India: the planet’s pandemic
India is experiencing the worst wave of infections and deaths the world has seen since the start of the Covid-19 pandemic. The healthcare chaos overlaps poor medical coverage and the endemic problems of lack of access to water and sanitation in the marginal slums and in the neglected rural world. The solution of the pandemic in India is key for the entire world.
India is experiencing the worst wave of infections and deaths the world has seen since the start of the Covid-19 pandemic. Hospital, one of the healthcare centers of the Vicente Ferrer Foundation. © Rodríguez Roberto
The second wave of the pandemic, which started at the end of March, has exceeded all forecasts in India. It began last month with an alarming exponential growth: in the week from the 18th to the 25th April, 2.24 million cases and 16,257 deaths were registered; on the 1st May, new cases reached more than 401,000 and 3,523 deaths were reported all around the country in 24 hours. On that day, the official number provided by the government reached 211,853 deaths since the outbreak of the pandemic, but health professionals fighting for life or death against the disease and WHO observers claim that these numbers are not reliable and many point out that they may be up to 30 times higher, since a high percentage of the most neglected population is suffering the disease in their homes with no treatment or medicines.
New confirmed cases of Covid-19 in United States, Brazil, European Union and India. Data updated April 23 2021. Source: Financial Times analysis data from Johns Hopkins CSSE, the WHO, the UK Government coronavirus dashboard, Public Health France and the Swedish Public Health Agency.
The second wave, out of control
Hospitals are overcrowded and lack basic supplies such as oxygen, mechanical ventilators and virus test kits, and healthcare workers are being decimated by the pandemic. On the 21st April, the demand of oxygen in India reached 13.04 million cubic meters, six times more than the second neediest, Turkey, whose shortfall on that day reached 2.77 million.
A case in point is Hospital, one of the healthcare centers of the Vicente Ferrer Foundation, which a year ago, at the beginning of the pandemic, was declared by the Andhra Pradesh State Administration as a referral center for Covid-19 patients. Today, the hospital is completely overwhelmed. The Vicente Ferrer Foundation launched the campaign “” on the 26th April, with the aim of obtaining a generator of this gas, an essential element for the treatment of seriously ill patients, whose demand has jumped throughout the entire country.
Hospitals are overcrowded and lack basic supplies such as oxygen. Hospital, one of the healthcare centers of the Vicente Ferrer Foundation. © VALLDAURAAINA.
The situation in the poorest regions of India, where the We Are Water Foundation is currently collaborating in different with organizations such as the Vicente Ferrer Foundation, World Vision, Habitat for Humanity and Gramya Foundation, is particularly dramatic because of the abandonment of its inhabitants, the lack of healthcare resources and other endemic diseases that plague areas lacking access to water and basic sanitation. There, Covid-19 is now affecting a population that loses more than 10,000 children every year due to endemics produced by the poor condition of water. What possibilities are there for effective action against coronavirus?
The healthcare chaos overlaps poor medical coverage and the endemic problems of lack of access to water and sanitation in the marginal slums. © Emmanuel DYAN
During the , the Indian government established a severe lockdown. It did so suddenly, with less than four hours’ notice, putting tens of millions out of work in the poorest neighborhoods of the city. The lockdown was implemented when many were returning to their home villages, so that thousands of people had to continue their journey on foot or with improvised or clandestine means of transport and a very large number of them died.
Now, in this second wave, the government has not announced a national lockdown; but, fearing to be trapped again, millions of workers started a massive and hasty return to rural areas in April. This exodus has caused a chaotic situation that has only encouraged the spread of contagion.
The worst healthcare system for a pandemic
© REUTERS/Adnan Abidi
In 2019 India invested approximately 1.25% of its GDP in (public and private) healthcare, while in 2018 it reached 0.9% (). These are data that place the second most populated country in the world among those that invest the least: in 2018 the USA reached 14.3% of the GDP in healthcare, Spain 6.2% and Mexico 2.8%, for instance. Many analysts and those critical of the government consider that these numbers are inflated and that the real investment rate is close to 0.4%. A figure that explains the severe situation experienced by the country, especially considering that approximately three quarters of the healthcare system are in the hands of the private sector.
In 2018, the government launched its National Health Protection Scheme (PMJAY, in Hindi) with the aim of providing medical coverage to 500 million Indians, among them the most vulnerable. The plan was commonly called Modicare, in reference to the Prime Minister’s name (Narendra Modi), who announced it as the world’s largest public healthcare program. But even before the pandemic, Modicare, which was based on a 15% increase of the investment in the healthcare system, had proven to be incapable of palliating the deficit of public services and showed cracks in its effectiveness, partly due to the fraudulent use of the provided financial aid and partly due to the lack of an efficient healthcare system to implement it. Covid-19 has managed to dismantle the objectives of PMJAY.
Lack of hospital transparency
The reality of the inadequacy of public hospitals to face the pandemic is reflected in Chengalpattu, in the state of Tamil Nadu, where the Foundation has finalized a with the aim of facilitating the management of wastewater of the
This university hospital, one of public hospitals in the district (there are 57 private ones), has 1,300 beds and provides free medical care mainly to low income communities. The facility has been powerless to treat the 86,265 cases in Chengalpattu since the outbreak of the second wave. According to only on Tuesday, May 4th, the hospital detected 1,608 new infections, and during that night at least 13 patients died in the hospital in just four hours, triggering a bitter controversy that shows the lack of government transparency regarding the evolution of the pandemic: while family members and some health personnel blame the lack the oxygen for the accumulation of deaths, the hospital management and the authorities deny this cause.
The reality of the inadequacy of public hospitals to face the pandemic is reflected in Chengalpattu, in the state of Tamil Nadu, where the Foundation has finalized a