COVID-19: In Rural UP, CHCs and PHCs Faced with Shortage of Medical Equipment

Lucknow: With a surge in COVID-19 cases across Uttar Pradesh, most government-run hospitals in rural areas including Community Health Centres (CHC) at the block level and Primary Health Centres (PHC) are facing a shortage of medical resources to treat patients.

A lack of preparation given the spike in COVID-19 amid a second wave of the disease across the country is being seen in rural areas – shortage of ambulances, beds, ventilators, Oxygen and medicines in government-run hospitals which are leading to a rise in casualties in many districts, a common sight in the state.

Amit Pandey, a doctor deputed at a CHC in Ballia district, said the health department "has not provided adequate facilities to us to fight COVID-19. Health department officials have still not visited our villages despite people dying everyday due to a lack of treatment. The villagers have to spend from their pockets, pay extra charges for vehicles and other facilities to save their lives. We are ready to provide services if the government turns CHCs into COVID quarantine facilities with more para-medical staff and resources,” said Pandey.

According to him, data collected by the Chief Medical Officer (CMO) says there are 70 ambulances and only 231 Oxygen cylinders in Ballia district. "People in rural areas are unaware of the coronavirus. They do not know what do to if anyone develops symptoms. In rural areas people are still mostly dependent on their local doctors to cure basic ailments like fever, cough, and body aches," Pandey told Newsclick, adding that the government should immediately put testing labs in place at PHCs in villages and that all government-run hospitals must function as per COVID-19 protocols.

Uttar Pradesh saw a new record of cases and deaths due to the novel coronavirus on Friday, with 36,605 new infections and 196 deaths, its highest single-day toll so far.

Newsclick also spoke with a doctor in Sitapur district who is associated with a government-run hospital. Revealing a similar ordeal, Jitendra said: "There is a lack of infrastructure and basic facilities in the villages. Despite the Modi government's efforts to boost the rural health infrastructure through programmes like the National Rural Health Mission (NRHM) and measures to increase availability of doctors and specialists, the more remote and rural areas remain disadvantaged."

He said there were many issues with the rural health infrastructure. "There is no dedicated quarantine centre at a district level; the delay in COVID-19 testing has become a major cause of worry among the people. Due to the delay, those awaiting results have grown more anxious. The government did not launch any health schemes even a year after the pandemic first struck. We have one COVID centre for ten villages. A dedicated fleet of ambulances is required in every village, which is currently missing. Despite this, a dedicated team of medical professionals, including doctors and paramedical staff are needed, but that has not happened. Last, but not least, complaints of overcharging by private vehicles are being reported," he added.

According to health experts, there is a huge demand for ambulances to ferry patients to hospitals in rural areas, but due an acute shortage of oxygen, the administration is forced to turn them away.

Elaborating on the "poor infrastructure" of PHCs and CHCs in the state, Dr. C.S. Verma, president of the public health outfit Jan Swasthya Abhiyan (JSA), Uttar Pradesh, said, "Our rural health network is weak and it is the reason why people rush to hospitals in cities. There are no basic facilities like X-ray and blood testing and not as many doctors as should be, which is the basic objective of opening health centres in rural areas," Verma told Newsclick.

He further said that the government, from the day the pandemic hit, had been maintaining that there was no reason to worry, but that an assessment was necessary. "In the last one year no beds have been added to any PHC and CHC, no recruitment of doctors, nurses, technical and other paramedical staff over and above the previous number has taken place. Among the foremost concerns now is Oxygen. People are dying due to a lack of it. It seems the government either has experts who could design a policy, nor have they upgraded infrastructure in a year so that people at least don’t die due to a lack of Oxygen,” he added.

HEALTH AWARENESS, TESTING LABS – NEED OF THE HOUR

Even as COVID-19 cases continue to rise steadily in Uttar Pradesh, according to official data, there is a lack of health awareness in rural areas about the disease and preventive measures to be taken. Besides, no testing labs for COVID-19 are available in rural areas.

The health expert believes that the government should engage its employees and volunteers to educate people about the novel coronavirus and the safety protocol through folk songs, paintings, slogans or posters. "Thorugh the campaign the volunteers will appeal to the people wear masks, follow social distancing and also get tested immediately if they experience symptoms such as fever, cold and cough," he added.

In Babhni, Sonbhadra district – primarily dominated by those from the Adivasi community and one of the most backward districts in terms of health infrastructure – a doctor posed at a CHC said: "In my CHC, we have pathology facilities, an X-ray machine and a blood bank, but we do not have specialists to handle them. If we have a gynaecologist then we do not have anesthetist. Similarly, if any CHC has a pediatrician then it does not have a surgeon. Basically, there is no proper team at CHCs or PHCs," he told Newsclick, adding that the people do not trust the latter either.

When asked for the reason behind a shortage of doctors, he said: "Doctors do not get proper facilities at CHCs and PHCs like others get in medical colleges and universities. So they do not want to stay at government-run hospitals for long," he added.

In Sonbhadra, a team of Accredited Social Health Activist (ASHA) workers and volunteers, in coordination with the district administration, are spreading awareness about vaccination and asking people to get tested if they develop symptoms. "The villagers say that people still test positive even after getting a double dose of vaccination. People do not want to get tested because they think the government might quarantine them forcefully," a volunteer said.

Rajdev Chaturvedi, a health activist based in Azamgarh associated with the Health Watch Forum, said: "There is a shortage of doctors at every PHC and CHC. Most importantly, OPD facilities, which were helping patients a bit, were closed. The government had a year to come up with extra beds, Oxygen, medicines or ambulances but they were in deep slumber and did nothing." He added that last year, during the pandemic, the govenrment had started a level 2 hospital to deal with COVID-19 patients but it was shut down a few months later. It was functional again when the pandemic began to create havoc, he added.