Derek Gomes is 77 years old and needs kidney dialysis three times a week. His wife Jennifer Gomes depends on auto rickshaws to take him to the Nanavati Hospital, four km away from their flat in Khar in Mumbai. But she is worried she won’t find one for the next 21 days.
Prabir Kumar Banerjee, 79, needs to complete his four-month-long chemotherapy cycle for bone marrow cancer. The resident of Faridabad, Haryana, has appointments at the Apollo Hospital in Delhi on March 25 and April 1. “The hospital said that the treatment cannot be delayed,” said Mahashweta Banerjee, his daughter-in-law, who has a car. “But we do not know if we will be allowed to go without curfew passes.”
In a televised address on the evening of March 24, Prime Minister Narendra Modi announced the world’s largest lockdown ever: 1.2 billion Indians will have to stay home for 21 days to prevent the spread of the novel coronavirus which has killed more than 18,000 people across the world. Until Tuesday evening, 536 people had tested positive in India, while 10 had died of the Covid-19 disease. Experts fear the virus has spread widely in the community.
“It is my responsibility, the responsibility of the government of India, of state governments, to save the life of each and every Indian,” Modi said in his speech.
But what happens to patients like Gomes and Banerjee who have life-threatening conditions that require urgent medical care? Will they be able to reach hospitals as transport dries up? Will hospitals have adequate facilities and staff to cater to them?
To reduce the burden on their staff, public hospitals in several states have suspended services at outpatient departments and cancelled non-emergency surgeries. As the number of Covid-19 cases rise, many fear even private hospitals could come under pressure, leaving even affluent urban Indians in cities like Mumbai and Delhi unable to access medical help.
While Modi reassured Indians that essential services would continue to run, families of seriously-ill patients are fearing the worst. There is no word from the government yet on the arrangements made for them.
Stranded without transport
It began with a one-day “janata curfew” on Sunday morning. By next day, however, around 30 states and Union Territories, including Maharashtra, Delhi, Haryana, Punjab, Rajasthan and Uttarakhand, had declared lockdowns until March 31.
Before the lockdown began, Jennifer Gomes could easily call for an auto rickshaw to drop her husband off, from their residence at Khar, to the hospital in the morning and pick him up after the treatment was done four hours later.
That was what she did for nearly five years. But now she is concerned she would no longer have that option. To implement the lockdown, several states including Maharashtra and Delhi have suspended the functioning of public transport including private taxis, auto rickshaws, metros and trains.
“I have not had any sleep last night,” Jennifer Gomes said. “He cannot miss his dialysis. He has already landed in the hospital twice because he has missed it earlier.”
“I have a few friends who can help but how often will they do it?” she asked.
Calling an ambulance from the hospital or doing the dialysis at home are not serious options. “It costs around Rs 70,000 to Rs 80,000 a month and the hospital staff does not have transport to reach here either,” she said.
Seventy-two-year-old Melanie Sequeira, who lives in Bandra, faces a similar predicament. She needs to take her husband, Errol Sequeira, 74, to the Holy Family Hospital three times a week for his kidney dialysis – a procedure he has depended on for the last 14 years.
With her husband unable to walk, Melanie Sequeira depends on her daughter-in-law to take them in a car. “It takes two of us to pull him up and put him in the wheelchair,” she said. “It is a very trying time as we are trying to look after him without any help.”
Travel during a lockdown
The challenges, however, continued even for those who own a private vehicle. With the lockdown in place in Delhi, several residents in the neighbouring areas of the National Capital Region are still unclear if they need a pass to travel around, especially for health purposes that counts as an essential service.
A 69-year-old resident of Sector 15 in Noida, Uttar Pradesh, travels three times a week to get her dialysis treatment from Apollo Hospital in South East Delhi’s Sarita Vihar area. On March 24 morning, while entering the National Capital, the Delhi police had stopped her vehicle at the border.
“The cops asked her to take her dialysis in Noida,” said her son, who did not wish to be identified. “Our helper who was with her told them that it is not possible and showed a letter written by the doctor. She is very weak. They let them go but the Noida police stopped her again while she retuned home.”
During the winter days when the city implemented the odd-even scheme to reduce vehicles on the roads and bring down air pollution levels, the hospital issued a pass for patients, he said. “But this time, there is no such initiative from the hospital.” The hospital even refused to send an ambulance to his residence in Noida to pick up his mother, he alleged.
Mahashweta Banerjee said she only had her father-in-law’s medicine prescriptions as proof of the chemotherapy treatment he was undergoing. She was unsure if that would be enough in case the police stopped their vehicle on the road.
For many others travelling longer distances to come to hospitals in Delhi, the anxieties were even more acute.
Travel for hospital staff
While patients struggled to make it to the hospital on Tuesday, doctors, nurses and other hospital staff members also found it difficult to reach the hospital given the lockdown and suspension of public transport services.
In a letter written to Delhi Chief Minister Arvind Kejriwal, the Indian Professional Nurses Association said the ban on public transport had made it difficult for health workers in public and private hospitals to report to work and return home.
In the letter, the association demanded that government-owned buses be made available to transport workers to public hospitals and that the government should instruct private hospitals to make travel arrangements for their health workers.
But most hospitals have not had the time to make arrangements for their staff members in the light of the outbreak, said Joanna Pinto, a counsellor at a paediatric hospital in Mumbai.
“Some private hospitals have arranged for buses for their staff and some nurses have also agreed to stay at the hospital for three days,” she said. “But there is a lot of pressure on hospitals.”