COVID-19: Bijnor has two dozen ventilators but no one to run them

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 wasteThe 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. 

This district hospital in UP has had no cardiologist for 14 years

Bijnor, Uttar Pradesh: The department of cardiology in the district hospital in Bijnor, Uttar Pradesh, has been vacant for 14 years. The hospital was designated as a Level-2 COVID-19 hospital or a Dedicated COVID Health Centre (DCHC) in September.The last cardiologist who served at the hospital was 14 years ago. When a cardiologist is needed, a special arrangement is made or the patient is referred to the Lala Lajpat Rai Memorial Medical College in Meerut, 80 kilometres away.As per the Directorate of Medical & Health Services, Uttar Pradesh, a DCHC is a dedicated health facility at a district/divisional level to manage any emergency case referred from COVID Care Centres (CCC). While the CCC are primarily for mild symptomatic/asymptomatic patients, all non-complicated cases requiring intensive care unit (ICU) facilities are admitted to the DCHC.Covid Ward - L2 facility District Hospital, Bijnor. Credits: Anuj ChaudharyDr HS Isser, senior cardiologist, Safdarjung Hospital, New Delhi, told 101Reporters that it has been observed that in about 10% of symptomatic patients of COVID-19, there is a high probability of different types of cardiovascular disease.If the patient already has a heart condition, COVID-19 is likely to aggravate the condition, he explained. Since the mortality rate is high in such cases, the presence of cardiologists in a DCHC is in the interest of such patients, he added.High costs at private hospitalsExperts say that in the case of heart conditions, even a few moments can determine the difference between life and death. To travel 80 kilometres for the treatment becomes necessary for people from the marginalised sections, but many try getting admitted in the private establishments in the town. Residents say that though the consulting fee of cardiologists isn’t high, the cost of injections, medicines and ICU in cases of heart attack can’t be afforded by most.Asif Ansari, a resident of Kotwali Dehat village, stated that his mother suffered a heart attack in September. When he reached the district hospital, he got to know that there are no cardiologists in the hospital to treat his mother. He didn’t risk going to Meerut and immediately rushed to a private nursing home. Though his mother recovered, he had to spend over Rs 50,000 for her treatment, he added. Entry Gate - District Hospital, Bijnor. Credits: Anuj ChaudharyAchal Kumar, a resident of Rahmapur village, stated that when his father had a heart attack, he couldn’t get any help in the district hospital. He too didn’t take the risk of going to Meerut and under compulsion got treatment at a private hospital.Sources in the district hospital’s emergency department say that at least seven to eight patients with heart ailments come to the emergency department of the hospital every month, but they are referred to Meerut as there are no cardiologists there.Earlier this year, two COVID-19 patients passed away after suffering a heart attack. Both of them had underlying heart conditions and were referred to a private hospital in Moradabad, about 80 kilometres away.Have requested CM: MLAApart from the vacancy in the cardiology department, several other posts in the hospital, like ENT specialist, paediatrician, radiologist and anesthesiologists, are also lying vacant in the district hospital.Dr Gyan Chand, Chief Medical Superintendent, Bijnor district hospital, admitted that the post of a cardiologist has been vacant for 14 years. He added that there are also many other specialist doctors whose positions are lying vacant.Ramakant Pandey, District Magistrate, Bijnor, told 101Reporters that letters have been written for the appointment to the vacant running posts of cardiologist and other specialist doctorsSuchi Mausam Chaudhary, MLA Bijnor from the Bharatiya Janata Party, told 101Reporters that she has written to Chief Minister Adityanath and health minister Jai Pratap Singh on this issue.

Unable to bear a child, rural couple adopts 6 abandoned babies

Bijnor, Uttar Pradesh: Unable to bear children of their own, a couple from Bijnor district of Uttar Pradesh has adopted six children who were abandoned by their birth parents.In 1986, Pritam Sharma, then 24, had got married. In the next 10years, he and his wife Satisho tried many times to conceive, but to no avail. Then, they decided that they would adopt abandoned or orphaned children. Since then, the couple has adopted five girls and a boy who were found abandoned near garbage dumps, agricultural fields and ponds.  A resident of Rampur Bakli village, Pritam is a labourer and earns about Rs 7,000 every month. He stated that their first daughter was found abandoned on his sister’s farm in Meerut district about 22 years ago. The couple had brought the child home and started raising her.By then, the villagers were already aware of his desire to adopt children. In 2000, an infant girl was left outside their house at night. In 2003, Pritam’s nephew and his wife passed away in a road accident, leaving their daughter orphaned. The couple adopted their daughter. At that time, Pritam mentioned, he was working for a daily wage of Rs 50 at a brick kiln. However, he took an extra job of selling bread to support his family.In 2006, while selling bread near Bijnor railway station, he found a newborn girl in a pile of garbage near a well. Pritam comforted the kid and brought her home. In 2009, the couple found an infant boy lying by a pond near their house. Later, they realised that he was visually impaired. In 2014, a relative of the couple brought them an infant girl who was found abandoned in an agricultural field.Pritam mentioned that whenever he found an abandoned child, he posted ads in the local newspapers, but nobody ever came to claim them. Help from community With a big family, Pritam took up odd jobs to support them. From selling bread, he took up a job at a local sugar mill, where he was first paid Rs 3,000 per month, which then increased to Rs 7,000 per month. With his meagre earnings, he could have enrolled his children only in a government school. However, he got them admitted to private schools. The school offered fee waivers and he just had to pay for their books and uniform. He got his two elder daughters married after the completion of their diploma in computer application. His elder daughter is married to an LIC employee in Bijnor in 2017 and his second-eldest daughter is married to an engineer from Chandigarh. The third daughter is in standard 11, the fourth daughter in standard 9 and their son is in standard 6, while their youngest daughter is in kindergarten.Pritam mentioned that many people helped him when they came to know his purpose and intention. In the beginning, a local doctor, Dr Deepak Gaur, helped him with Rs. 2,000 to procure a goat for milk. Later, one of his daughters, who used to get epileptic seizures, was treated by Dr Vipin Mohan Vashistha, a paediatrician, pro bono. An ophthalmologist Dr Sanjeev Rana had operated on Pritam’s son and helped him regain his sight. Apart from that, many social workers and NGOs have contributed to help him run his family. A Bengaluru-based organisation had sent Rs 80,000 for the construction of his house, with which he was finally able to construct a pucca house. Even during the lockdown, when his livelihood was affected, local residents offered him groceries.Pritam's wife Satisho has supported him at every step. While he was busy arranging daily needs through his wages, Satisho used to cut fodder for cow, goat and took care of the children. Satisho said, “Little souls find their way to you whether it's from your womb or someone else's.”Even today, if they will find a child rejected by society, they would not step back in adopting it too, she added.

This hospital in UP village has had no doctor for a decade

Bijnor, Uttar Pradesh: In 2009, Baruki village in Bijnor district of Uttar Pradesh had got its first Primary Healthcare Centre (PHC). It was supposed to serve about 70,000 people from the nearby areas, but the residents claim that except for the two or three months just after it started, they have not seen any healthcare worker in the hospital. Even during the coronavirus pandemic, the residents have had to travel over 12 kilometres to get medical attention.Located on Nagina Road, the hospital was supposed to help people from about 40 villages from four blocks of the district. In the 10 years since it was established, 10 Chief Medical Officers (CMOs) have been changed but the situation hasn’t improved. Local residents claim that no staff has been appointed by the district administration yet; and even if appointed, it's only on paper and no one has ever bothered to sit in the hospital to attend to patients. Owing to the apathy of the health department officials, this PHC is almost in ruins, local residents claim. Thieves haven’t even spared the inner doors and windows. Standing in this hospital complex is itself a challenge. Common people are afraid to come as snakes and scorpions roam around in the hospital. People of the area also stated that owing to the broken doors, drug addicts break into this place and outside the hospital, people dispose of cattle dung. Kartar Singh, former gram pradhan of Baruki (2005-10), stated that the PHC was built during his tenure, and even though the budget was Rs 77 lakh, the expenditure had come to around Rs 1 crore. Initially, the doctors and Auxiliary Nursing Midwifery staff used to attend to patients there, but after a few days, the staff stopped coming. Many CMOs have been informed about it, but for 10 years, no doctor or staff came here, he added. Now the windows and doors inside have been uprooted and the purpose for which this hospital was built was never met and all the efforts went in vain, he told 101Reporters.No hospitals nearbyIn cases like dengue, malaria, or other serious diseases, the health of the villagers is left on God’s mercy. Even in the case of minor fever or injury, there is no government hospital in the 12-km range. Anand Kumar, a 40-year-old resident of Baruki, stated that Baruki is in the middle of dozens of villages but people here are denied government medical facilities. Even for minor bruising, people either have to go to Bijnor by travelling 12 kilometres or to Kotwali, which is 13 kilometres awa. If travelling is not possible, then people have no choice but to visit quack doctors, he highlighted. He added that they are unable to express their problems to the government as the MLA has not visited the area since he won the election.Rampal Singh, a former gram pradhan of Baruki (2010-15), stated that during his tenure, he appealed to different CMOs, requested them regularly but there was no result. At times, it was assured that a doctor from another hospital had been directed to look at patients for a couple of days each week; however, no doctor ever came to the hospital, he added.The present gram Pradhan Brahmapal Singh stated that he started approaching authorities for the appointment of doctors and staff in this hospital as soon as he took the office. He stated that he submitted letters and applications to the District Magistrate, visited the CMO and even tried to request the chief minister, but in vain.MLA unaware of issuePart of the Nehtaur Assembly constituency, Baruki has had Bharatiya Janata Party’s Om Kumar as the MLA since 2012, but he was unaware of the situation, when questioned by the reporter. He was also unaware that a PHC was established in Baruki and was upset to learn that no doctor has visited the area in 10 years. However, he claimed that he has visited the area multiple times but no one apprised him of the situation. He said, “It’s not possible to go to every house, also no one made me aware of this case.” Later, through the MLA’s office, it was found that a Dr Sachin was recently appointed by the CMO in Baruki PHC. When the reporter called Dr Sachin to ask about it, he abruptly disconnected the call and switched his phone off.Dr. Vijay Kumar Yadav, CMO Bijnor, stated that about two months ago, the government appointed Dr Sachin, but owing to the coronavirus pandemic, he is unable to go there. Ramakant Pandey, District Magistrate, Bijnor, stated that at present, there is a shortage of doctors at many PHCs across the district. He also assured that the problem would be solved as soon as possible.