By Disha Bandyopadhyay and Ashish Dash 19 June 2021
Introduction via Contention
The second wave of the pandemic has revealed that India’s healthcare system requires reform on numerous fronts, demanding a rethink from all the stakeholders as the recent increase of coronavirus cases has once again taken India’s sagging healthcare system off guard. This issue can be traced back to November 2019, when the nation had woken up with a severe category air pollution warning over the national capital of Delhi. Pollution levels reached a record of “hazardous” according to the Air Quality Index (AQI) by the Environmental protection agency. As smog, a form of air pollution produced by the photochemical reaction on industrial emissions impregnates the skies, health experts expose the looming threat of worsening situations. Months into the second wave of the pandemic, the worsened air quality resulted in a predicted massacre with COVID- 19 and pollution resulting in more severe symptoms amongst the individuals. The mutated strain brought a higher degree of breathing-related issues and a question of whether the quality of the air we breathe stands silently responsible somewhere. The shortage of medical oxygen in the backdrop of surging cases in the last few weeks came from calculated incompetence and what could be identified as a sheer “mishandling of nature.” India has been deforesting at an annual estimated rate of 13.7 million hectares. Recent efforts to import 100 cryogenic containers, one lakh portable concentrators and oxygen plants in every district have only tried to bridge ages of environmental negligence. While these short-term measures might help calm the compounding demands but as the needs fluctuate from 2800 MTPD to 5,000 MTPD, Delhi’s environment minister, Gopal Rai, revealed that planting trees was the only permanent solution in the prevailing situation. The whole resolution is that when in total unconsciousness, we keep on breathing and never think it’s the oxygen that keeps us going. Now, seeing the tantrums of time, the burden of the present has given rise to an intense conflict that incites the dominating minds of the people in India. Our reactions are varying and depend on our previous environment and the experience we had before this duress. It’s an honor that our country is sublime in its great variety despite the vast numbers but, it’s painful to know the failings and weaknesses of the present situation where oxygen costs are going higher than humanity.
Pauperized Infrastructure: A Catalyst
The time we were just short of rejoicing and declaring the end of the pandemic, it struck again, and this time with far more ferocity. Did we take it lightly, or as a developing country, we had no other option but to come out and face it? The point could be debated as some say we almost brushed it aside while some experts believe that since more than sixty percent of our populace are daily wage workers, they saw this coming.
However, one undeniable aspect is our health infrastructure.
A productive population is required for the development of any nation, whether developed or developing. However, the population’s productivity is a minor indicator of how much expertise, skills, and health the population holds. Health infrastructure is the cornerstone upon which the responsibility for keeping the population safe rests so that any blip in the mass’s health does not obstruct the growth of any sector of a nation. It was observable from the beginning that the COVID 19 Pandemic would strain our already stretched healthcare resources. During the early stages of the pandemic, an infected patient could be predicted to form an infected chain with three nodes, identified as the infection bearer, infected, and the indirectly-in-contact. According to the WHO, COVID-19 took roughly eight weeks to infect the first lakh people but only two weeks to infect the next one lakh. The next one lakh became infected in just four days. The total number of confirmed cases is now over 81.4 lakh worldwide, and it is continuously increasing exponentially.
We can simply say that the healthcare needs caused by the coronavirus pandemic will exceed our capacities based on a global trend. In contemporary medicine, India has 12 54,686 registered doctors, and India’s rural population accounts for 60% of the country’s overall population. The government has created 25,743 Primary Health Centres 1, 58,417 sub-centers, and 7,624 Community Health Centres to provide healthcare to people in rural India in the current fiscal year. Some states like Haryana, Bihar, Assam, Gujarat, Odisha, and Madhya Pradesh, home to 70% of the total Indian population, have a population to bed ratio even lower than the national average.
National adversity: An International prerogative
The renewed zest of the coronavirus pandemic with clinical symptomatic shortness of breath reached an unfathomable zenith during the last two weeks of April and early May. In the week following the Kumbh Mela at Haridwar, Uttarakhand, between 31st March and 24th April, we saw nearly 3.5 million Hindus assemble in the riverside town, and the mega Hindu festival was declared to become a “super spreader” event. With the country battling a second wave and states going in for a second lockdown, election rallies and Kumbh Mela appeared to have compromised all efforts to curb its spread. These two mega-events earned their tag, with daily cases increasing by about 6000% in a poll-bound Bengal from 1st March to 22nd April. By over 450 percent between 1st April, when the Kumbh Mela began, and 17th April, when the religious gathering was called off. Due to severe time restrictions, the police could not impose the standard operating procedures (SOPs) on the Akhara seers and ash-smeared ascetics thronging “Har Ki Pauri” on the two major bathing days despite their best attempts. These microcosmic estimates sent alarming bells to the central Indian state as health officials felt that if positive cases were left untraced, they could turn into “super-spreaders” of the virus. Even the High Court of Uttarakhand took a stand on the matter and picked up the government for allowing the festivities. Although disturbing visuals of people without masks surfaced, and the pandemic deaths rose, what surfaced as a resonating fact is that the predictions of the scientific community about the second wave were ignored, and “we are now paying through our noses to make up for it.”
While one part of the country gambled health against the divine, a poll-bound Bengal recorded a spike of 3,400 percent after the sixth phase of its elections, which came to a disputed end on 26th April. While the moves of the elections had every party blaming the other’s sectoral policies, the damage went as a delayed lockdown and numerous political gatherings, in-poll contact, and interstate travel for polling duties. The roadshows were only banned during the last phases by a censor order from the Kolkata High Court. However, the surmounting numbers and a declining strain of defense showed the grim reality that the damage was already done.
While the national media faced constraints with covering all, the national situation caught international attention. In contrast, the smoke from the national pyre rang international alarms with the French satirical magazine Charlie Hebdo publishing a cartoon ridiculing the country’s rave oxygen shortage. The aggressively shared cartoon accompanied a catchphrase in French that read, “33 million gods in India and not one capable of producing oxygen” While the caricature got a mixed response, it did raise questions on the government and its measures to cope with the second wave. Coming at a time when the country is at the loci of international attention, the satirical magazine had run a few more pieces on India, the Covid-19 policy of the Indian government was questioned in a story published recently. This resounding warning from the global spheres interrogates: Had the nation not realized itself while it burned?
The resonating reality
India is planning to spend around 2.1 percent of its GDP on healthcare for 2022-23. The government already allocated around 2.5-3 percent of GDP on health and well-being, one of the six pillars of the Union Budget 2021-22. India currently has 1.4 beds per 1,000 people, i.e.1 doctor for every 1,445 people, and 1.7 nurses per 1,000 people, according to the data released by the Health Index for States, Niti Aayog. India also ranks 184th out of 191 countries in terms of health spending, according to the World Health Organization report, 2020.
The government claimed that the countrywide lockdown was implemented to improve the public health system. Still, in reality, the years of underfunding have left the healthcare system grossly unprepared for a catastrophe of this severity. The coronavirus pandemic has posed significant difficulties for developed countries. These issues would exacerbate for emerging countries such as India as the number of infected cases is on the rise in different waves. The need of the hour is for a regulator who can work with states to guarantee that the focus turns away from illness management and towards affordable health care, the availability of more medical experts, well-equipped amenities, and disease prevention. The silver lining here is, we have identified these and other problems as we prepare to embrace a future that is highly engaging, full of opportunities and uncertainties lined, and prepare to confront them, recognizing that the struggle against poor health is the struggle against all that is destructive to humankind. Difficulties serve as a check on our genuine potential and power, and the distinctiveness found in nature is unquestionably invaluable.