With Poor Infrastructure, Bihar Faces Tough Fight Against COVID-19

Patna: Two days ago, Dr. Geeta Rani of the Jawahar Lal Nehru Medical College and Hospital in Bhagalpur made a personal protective kit from her car cover. It exposes the lack of basic safety kits for examining or treating suspect coronavirus cases in Bihar. However, she did write an email to Prime Minister Narendra Modi and Chief Minister Nitish Kumar about the same.

A day after Dr Geeta dared to raise the issue of a lack of basic facilities to keep the doctors safe, a top health official admitted that the healthcare infrastructure in Bihar to fight coronavirus is poor. “There is nothing to hide. The fact is that we have poor healthcare with inadequate high-tech equipment, are facing a shortage of doctors, beds, ICUs and ventilators.  Even our medicine stock is less than what is needed,” said a top official of the health department on the condition of anonymity.

His views were reflected by none other than CM Nitish Kumar on Thursday, when he demanded 10 lakh N95 masks and 5 lakh PPE kits from the Centre for the protection of doctors, nurses and other health staff. Kumar has made it clear that the state has received only 50,000 masks and 4000 PPE kits so far.

Faced with a shortage of testing kits and other essentials at a time when the number of cases is increasing, Kumar sought at least 100 ventilators and 10,000 RNA extraction kits. As of now, the state has received only 250 extraction kits and no ventilators.
 

Over the last ten days, doctors, nurses and other healthcare staff at government-run hospitals in the state expressed anger and unhappiness over the lack of a basic safety kit. Some even took to social media to request PM Modi to save them by providing PPEs.

Last week, Julie Kumari, a staff nurse at the Patna-based government-run Nalanda Medical College and Hospital (NMCH) took to social media to urge Modi to “please save them from likely death” as they have been working in the isolation ward without safety kits, N95 masks or alcohol-based sanitisers.

She also questioned the quality of the common safety kit (used for surgical operation) given to them by health department authorities. The nurse said that banging plates will not boost their morale, mentioning that the staff was working despite the risk to their lives. 

Following the video, staff nurses of NMCH staged a protest and gheraoed the hospital superintendent while demanding safety kits. The nurses also expressed solidarity with Julie and expressed their unhappiness after authorities threatened that they would take action against her.

Bihar’s poor health infrastructure was in the news in June 2019 when more than 150 children died due to Acute Encephalitis Syndrome (AES).

What has also sent alarm bells ringing is that after the outbreak of COVID-19 nearly 2 lakh migrant workers from across the country arrived at their native villages across Bihar after the lockdown, according to official figures. The state government is wary of them spreading the coronavirus in rural areas.

According to health officials, only one-third of the migrant workers who had reached the state were made to undergo tests. Most of them are neither in temporary isolation wards nor in quarantine in their homes. “Most of the temporary isolation centres set up in government schools and panchayat buildings in villages are deserted, as migrant workers prefer to stay in their homes. The local administration has also failed to ensure that they should stay in isolation wards created for social distancing,” said a health official.

The CM has also come under attack from the Opposition, with RJD’s Tejashwi Yadav saying that Nitish “did not update the stockpile or begin procurement of Testing kits, PPE, masks, ventilators, ICU beds, gloves, sanitisers which doctors, first responders and all of us have been demanding from day one. We are lowest in testing and that alone is the first step to contain the spread,” he said.

“Remember, it's a marathon and therefore a comprehensive and forward looking action plan is required,” the former deputy CM said, requesting Nitish to expedite containment measures by ramping up medical capacity, testing more people and slowing the rate of infection till April 14.

As per Bihar Health Minister Mangal Pandey's own admission, there is one doctor for every 17,685 persons in the state. There are 6,830 doctors including those in medical colleges in Bihar, which has a population of nearly 12 crore. Over the last few years the state government repeatedly announced appointments for between 1000-2000 doctors, but it never happened. Most of the hospitals including those at district level, community health centre at block level and Primary Healthcare Centres are facing a shortage of doctors.

Similarly, there are only 1,900 PHCs in the state against the required 3,470 and 150 community health centres instead of the 867 that are needed. There are nine government-owned medical college and hospitals including two in Patna and one each in Gaya, Darbhanga, Bhagalpur and Muzaffarpur districts. The government has announced that the Nalanda Medical College and Hospital(NMCH) in Patna has been designated as the state’s primary hospital to treat cases of COVID-19. The government claims that the hospital’s isolation ward has 600 beds.

The state lacks isolation beds, ICUs and ventilators. “The health department has been increasing isolation beds and ICUs in different hospitals and has decided to purchase 1000 ventilators,” the health official said.

Till April 2, the state had tested 1623 samples, a number far less when compared to its huge population. There was only one COVID-19 test facility in Bihar till last week. A few days ago testing began at IGIMS and AIIMS in Patna and at DMCH on April 2.The government plans on starting a test facility in Bhagalpur and Purnea districts soon.

Dr Pradeep Das, the Director of Patna-based Rajendra Memorial Research Institute (RMRI) where COVID-19 tests have been conducted since the beginning, said tests of COVID-19 positive cases sped up over the last few days after they acquired kits from Pune

Till Tuesday there were three COVID-19 positive cases in Bihar, with one person dead.

Sanjay Kumar, principal health secretary said that nearly 6050 people are under observation in the state. As of Friday there were 30 COVID-19 positive cases in Bihar with one person dead. An official release by the State Health Society, Bihar, said of the 30 positive cases, three are on ventilator support in different hospitals in Patna.