Letter from Hell: a personal account from India's failing healthcare system

Image source: John Hopkins University CSSE Covid 19 Data

Nobody saw it coming. I don’t know whose fault it is. Should we blame the epidemiologists who didn’t flag it enough or should we blame a society which had discarded scientific advice long ago or should we blame the government which focussed on business and elections more than anything else?

I work with the Delhi government, and around a fortnight back, things started getting visibly bad. Gradually, demand for convalescent plasma (a proposed treatment for COVID) started increasing to the extent that it overwhelmed the system. It was a predictable problem given COVID cases in Delhi had dropped significantly in the past few months meaning that there weren’t enough recently recovered plasma donors.

And then things started getting worse. There was a sudden spike in COVID cases. This time it was more contagious and deadlier. 

Suddenly, my phone was flooded with messages from people seeking help. Everything that could help in the fight against COVID started disappearing from the market. People were crying for beds, oxygen, ambulance, Remdisivir (a drug used to treat COVID). Even in my dreams I could still hear those words – beds, oxygen, ambulance, Remdsivir! It was like the entire city was crying out for help, and the system was failing to provide anything. We grossly fell short of all kinds of support. 

Everyone you know knows somebody who has died in the past few weeks. Slowly, I saw the entire system collapse. I saw how the machinery that should keep running becomes helpless. There came the point where nobody could help you. If you are sick, you are on your own. It is better if you accept it and prepare accordingly. 

All this death, all this disaster, is happening in the same country where, even as I write this, the Indian Premier League is being held- the most glamorous and expensive event of the year. It is the same country which is organising ‘Maha Kumbh’, one of the world’s largest religious gatherings (because faith trumps all in India).  It is the same country in which the ruling party, in its insatiable lust for power and money, is still holding election campaign rallies in huge numbers without following any of the COVID protocols. 

It is the same country where people are dying on the roads waiting for an ambulance or a hospital bed, or an oxygen cylinder, or sometimes oxygen cylinder connectors. It is the same country where crematoriums and burial grounds have been overwhelmed, and people are cremating their dead on the footpath.  It is the same country where people aren’t even able to grieve their dead because they have to save someone who could be saved. It is the same country where hospitals with hundreds of patients on oxygen support are on the verge of running out of oxygen supply. It is the same where people have lost all faith in the system and are fighting for oxygen cylinders even after paying for them. These are just the stories that are being reported. There are stories that aren’t getting reported and never will. 

When things became too much I decided to travel back home because I thought that it’s better to stay with family right now. My family lives in a very small town in India, and the situation here is so much worse. 

Small towns are fighting ignorance of the people and incompetency of the government simultaneously. COVID carries a taboo for a lot of people in small towns. People do not want to get tested because of huge misinformation around the disease and its treatment. Even if somebody decides to get tested, there is a scarcity of testing kits, and the government has nothing to offer if tested positive. There are hospital beds but without oxygen and healthcare staff. You are literally left in the hospital to die. A few months ago you could travel to bigger cities for treatment, but now those cities are overwhelmed. 

It seems like other diseases have stopped being potent because COVID is so bad right now. The government has closed all outpatient departments, and the entire burden is now on the emergency department which have been left in chaos, left to fight for the limited resources that this administration has provided them. 

I know somebody who was admitted to the government’s emergency ward. A doctor went to check on her and saw that there are 3 dead bodies lying beside her. She was on her bed waiting for oxygen. Apparently, people are walking to the emergency ward, are lying on the bed and then they just die! The newspaper on the next day reported just one COVID death.  None of this will be recorded because you have to be tested to be recorded as a COVID patient or a COVID death, and the government won’t provide testing kits. In death, people aren’t even provided with the dignity of being a number, a statistic. 

To live through this time is to leave yourself at the mercy of your fate because literally every safety net that you ever created for yourself or that you know of has abandoned you. You can just be grateful that you can at least become part of a riot where people with money fight for that one oxygen cylinder or that one dose of injection that can save you for a little longer. 

The system has failed and we are in free fall.

You can donate to grassroots relief efforts in India by following this link.