How a remote Indian hospital struggles to treat COVID-19 patients

Guards armed with rifles escort Dr Kumar Gaurav as he makes the rounds at his hospital on the banks of the Ganges River in the eastern state of Bihar.

The guards are there to protect him from the relatives of patients, including those suffering from COVID-19 – the disease caused by the novel coronavirus. The relatives keep barging into the wards, even the ICU, to stroke and feed their loved ones, often without wearing even the flimsiest of masks as barriers against the disease.

“If we stop them, they get angry,” he says. “They want to give homemade meals to their patients, and some even want to massage their patients. And they are taking the infections from our ICUs to the other people in the society.”

He stops to tell the wife of a patient in the ICU she must leave. She obeys, only to return after a few minutes from another entrance.

It is monsoon season, and the humidity is reaching unbearable levels. But the few air conditioners in the hospital are not working, and some relatives use hand fans to keep their loved ones cool in the ward’s discarded protective equipment.

It was not supposed to be like this for Dr Kumar.

Nine years ago, the 42-year-old psychiatrist moved his family back to his hometown for a quieter life and better pay after three years in the Indian capital, New Delhi. He accepted a job as a medical professor and consultant psychiatrist at the 900-bed Jawahar Lal Nehru Medical College and Hospital, named after India’s first prime minister. Life was uneventful but rewarding, spent teaching classes and visiting his psychiatry patients.

Now, with some doctors struck down by the coronavirus and others refusing to work, he has been named the top official at the hospital, despite being one of its most junior consultants – and suffering from diabetes and hypertension, two risk factors for severe COVID-19 symptoms.

But he says he felt compelled to volunteer for the job.

“A lot of my colleagues refused,” he says. “I had to take up the responsibility.”

In April, as the pandemic struck here in Bihar, the hospital was selected as one of just four COVID-dedicated hospitals for a population of 100 million people – at least in theory.

In practice, Kumar says the nearest hospital with proper critical-care facilities is around 200 kilometres (120 miles) away. And with proper healthcare in the surrounding rural areas difficult to find, general patients have nowhere else to go but his hospital.

In June, Kumar says, the district administration instructed the hospital to treat uninfected patients, too.
“In an ideal world, there should not be any non-COVID patients in this hospital,” Kumar says.

The healthcare system in Bhagalpur, like many other parts of Bihar, is on the verge of collapse, he says.

Interviews with dozens of staff, patients and relatives at the hospital paint a picture of conditions that might shock those accustomed to images of hermetically sealed ICUs during the pandemic, with relatives not even allowed to touch their dying loved ones.

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