• Suhani Daruka

Bihar's Healthcare System: On the Brink of Collapse

With approximately 3.17 million cases of the COVID-19 (as of August 25, 2020), India continues to retain its position among the three-worst-hit-countries, also bagging the second position in terms of daily increase in the number of COVID-19 patients, worldwide. While almost all the 29 states of the country remain victims of the deadly pandemic, Bihar remains the worst hit, not in terms of the number of COVID-19 patients but the healthcare facility of the state as a whole.

"According to protocol, we should be given an N95 mask, a personal protective equipment (PPE) kit and sanitizer. Our situation is so dire that we use HIV kits to protect ourselves while treating patients. We also wear one pair or two pairs of gloves for eight hours. We reuse the gloves by sanitizing them. I am scared that I will contract the coronavirus if I continue to treat patients without proper safety equipment," - Doctor at the Jawaharlal Nehru Medical College and Hospital (JLNMCH) in the city of Bhagalpur in Bihar

Why does Bihar’s healthcare system struggle?

The current state of affairs in Bihar can be seen as an acute manifestation of weaknesses in its already present sub-par healthcare system and calling the situation "bad" would be an understatement of the highest proportions. It has been in a state of constant neglect, because of which it has not been highlighted in the national or even the state’s policy agenda. Despite several timely reforms, the overall system never developed enough to meet the needs of the growing population. Most of the growth remains confined to the capital city of Patna, disregarding the 88% of the population that lives in villages.

The health department is so poorly equipped to deal with public health care concerns that public health crises often make way for political control. Apart from that, the qualification to become a civil surgeon remains just an MBBS degree, at the district level. Notably, educational qualifications, professional ability and service performance are not evaluated before selection. Not only is there a shortage of staff, but this also suggests that some of the staff present might be incompetent to deal with such a dire situation.

Implications of the COVID-19 on the healthcare system

On March 23, Prime Minister Narendra Modi pledged an investment of 15 billion Indian rupees in India's healthcare system, to tackle a surge in cases of the coronavirus. The Indian government has since then made strides since in manufacturing of testing kits and ventilators. But it has failed to provide basic safety kits to doctors on the front-line. Bihar faces an acute shortage of resources like PPE kits and protective masks, things considered absolutely essential to stand any chance against the pandemic. Locals from Patna claim that the state government has yet to receive any money from the federal government to tackle the health crisis. Due to the underwhelming public healthcare facilities in Bihar, a network of private hospitals has made its footing in Bihar but it can only be accessed by the privileged.

As dramatic as it sounds, there are instances of relatives not even being allowed to touch their dying loved ones, as they take their last breath. The ICUs in almost all public hospitals, are in shambles, coming as a shock to almost everyone accustomed to seeing intensively sealed ICUs. Doctors speak of acute shortage in manpower, resources and feel powerless as the curve refuses to flatten.

The brave Essential Workers on the frontline fighting this pandemic have been reduced to ‘Sacrificial Workers’.

What can be done?

The challenge ahead is to accommodate the critically-ill patients into isolation wards and give them the necessary support. On the part of government, there is an urgent need to intensify testing process, which has been largely reduced in the rest of the country and improve infrastructure so as to instill trust and accountability. Proper investment in the healthcare sector is of vital importance. It is imperative that those of us who can, donate to reliable sources for the betterment of Bihar’s healthcare facility and to help the medical staff fight this pandemic so that the India's third most populous state can successfully tackle this pandemic.

~Suhani Daruka