COVID-19: Oxygen Crunch and Defunct Ventilators Endanger Lives in Bihar

The second wave of COVID-19 is taking a heavy toll on lives across the nation. Bihar, too, has been gripped in the dreadful clutches of the pandemic that has spread its reach to hundreds of villages affecting millions.

Meanwhile, the rising cases of infections across villages are not being challenged by the healthcare services as hospitals i.e. medical college cum hospital or sadar (district) hospitals or Primary Health Centres stand with empty oxygen cylinders and defunct ventilators and without technicians to handle the equipement. Shockingly, the defunct ventilators across district hospitals in the state have been left out of the government’s concern book.

With the state reporting a total of 1.15 lakh active COVID-19 cases till May 7, the Bihar government is apparently struggling to provide medical facilities to patients. The insufficient skilled manpower in public healthcare has come back to haunt the state government again after the first wave of the pandemic. The district hospitals (commonly known as sadar hospital) are ill-equipped and without functioning ventilators, which have emerged as urgent requirement of COVID-19 patients, indicate the government’s inability to learn lessons from the past.

As per reports, ventilators in nearly 36 districts are lying idle with no technical hands to operate. Two ventilators at Arwal Sadar hospital were found to be non- functional. The sadar hospitals in Araria, Aurangabad, Banka, Begusarai, Bhagalpur, Bhojpur, Buxar, East Champaran, Gaya, Gopalganj, Jehanabad, Jamui, Kaimur, Katihar, Khagaria, Kishanganj, Lakhisarai, Madhepura, Madhubani, Munger, Muzaffarpur, Nalanda, Nawada, Saharsa, Samastipur, Saran, Sitamarhi, Siwan, Supaul and Vaishali all have six ventilators each but with no technician to handle and operate. While seven each in Purnea, Rohtas and Sasaram have been found to be not working. 

The status of the state healthcare system even compelled the Patna High Court to take cognisance of the issue. A two judge bench of the high court lambasted at the Nitish Kumar-led government in April and said, “You had spoken about 1,000 beds at the IGIMS (Indira Gandhi Institute of Medical Sciences) and 500 beds at the ESIC (Employees’ State Insurance) hospital, but it could not start. PMCH (Patna Medical College and Hospital) is in shambles, NMCH (Nalanda Medical College & Hospital) is struggling.”

Further, disturbing visuals and inputs from Kishanganj sadar hospital have also surfaced. Distressed and critical patients are not getting ventilator support as the hospital has no technician to test the functionality of equipment. Dr. Vishwajeet Kumar, who is working at the hospital, told NewsClick that unavailability of technical hands is a deficit amid the pandemic.

“Critical patients cannot be treated due to the six non-functional ventilators placed in trauma centre of the hospital. It has compelled patients to go to as far as Bhagalpur, Madhepura or Patna. The lack of sufficient technicians exposes the non-serious preparedness of the state Health Department along with district administration,” he added.

Ill equipped APHC in Pothia block, Kishanganj district 

The Damalbadi Additional Primary Health Care Centre (APHC) is the first stop for health services in Pothia block for an approximate rural population of more than 30,000. However, it lacks even the most basic medicines like paracetamol. The closest Primary Health Centre (PHC) is 22 kms away from Pothia block.

Those with stable economic background from the region are choosing to get treated at Silliguri hospital in West Bengal that shares border with Kishanganj as distance wise it is feasible for the patients. “Such practice is underway due to defunct ventilators and oxygen shortage at the district hospital,” said Shah Faisal, a social activist based in Kishanganj. He further said that getting treated at the sadar hospital is a distant dream as it is 24 kms away from Pothia block. “Till April 27, the hospital reported 21 COVID-19 related deaths which could have been averted if ventilators were put to use. The state Health Department, instead of confronting, has kneeled down in front of COVID-19 pandemic,” he added.

The next nearest destination for people of Seemanchal ailing from COVID-19 is the Jan Nayak Karpoori Thakur Medical College and Hospital (JNKTMCH), Madhepura. One of the largest state-run hospital in Bihar's Kosi-Seemanchal region, it is a disappointment for those struggling against COVID-19 for better treatment. Dearth of medical staff and technicians to handle ventilators, and inadequate oxygen at the JNKTMCH, established at a cost of Rs 800 crore, has crippled the services for COVID-19 patients. As per hospital superintendent Dr. Rakesh Kumar, the hospital has 325 beds but only 102 have been reserved for COVID-19 patients due to working staff crunch.

As a result of the ill equipped district hospitals, critical patients hailing from Seemanchal often have to bear the brunt of travelling long distances, many breathing their last before they can reach the Madhepura medical college and hospital.

The Madhepura hospital came to existence in March 2020 in an area of 25 acres and was designated to serve patients across seven districts i.e. Supaul, Madhepura, Saharsa, Araria, Katihar, Kishanganj and Purnea, but non-sufficient work strength has exposed its inability in midst of pandemic. 

As per India Today’s report, a 60 bed COVID-19 dedicated hospital in Simri Bakhtiyarpur, Saharsa, lies locked since last year as there is a lack of doctors and medical staff. As per the BDO of the block, Manoj Kumar, the gates of the hospital have been shut due to a crunch of doctors and medical staff. 

Not only that, the state’s largest city after Patna, Muzaffarpur too is suffering a similar condition where hospitals both private and governments are badly in need of oxygen and ventilators. As per district administration, there are 325 patients admitted across the city who need 900 oxygen cylinders while hospitals have only 300. Shri Krishna Medical College and Hospital (SKMCH) has 200 patients alone with 200 cylinders but the requirement is of 700 cylinders. 

The second largest hospital in North Bihar, the Darbhanga Medical College and Hospital (DMCH) has also proved a big disappointment for people amid the second wave. With 27 dysfunctional ventilators and oxygen dearth, it is allegedly failing to serve patients pouring in from nearby districts of Madhubani, Samastipur and Begusarai. The medicine department head reportedly offered to resign on May 7 blaming the insufficient resources like oxygen shortage while handling critical COVID-19 patients.

As per the civil surgeon of neighbouring Madhubani district, Sunil Kumar Jha, the district hospital has not been equipped with technicians since the last summer and that coincided with COVID-19 pandemic, posing a grave challenge for rural patients.

Civil Surgeon at East Champaran (Motihari). Akhileshwar Singh, admitted the dearth of technicians to operate ventilators in the district hospital while West Champaran (Bettiah) is facing an oxygen deficit. The Sheohar and Sitamarhi district hospitals lack even basic infrastructure i.e. pipe connections for oxygen supply and on-site oxygen plant, in addition to lack of ventilators.

As per media reports, the Gopalganj district hospital also failed to meet treatment standards for patients. It witnessed reportedly 42 deaths in four days between May 1 to 4, and majority of them had breathing problem. Meanwhile, the claims of bed shortage and unavailability of oxygen were ignored by the hospital administration.

Besides oxygen supply and ventilators, hospitals across Bihar are neck deep in terms of bed crunch too. The unavailability of beds has not spared even private hospitals. Over 30 private hospitals have been treating COVID-19 patients but there are less than 3,500 ICU beds in the state.

Talking to NewsClick about it, MLA from Paliganj, Patna, Sandeep Saurav alleged that Paliganj division has only one isolation centre at Bikram but the government has befooled people by arranging 10 oxygen beds against the claimed order of 25 for an approximate population of 5 lakh. While the centre is devoid of medical staff, all complaints about its ill equipped capacity have been ignored by Patna DM and Civil Surgeon, who remained unresponsive despite several calls made to them.

Similar apathy is of Ara sadar hospital where patients are scared because desire to get cured is turning into disappointment. Without oxygen, ventilator, flow-meter and CT-scan machine, the hospital has become a death bed for many patients. The district is home to MLA and MP who are sitting ministers in the state and central government.

Aigaon MLA Manoj Manzil slammed the state Health Department for failing the need of medical services delivery at Ara sadar hospital.

Munger sadar hospital staff went on strike following the death of a 27-year-old co-worker, Anand Kumar. With oxygen crunch and non-functional ventilators, the negligence of doctors and nurses have added to the plight of frontline health workers.

Divya Sagar, Medical Officer, Buxar Hospital refuted the claim of oxygen shortage and said, “We are trying to make all the efforts but number of patients is too high to get efficient oxygen supply. Buxar has a 5,000-bed COVID-19 hospital running short of oxygen supply, which is forcing patients either to shift to other hospital or suffer and die.”

Bihar Govt order on handing over ventilators to private hospitals

Amid this rapidly unfolding disaster, the Government of Bihar does not seem to have spared an opportunity in betraying and befooling the masses, as claimed by Rashtriya Janta Dal (RJD) spokesperson and Member of Parliament Prof. Manoj Kumar Jha.

Prof Jha told NewsClick over phone, “There’s nothing in the name of public healthcare for people of Bihar. Chief Minister and Health Minister are clueless to handle the pandemic and if Nitish Kumar is thinking about outsourcing lives of ordinary citizens through hands of private hospitals then he’s highly mistaken. Examples could have been drawn from Kerala’s public healthcare infrastructure and Maharashtra’s municipal corporation pitching at higher level."

Jha was referring to the government’s decision to hand over non-functional ventilators in 36 district hospitals to private hospitals citing overburdened medical staff. According to the circular issued by the government, private hospitals were asked to serve list of skilled manpower to civil surgeon of the respective district so as to acquire them.

In backdrop of the decision, more than 200 ventilators did not find use amid the life threatening pandemic.