Updated: May 27, 2020 12:31:01 pm
ON APRIL 22, when the first Covid case was reported from Burhanpur, near Madhya Pradesh’s border with Maharashtra, the district hospital had one ventilator, a severe shortage of doctors, and two ambulances with emergency support systems and two hired vehicles with basic equipment.
One month, 293 cases and 13 Covid deaths later, the main government healthcare facility has got more beds, but is still short of key equipment and doctors.
The Indian Express visited Burhanpur on its countrywide journey to track hospital inventory in Covid-care facilities far from urban areas — and found a district that is scrambling to contain the outbreak.
There have been upgrades since the first case was reported, say officials.
The ANM training centre, near the main building of the 200-bed district hospital, has been converted into a 60-bed Level-2 facility for moderate cases. Three BiPap machines, for non-invasive ventilation, have been shifted from the hospital.
A new building block behind the centre is being used to quarantine asymptomatic patients, the first Level-1 Covid Care Centre (CCC) in the district.
And, a part of the government Ayurveda College and Hospital, located a few kilometres away, was “acquired” in the first week of May to serve as the second CCC, which can accommodate nearly 100 cases.
But there are still some glaring gaps.
At the ANM facility, where 60 patients are undergoing treatment, not all nine oxygen cylinders earmarked for Covid cases are available together. “We have a serious shortage of doctors, too. Only four MBBS doctors and two MDs, who work in 12-hour shifts, attend to Covid patients. You can imagine the consequences. We treat patients to the best of our understanding. Or else, we refer them to M Y Hospital in Indore, which is about 175 km away,” said Dr Prateek Navlakhe, one of the doctors on duty.
With only a small board that reads ‘Infection Disease Control’, it is difficult to identify the isolation area in the same compound. “It’s not uncommon for non-Covid patients and their relatives to enter by mistake. The ward boys and sweepers don’t report for work out of fear,” said another doctor, who did not wish to be identified.
At the Ayurveda facility, where 61 patients are being monitored, there are only three private Ayush (Unani) practitioners, hired on ad hoc basis on a salary of Rs 25,000 each, and three support staff. “We manage the show here. No MBBS doctor has come here to check on patients. We have to do everything on our own. We need paramedics. The support staff provides only food and tea,’’ said Dr Irfan Shaikh, one of the Unani practitioners.
Besides, it takes a minimum of three days to get the test results from Indore.
And yet, with 100 patients having been discharged so far, officials say Burhanpur — the district was created just 17 years ago — is on track to face the crisis.
The administration is giving final touches to a separate 60-bed isolation facility on the first floor of the district hospital with oxygen facilities —13 patients from the existing isolation area have already been shifted.
“The administration is prepared for any eventuality, We are not worried about the numbers going up. The District Institute for Education and Training outside the city has been readied to house 150 patients. A tribal department building at Nepanagar, a town nearby, will be used to house 500 cases, if needed. We can start these facilities with just 12-hour notice,’’ said District Collector Pravin Singh, who took charge on May 2.
“The government has also purchased five oxygen concentrators (that provide enriched air). We don’t wait for patients to come to us in an advanced stage of infection. So we are tracking all wards and mohallas,’’ he said.
“The administration has also involved government teachers and employees of different communities to build confidence and make people report illness and undergo tests. At 2,500 samples for a population of 2.5 lakh in the town, the average is more than the state’s average of 1,144 tests per 10 lakh,” Singh said.
Officials say that by keeping a tab on graveyards and the crematorium, the administration has also tried to ensure that no death goes unreported. “Irrespective of whether the death is due to Covid or not, we monitor family members, order tests, and ask those showing symptoms to go into quarantine,” a senior official said.
But yes, top district health officials admit, there’s still some way to go.
“It’s difficult to manage the district hospital with less than 20 doctors. We need at least 60. But we will continue working, whether we get doctors or not,’’ said Civil Surgeon Dr Shakeel Khan.
Chief Medical and Health Officer Dr O P Garg is more forthright. “There are less than 10 doctors. And having just one ventilator has made it really difficult. We have sought 10 oxygen concentrators, more BiPap machines and a portable x-ray machine,’’ he said. “There are PPE kits and masks in sufficient quantity.”
The administration has also drafted All Is Well, a 350-bed hospital that is among the largest private facilities in the state, as a Level-3 facility for severe cases — a respiratory ICU has been created and 15-20 rooms earmarked for suspected cases. Officials said 13 Covid patients are currently undergoing treatment here.
“When Covid hit the town, private practitioners were scared. People suffering from other respiratory illnesses were scared, too, and did not want to go to the government hospital. The system struggled,’’ said Medical Superintendent Dr Subodh Borle. “But things are in place now”.
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