As Cases Spike, Doctors in Bihar Threaten Hunger Strike to Protest Govt Apathy

Patna: On the day Bihar saw the worst single-day spike of 1,432 COVID-19 cases, pushing the tally to 18,853 cases across the state, doctors and healthcare workers threatened to go on a day-long hunger strike, protesting ‘negligence’ by the Nitish Kumar-led government.

Disappointed and worried, the Indian Medical Association (IMA), Bihar, blamed the state government for acute staff shortage, including of doctors, and poor infrastructure at government-run hospitals that are treating the coronavirus positive cases. All this was increasing the risk of doctors getting infected, IMA Bihar said.

This is bad news amid the sudden spike in positive cases and the number of deaths in the past few days. IMA, Bihar has made repeatedly held that the state had reported a spike in COVID cases despite low number of testing.

IMA, Bihar is probably the first in the country that has publicly expressed its dismay against the state government’s “negligence and apathy” toward fight COVID-19.

“Doctors will stage a day-long hunger strike next Sunday if the government fails to immediately appoint doctors, improve health infrastructure and agree to the demand for COVID testing of doctors and other medical staff twice in a month”, Sunil Kumar, secretary of IMA, Bihar, said.

Kumar said as doctors cannot go on strike amid surging COVID cases because it will paralyse the healt care system, “we will take a final decision on Friday to stage a hunger strike to protest the ignorance of government to our demands”.

Ranjit Kumar, general secretary of the Bihar Health Services Association, said the state has been facing acute shortage of doctors, with nearly 75% vacancy in the public health sector. What is alarming that 35% of working doctors are over 60 years of age. “This is the hard reality of nearly half of workforce of frontline corona warriors in Bihar compared with other states”, he added.

According to data of the National Health Profile, 2018, Bihar’s doctor-population ratio is the lowest in the country, with one allopathic doctor per 28,391 people and only one hospital bed per 8,645 people.

Dr Sunil Kumar said a large number of doctors were getting infected due to lack of safety and proper infrastructure in the hospitals, including in the three three designated COVID hospitals.

“As per our reports collected through IMA offices at districts, more than 200 health staff, including doctors, are infected by COVID.But the state government has so far not released any information on the number of healthcare workers infected by the coronavirus infection,” he added.

According to Dr Sunil Kumar,a private medical practitioner (doctor) from Gaya town, Ashwani Kumar Nandkuliar, 57, died at AIIMS Patna on Monday. He was the first doctor who died due to COVID in Bihar. Two other doctors -- one from Patna Medical College and Hospital and another from Nalanda Medical College and Hospital -- are critical in AIIMS Patna.

Dr Ajay Kumar, senior vice president of IMA, Bihar, said doctors are with no option but to stage a hunger strike. “It will be a symbolic protest against the government’s indifference and inefficiency,” he added,

Dr Ajay said in the nearly four months after lockdown began, not a single doctor has been added at government- run hospitals in Bihar.

“About 6,000 doctors applied for jobs at government hospitals. They have been interviewed but not yet appointed. All of them waiting to join” said Dr Ajay, former president of BHSA and its advisor.

He said the government had ignored their repeated requests to clear pending appointments.

Dr Ajay alleged that “below standard” treatment was being provided to COVID patients due to shortage of healthcare staffs and lack of basic infrastructure.

Take the case of Patna based NMCH, one of three designated COVID hospitals in the state, there is not a single senior resident anaesthesia there. There is no technician who can run around 100 ventilators and monitor them round the clock, he added.

Dr Ranjit said in 2016, the state government had issued an advertisement to appoint 1,100 specialist doctors, but till date appointments are pending.

Dr Sunil said at least anaesthesia specialists and physicians should be appointed quickly by the government as cases are spiking in the state.

“There are posts of 25 senior resident anaesthetists and eight junior anaesthetists at NMCH but there is not a single doctor. This is how the state government is fighting COVID,” he said.

Dr Ajay alleged that the well-established principle to fight COVID by testing, tracing and treating was not being properly implemented in Bihar.

Government doctors are asked to mark attendance every day and are not being given leave or a weekly offs. Most of the doctors are exhausted as they have been working for months without break.

If this situation continues, all doctors will be infected one day, feared some doctors.

Last week, IMA, Bihar, in a letter to Union minister of state for health and family welfare, Ashwani Kumar Choubey, had demanded that AIIMS Patna be declared a dedicated COVID hospital and 50% beds be reserved for doctors and healthcare workers.

IMA, Bihar members also pleaded that since COVID required specialised treatment, other illnesses could be treated at other state government and private hospitals.

As per Bihar Health Minister Mangal Pandey's own admission, there is one doctor for every 17,685 persons in the state. There are 6,830 doctors, including those in medical colleges in Bihar, which has a population of nearly 12 crore. Over the last few years the state government has repeatedly announced appointments for between 1,000-2,000 doctors, but these never happened. Most of the hospitals, including those at district level, community health centres at block level and Primary Healthcare Centres (PHCs), are facing a shortage of doctors.

Similarly, there are only 1,900 PHCs in the state against the required 3,470 and 150 community health centres instead of the 867 that are needed. There are nine government-owned medical colleges and hospitals, including two in Patna and one each in Gaya, Darbhanga, Bhagalpur and Muzaffarpur districts. The government has announced that the Nalanda Medical College and Hospital(NMCH) in Patna has been designated as the state’s primary hospital to treat cases of COVID-19. The government claims that the hospital’s isolation ward has 600 beds.

Wary of the rising cases of COVID-19 in Bihar, after more than a dozen district authorities imposed a lockdown again last week till July 16, the state government is likely to announce an extension of lockdown across Bihar to July 31 to check and control spread of COVID.

On Monday, 1,116 COVID-19 cases were reported in Bihar and on Sunday (July 12) Bihar reported 1,266 cases.

Patna has so far reported more than 2,000 positive cases, the highest in the state. As per reports, about 75 BJP leaders in Patna tested positive in the past 24 hours.

Bihar has increased its testing rate after lagging for nearly three months. Official data show that the state has one of the lowest testing rates in the country.