The public health care system in Maharashtra has many loopholes, which were primarily exposed during the Covid pandemic. The health infrastructure of the state crumbled entirely during the first 2 waves of Covid-19, with critical patients wandering from hospital to hospital for a bed, people gasping for oxygen and crematoriums running out of wood to cremate the deceased victims.
Despite the fact that the Covid-19 pandemic situation has significantly improved in recent months, the state government’s hospital and health care facilities have remained unchanged. In the last couple of years, several hospitals across Maharashtra reported incidents of mishaps, leading to deaths of patients and hospital staff, underscoring the precarious state of health infrastructure in the state.
According to a report by The Indian Express, the state’s public health department revealed the footfall of patients in the OPD and emergency sections of government hospitals across Maharashtra dropped by nearly 70 per cent following the outbreak of the Covid-19 pandemic in early 2020. With the pandemic curve flattening, these hospitals are now overrun with non-Covid patients, and Maharashtra’s state-run hospitals are struggling to keep up. According to the report, the majority of them have run out of even basic, life-saving medications.
To further illustrate, the report uses the case of a patient named Kaliprasad Ramlakhan. After being bitten by a dog, the 36-year-old patient was rushed to Mumbai’s Sir Jamshetji Jeejeebhoy (JJ) Hospital, the largest state-run hospital in Maharashtra, on March 25. Since it lacked even basic medicines such as TT injections and antibiotics such as Amoxicillin, his brother was forced to go to a nearby private chemist shop and procure the medicines.
“There were no medicines in the hospital. It refused to give me even a rabies injection from their stocks, although they obliged when I pleaded,” said Ramlakhan, who was running a high fever and had to wait outside the hospital.
Pertinently, JJ Hospital in Mumbai is getting over 30 dog bite cases daily for treatment.
Kaliprasad Ramlakhan’s case is not the only such case. When The Indian Express team reached JJ hospital’s OPD ward, they saw many patients and their relatives pleading before the hospital staff at the drug counters for medicines. “We have been given targets for a daily allotment of medicines. We can’t surpass it to help the patients as we are accountable,” said a hospital staff.
The report quoted Dr Pallavi Saple, Dean, JJ hospital as saying, “Currently, we are procuring the medicines at the local level to handle the shortage. We have given the list of required medicines to Haffkine. We are hopeful that we will get the medicines within the next 15 days.”
Notably, while patients continue to suffer, state and hospital officials are busy blaming one another. According to a Free Press Journal report from last month, hospital officials stated that they provided the list of medicines to the Directorate of Education and Medical Research (DMER), Government of Maharashtra, but received no response. Meanwhile, when the issue of medicine shortages at JJ hospital was brought up in the Assembly, Medical Education Minister Amit Deshmukh blamed the deans and medical college superintendents for the delay in placing their requisition for medicines, which caused the crisis.
“They need to place their requisition for medicine procurement to the government in advance… They need to be more efficient so that there is no time lag in procedures. It is about reforming the whole structure,” Deshmukh said.
Many hospital deans refuted such charges and pointed fingers at Haffkine for “their failure to meet the requirement of bulk medicine purchase, leading to the shortfall”.
When contacted, Dr Madhavi Khode Chaware, Medical Director, Haffkine Bio-Pharma, said technical issues were behind the delay.
However, the problem is not exclusive to only JJ hospital. The Indian Express report further stated how many such state-run hospitals are refusing to treat even diabetic and hypertensive patients. Hasan Mehdi, a 57-year-old unemployed man from Dogri who is a chronic diabetic patient, is being forced to shell out Rs 2,000 per month for medicines due to the unavailability of medicines for diabetes and hypertension in such hospitals. “I have to ask my relatives for financial assistance for my medication,” he explained.
The plight of patients in rural districts such as Latur, Amravati, and Dhule, who rely on government hospitals for free treatment and medicines, is even more distressing, the report stated. Amir Ali Siddiqui, 39, a Dhule worker, recently suffered severe burns on his hand while making roti. At the Shri BhausahebHire Government Medical College (SBHGMC), Dhule, all he could get was paracetamol. “I had to spend Rs 650 to buy medicines from outside (Amoxicillin, Pantoprazole, and Polyvitamin tablets),” he lamented.
These state-run hospitals, on the other hand, have stated that the issue of medicine shortages has already been raised with the appropriate departments, but no concrete steps have been taken to resolve the issue.
The Maharashtra Association of Resident Doctors’ unit in Yavatmal’s government medical college said it has already submitted a list of 34 vital medicines that have gone off the shelves to the Shri Vasantrao Naik GMC’s Dean on March 22.
The resident doctors said they “are facing many difficulties while treating patients” in the hospital, despite the fact that there have been shortages of “emergency and essential” drugs for months.
Due to limited drug supplies, hospitals have asked their doctors to ‘rationalise’ the use of medications, putting them in a moral bind. “For us, all patients are equal. It is ethically wrong for us to rationalise the use of medicines when a patient is in a need. But due to the situation, we are being forced to provide the limited medicine only to emergency patients and ask others to buy it from outside,” said a resident doctor at the Yavatmal GMC.
Many drug vendors, on the other hand, claimed they “boycotted” the bidding process because they owed nearly Rs 220 crore for supplying drugs and non-surgical equipment to the 18 government hospitals.
The All Food And Drug License Holder’s Foundation (AFDLHF)’s president Abhay Pandey said the vendors were yet to get their 2019-20 dues of Rs 90 crore and 2020-21 dues of Rs 30 crore from Haffkine. The Directorate of Medical Education and Research (DMER) also owed around Rs 100 crore to the suppliers. “We are still compiling the pending dues of the ongoing financial year,” Pandey said.
It is appalling that though the Maha Vikas Agadi government led by Uddhav Thackeray in the state claims to have budgeted Rs 2,077 crore for medicine procurement in 2021-22, the state’s health capabilities are in such disarray that people are being denied access to basic medicines and treatment.
Maharashtra heath system crumbled during Covid-19 pandemic
It is imperative to note here that the medical situation in Maharashtra, during the pandemic, was even worse. With the advent of the second wave of the pandemic, Maharashtra ran out of hospital beds too soon. In a heart-wrenching incident, Sagar Kishore Naharshetivar who had been on the move for days in search of a hospital bed for his father said, “Give him a hospital bed, or just kill him with an injection.”
In another video that surfaced on social media, a severely ill man is said to have died in the car itself while his family ferried him from one hospital to another in search of a hospital bed.
A woman COVID-19 patient in Satara district, Maharashtra, was seen waiting in an autorickshaw with an oxygen cylinder hooked on to her to enable breathing.
COVID-19 patients at Osmanabad district hospital in Maharashtra were given oxygen on their chairs as the hospital appeared to have run out of beds.
A 38-year-old critical COVID patient succumbed to the infection while protesting outside the Nashik Municipal Corporation in April. Babasaheb Kole had reached the corporation office with his oxygen mask on after he was refused admission by multiple hospitals in Nashik.
In September 2021, OpIndia reported how out of the total 4,43,960 COVID-19 related deaths recorded in India then, over 30% were recorded from Maharashtra.