The lack of appropriate doctors and technicians has rendered useless the ventilators supplied to the district hospital in Bijnor. 

Bijnor: A year ago on April 13, when Bijnor saw its first COVID-19 diagnosis, the district hospital did not have a single ventilator. Over the course of the next few months, the Uttar Pradesh government sent 24 ventilators to Bijnor to help severe COVID-19 patients gasping for breath, but the officials sitting in Lucknow forgot that anesthesiologists are needed to hook up patients to these ventilators. District authorities were not even asked if there were enough specialist doctors available to operate them.

There have been 7,240 cases of COVID-19 in Bijnor till April 23 this year but none of them could benefit from these ventilators. Over the past year, doctors here were forced to refer hundreds of patients with a severe case of the coronavirus to the Teerthanker Mahaveer University (TMU) Hospital in Moradabad, more than 80 km away. Now due to the increase in the number of patients in TMU, it is feared that getting admissions there will become difficult. 

Resources lying in waste

The district hospital in Bijnor has a dedicated L-2 COVID-19 ward in operation since last year (to deal with complicated and critical cases), but despite the availability of resources, it is only able to admit either asymptomatic patients or those with mild symptoms. The hospital has the infrastructure to be able to admit serious patients though. According to hospital sources, in June 2020, four ventilators were sent by the state government and later a few more were sent in batches until the hospital had 24 ventilators in total. 

Of these, 14 have been kept in the storeroom and 10 have been set up in the L-2 COVID-19 ward. But right now, they are nothing more than display pieces because there are no anaesthesiologists working here who can operate them. 

In COVID-19 care, the anesthesiologist has one of the riskiest jobs. When a patient is no longer able to breathe on their own, an anesthesiologist is called on to intubate them. They insert a breathing tube, or an endotracheal tube, through the mouth and into their air passage. The patients need to be anaesthetized during this process so that they don't feel like they are choking. The tube is connected to a ventilator, which pushes air into the lungs to help patients breathe.  

The L-2 COVID-19 ward in the Bijnor's district hospital (Picture courtesy: Anuj Chaudhary)

Right now, not a single anesthesiologist is working at this L2 COVID-19 ward. At least three anesthesiologists must on the hospital's roll so that they can each work 8-hour shifts and ensure the ventilator is continually in operation for 24 hours. Additional specialist doctors are needed to relieve these doctors after a few days in order to give them a break. Last year, after demands from the district authorities, a specialist doctor was sent by the government, but he was only here temporarily and wasn't of help anyway because he didn't have enough anesthesiologists to support him. 

There isn't even a ventilator technician available on hand for maintenance and repair of the machines. 

'My father could have been saved' 

Waseem Ahmad, 32, son of the deceased Azimuddin (he goes by one name only) told 101Reporters that his father tested positive on July 19 last year. His situation turned serious but he couldn't be treated at the district hospital and was referred to TMU Moradabad the same day. Unfortunately, the 60-year-old Azimuddin, a retired nazir (registrar) at Bijnor tehsil, could not make it to Moradabad and died on-route. Waseem believes that if the facilities available at the district hospital's L2 facility could have been properly utilised, his father could have been saved.

People familiar with the matter are of the view that if the government cannot afford the staff to operate the ventilators, the machines should at least be sent to places where they can be used. At a time when there is a huge shortage of resources, two dozen ventilators sitting idle makes no sense. Maybe these could be used to save the lives of people in some other hospital.

Dr Gyan Chand, the Chief Medical Superintendent at Bijnor district hospital, admits that they do not have a single anesthesiologist to operate the 10 ventilators that have been set up. "Last year, one Dr Radheshyam Swamy was sent by the government, but to run the ventilator continuously for 24 hours, at least three anesthesiologists are required to work in three shifts. Also, we have no ventilator technician. Therefore, it is our compulsion to refer serious patients to TMU Moradabad."

Ramakant Pandey, District Magistrate, Bijnor, told 101Reporters that they know two anesthesiologists who can take up duty but that is still not enough. "Because once you start the ventilators, they cannot be stopped. All efforts have been made to recruit another expert anesthesiologist. We are also willing to hire a private anesthesiologist at any cost," he said. But there simply aren't any available. 

"Lucknow has its own needs," he said when asked why the government can't appoint the appropriate doctors to Bijnor on an emergency basis. "After the beds go full at TMU Moradabad, arrangements will be made at Pulkit Memorial for serious patients," he said. It is worth noting that Pulkit Memorial, a private hospital in Bijnor that was designated an L-2 COVID-19 hospital last year, has not admitted a single coronavirus patient since the pandemic began.

"We are also planning to send some of these ventilators to Moradabad where they can be used," Pandey added.

Update: The latest from Bijnor is that 10 of these ventilators have been shipped to Moradabad, according to the DM, and some "private staff" were finally roped in to start the ventilators at the L2 facility.