kilometres away.
The district of 8.26 lakh people, according to the 2011 Census, is tackling the outbreak — 208 cases and five deaths — with eight Level-1 Covid Care Centres (CCCs) for “pre-mild” and “mild” cases, only one Level-2 Dedicated Covid Health Centre (DCHC) for “moderate” cases. And a 70 per cent shortfall in the mandated number of government doctors.
The Indian Express visited three CCCs where patients or suspected cases were accommodated, including a converted hotel, and came across dissatisfied staff and complaints about facilities.
Local officials point to a severe staff crunch: Of the 54 Class I posts for doctors (seniors/specialists), only 10 are occupied; of the 73 Class II posts, only 27 have been filled. Most of the serious cases are taken to the Sri Aurobindo Institute of Medical Sciences in Indore or the R D Gardi Medical College in Ujjain, about 200 km away — both private hospitals.
“One MD (Medicine), seven Medical Officers, and 49 staff nurses were hired for a three-month period from April to June,” says Sangita Bharti, the interim Chief Medical and Health Officer (CMHO), Neemuch.
According to District Collector Jitendra Singh Raje, the district reported its first case on May 2 and most of the early infections can be traced to a “huge influx” of migrants from Rajasthan. “By May 10, over 25,000 people had entered the district and moved to other parts of MP. We set up camps for their screening, organised their stay, arranged meals and logistics…a lot of people came in touch with local residents,” he says.
Currently, 169 people are in institutional quarantine, 98 in CCCs, and 29 in isolation. Officials say there are about 800 quarantine beds and 428 isolation beds, including 373 in government facilities of which 102 have oxygen support.
The CMHO says the District Hospital, where the Trauma Centre is the lone DCHC, has 90 isolation beds, 17 ICU beds with oxygen support, and four ventilators. Collector Raje says the eight CCCs together have about 250 beds — some of the CCCs are still vacant.
The numbers look impressive, but the situation on the ground does not:
# The Vatsalya Bhawan CCC, near the Nagar Palika office, has 16 beds, and currently houses ten people, including nine positive and one suspect case. However, in violation of Health directives, suspected and confirmed cases are housed in the same building, with no separate entry or exit.
Among the staffers here is Dharmendra Parihar, who is among those hired for three months. “We are getting Rs 650 per day or a maximum of about Rs 20,000 for a month. This amount should be increased, considering the risks we are taking, and the tenure should be extended,” he says.
Pukhraj Bairagi, another staffer who is also the district president of the Multipurpose Health Workers Association, complains that “there has been no action” on an announcement in April by Chief Minister Shivraj Singh Chouhan that health workers involved in Covid treatment would get an additional honorarium of Rs 10,000 per month.
# The four-storeyed Hotel Dev Residency, which was converted into a CCC with a capacity of 60 beds, currently houses 48 suspect cases. “We keep symptomatic patients or those with contact history with positive patients. If a person is positive, we send them to the district hospital, otherwise we discharge them by the next morning,” says a health personnel.
Officials say this is “the best CCC in Neemuch” and “people from well-to-do families are kept here”. However, a video shot by a local resident, who was in quarantine here recently, shows a dirty washroom and used bedsheets. S L Patidar, nodal officer for Dev Residency, says the hotel is providing “100 per cent facility”. “The day after the video was circulated, the SDM, CMHO, and other officials visited the hotel to see the facilities for themselves,” he says.
# At the Radhakrishnan Samudayik Bhawan, which houses positive patients from the DCHC, there is no separate entry or exit.
Last Friday, Neemuch got a boost with the opening of a testing lab. However, the samples will still have to be sent to Ratlam, over 140 km away, for confirmation.
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