By Dr Gurpreet Sandhu
Moved by the sheer enormity of the implacable COVID-19 which has now shown no signs of relenting. Even the 15th Finance Commission in its report has, for the first time, included a chapter on health financing giving out a few details on India’s infamously inadequate healthcare infrastructure. And this inadequacy has been glaringly evident in the low proportion of doctors, nurses, and other support staff vis-à-vis the patient population they serve. However, despite this huge stumbling block, the healthcare community has rallied itself to deliver the best COVID outcome to India under the circumstances. If it wasn’t for the devastating second wave that took most people including health authorities and experts by surprise barring a few sero surveys which had indeed made dire forecasts, India had come out relatively unscathed by global standards.
And this had been made possible by the untiring and unstinting efforts of the healthcare community led by doctors themselves. It is particularly commendable amidst the low staffing support that they had and the staggering nature of the COVID challenge in terms of severity and numbers.
Yawning gap between requirement and availability
The gap between demand and supply need not be laboured much. Against the World Health Organisation (WHO) norm of 1:1,000, the doctor to population ratio in India is a pathetic 1:1,511. We all know how invaluable the supporting role of trained nursing staff to the practitioners is when the latter examine and initiate a course of treatment for patients. Yet, against the WHO recommendation of1:300, the nurse to population ratio in the country is even more lamentable at 1:670 making the task more difficult for doctors. As expected, doctors in some states have had to grapple with more difficult human resource shortages with Jharkhand, Chhattisgarh, Uttar Pradesh and Bihar being among the worst in terms of doctor to population ratio. Similarly, because of the shortfall of nurses being highest in Bihar, Jharkhand, Sikkim, Telangana, Uttar Pradesh and Uttarakhand, doctors in these states have virtually waged a single-handed battle in their treatment of COVID patients every day. The fact that most of these states have also recorded a substantial number of COVID cases apart from having extremely poor physical infrastructure and facilities further indicates what the doctors must have gone through. And we haven’t even begun about the shortage of ancillary healthcare workers such as the ward boys, the lab technicians, the sanitation workers and other staff making it extremely strenuous for doctors to extend the full benefit of treatment to COVID patients.
Pressure intensified as COVID progressed
For the doctors themselves, the early weeks in the first phase were one of continuous stream of new discoveries and information about the virus as it unleashed itself. With time, as caseloads mounted notwithstanding the lockdowns and patients’ footfalls surged, they would have realized how stretched thin they really were. But no one can really replace a doctor. And amid all this, there were periodic incidences of nursing staff and paramedics going on strikes or in some cases, even some doctors taking the protest route putting only more burden and pressure on the rest. So, the protests of their colleagues against unreasonable working hours, reduction in salaries, late payments, and many such occupational reasons, had further compounded the challenges faced by doctors.
Since doctors are the first point of contact, imagine their plight if there were shortages or lack of safety gear and equipment especially during the early weeks and months of the pandemic. Stemming from the absence of infection control products and protocols in hospitals to lack or shortage of PPEs, face shields, N 95 masks, and sanitizers, the doctors would certainly have been at mortal risk at their workplaces. Then the fear of infecting their families and close ones would have been a very strong deterrent against their joining regular duties.
Toll on mental health of doctors
Working incessantly even against natural body clock in full COVID gear, lack of sleep, unduly long hours, the feeling of burning out due to overwork, the sheer frustration at the inability to successfully treat some patients, the facing of relatives’ anger and wrath, there are a plethora of reasons that would have spelt mental health troubles for doctors. A study conducted on the mental health of doctors during COVID-19 found that about 30 percent of doctors had high stress while 60 percent of doctors experienced moderate stress.
We must remember that doctors after all are also human beings first. It is eminently possible that they would have often faced the dilemma between responding to the call of duty and protecting their persons and lives. Yet, the community as a whole has indeed put duty before life notwithstanding the necessary precautions that they would have also taken. Nearly 1,550 doctors have lost their lives including 798 during the second wave solely due to COVID-19. Last year, more doctors had perished in the line of duty than soldiers.
Therefore, on the occasion of Doctor’s day, in the course of remembering and paying tribute to the doctors (and patients) who succumbed to COVID-19, we must not only salute the spirit of fortitude displayed by our brethren in the face of such overwhelming odds but also call attention to the need for addressing the issue of low staffing and infrastructure in the healthcare sector.
Dr Gurpreet Sandhu, President, Council for Healthcare & Pharma and Founder, Reva Pharma
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly).
News source- Economic Times