Parth M.N.

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She
starts to speak, but stops midway. Drawing a deep breath, she tries again. But
her voice quivers. She looks down, and her chin wobbles. Anita Singh has been putting
up a brave front for nearly a year. But the memory of her husband is
overwhelming. “Ours was a happy little family,” says Anita, 33. “My husband was
our anchor.” Anita’s
husband, 42-year-old Jaikarn Singh, was a teacher in a primary school in Lakhaoti
village, 20 kilometres from Bulandshahr city in Uttar Pradesh. He started
showing symptoms of Covid-19 in the first week of April 2021. “He had a cough,
a cold and fever,” says Anita when we meet at her home in the city. “The
teachers had been asked to go to their school even when the second wave was raging.
He must have caught the infection on one of those days.”

On
April 20, 2021, Jaikarn tested positive for the coronavirus. When he started
gasping for breath, there was no oxygen bed available in any of the hospitals
in the city. “I pleaded at several hospitals, but they just said no,” recalls
Anita. “We made many phone calls because his health was deteriorating rapidly.
But nothing helped. We had to treat him at home.” 

A
local doctor treated Jaikarn for the fever and cough. Anita’s relatives arranged
an oxygen cylinder somehow. “We didn’t even know how to use it. We had to
figure it out on our own,” she says. “But we kept looking for a hospital bed.”

The
pandemic exposed the extent of India’s crumbling public health infrastructure, especially
in the villages and small towns. Considering the country’s public expenditure
on health has only been 1.02 per cent of the GDP (in 2015-16), there isn’t much
for people to depend on. According to the <a href="http://www.indiaenvironmentportal.org.in/files/file/NHP_2017-1.pdf">National Health Profile 2017</a>, there was one government allopathic doctor for
10,189 persons in the country, and only one public hospital for every 90,343 people.

The <a href="https://www.oxfamindia.org/knowledgehub/workingpaper/inequality-report-2021-indias-unequal-healthcare-story">Inequality
Report 2021: India’s Unequal Healthcare Story</a>, published by Oxfam India in July last year, noted
that in 2020 there were 5 hospital beds and 8.6
doctors for every 10,000 people of the country. And rural India, housing 70
per cent of the country’s total population, had only 40 per cent of the total hospital
beds. Anita’s
search for a bed ended with Jaikarn’s death. He died gasping for breath on
April 26, 2021. He was to go for poll duty two days later. The state
government had gone ahead with the panchayat
elections even though the pandemic was at a peak. Others
who went on the compulsory duty in UP’s panchayat elections (April 15-29, 2021) paid a heavy price. By
mid-May, at least <a href="https://ruralindiaonline.org/en/articles/up-nothing-can-be-done-duty-has-to-be-done/">1,621 schoolteachers had died</a> of Covid-19 or ‘Covid-like’ symptoms. The
state government announced compensation of Rs. 30 lakhs for each of their families.
But Anita did not receive any of it because Jaikarn died two days before he was
to go on duty. “It is unfair,” she says, and breaks down. “He was an honest
government servant. And this is what we get in return. How will I look after my
children? I want to do right by them. But you can’t do anything without money.” Jaikarn’s
monthly salary was Rs. 70,000. He was the family’s sole earning member. After
his death, Anita got a job on compassionate grounds at a primary school in
Bulandshahr city. “My salary is Rs. 20,000,” she says. Her daughter Anjali and
son Bhaskar, 7 and 10 years old, have not been going to school since Jaikarn’s
death. “I am struggling to run the household,” Anita says.

According to <a href="https://d1ns4ht6ytuzzo.cloudfront.net/oxfamdata/oxfamdatapublic/2022-01/India%20Supplement%202022%20lo-res%20single.pdf?qpboOXJULM6jrm1QUPjW_e2zSPYHDVhx">Inequality
Kills</a>, an Oxfam International report released in January 2022, 84
per cent of households in India saw their income decline in their income in the
beginning of the pandemic. 



In
March 2021, a <a href="https://www.pewresearch.org/fact-tank/2021/03/18/in-the-pandemic-indias-middle-class-shrinks-and-poverty-spreads-while-china-sees-smaller-changes/">study</a> published by the
US-based Pew Research Center noted that the middle class in India shrunk by
about 32 million in 2020, while the number of poor people (with
incomes of $2 or less a day) was estimated to have increased by 75
million.Job losses triggered by the sudden nationwide Covid lockdown in March
2020, along with the weak health infrastructure led to a steep fall in the purchasing
power of households across the country. And when public health facilities were
overloaded with Covid-19 cases, many families had to turn to private healthcare
even though it was unaffordable.Rekha Devi’s family was one of them. In
April 2021, her sister-in-law Sarita, 24, was admitted to the Banaras Hindu
University’s hospital in Varanasi. But when she didn’t receive proper treatment
there, Rekha got her discharged from there. “People were dying all around us,”
says 36-year-old Rekha, sitting outside her hut in Chandauli district’s Tendua
village. “Sarita didn’t have Covid. But her stomach pain was not going away. No
doctor would pay any attention to her because of the number of patients at the
hospital. She just kept lying on the bed without any idea of what was happening.”


Sarita had been ill for a week before
being taken to the BHU hospital, a public facility. Her husband Gautam, 26, had
first taken her to a private hospital in Sonbhadra town, where they live. It is
about 30 kilometres from Tendua in Chandauli’s Naugarh block. “That hospital
admitted her for a day, charged Rs. 12,000 and said she needed to be moved
somewhere else for further treatment,” says Rekha. “Gautam refused to do that.
The hospital said she could die anytime. So he got scared and brought her to
me. We immediately went to BHU.”

The Varanasi hospital is about 90 kilometres
from Tendua. Gautam and Rekha hired a vehicle for Rs. 6,500 to travel there. After
discharging Sarita from the BHU hospital, they took her to Chakia town, which
falls between Varanasi and Naugarh block. That journey cost them Rs. 3,500. “A
private hospital in Chakia admitted her and treated her for a week, and she
recovered from her illness,” says Rekha, who still doesn’t know what it was other
than a ‘stomach ache.’ “But her medical expenses came up to one lakh rupees.”Rekha and her relatives belong to the
Jatav community, a Scheduled Caste in Uttar Pradesh. She works as an
agricultural labourer, earning Rs. 200 a day. Gautam works in stone mines in
Sonbhadra, and earns Rs. 250 a day. “He rarely gets work since the lockdown [of
March 2020],” says Rekha. “We had no income for months.” The situation was so
bad, she says, that he worked covertly in the mines during the lockdowns, flouting
the rules. “We mainly survived on the free ration given by the government and
local NGOs. We did not expect Sarita’s illness to cost so much.”A survey report by Oxfam India released in
November 2021, Securing Rights of Patients in India, found out that 61.47 per cent of the 472 respondents
from UP were not provided with an estimated cost of treatment. Across the
country, 58 per cent of 3,890 respondents had the same experience, which is a breach
of patients’ rights. According to the 17-point <a href="https://nhrc.nic.in/sites/default/files/charter_patient_rights_by_NHRC_2019.pdf">Charter of Patients’ Rights</a> drawn up by the National Human Rights Commission, a patient and their caregivers “have the right to information on
the rates to be charged by the hospital for each type of service.” Rekha was forced to pawn about a third of
her two-acre farmland, and some jewellery, to raise funds for
Sarita’s medical expenses. “The  moneylender is charging us an interest
rate of 10 per cent month,” she says. “So we are only repaying the interest,
while the principal amount [Rs. 50,000] remains. I wonder when we will be able
to get rid of our debt.”

In many of UP’s
villages people’s debt grew by 83 per cent in the first three months of the
pandemic (April to June 2020). The data was gathered from nine districts
through a <a href="https://www.communitycollect.info/community-monitored-accountability">survey </a>by COLLECT, a collective of grassroots organisations. It found
that in July-September and October-December 2020, the increase in indebtedness
was 87 and 80 per cent respectively.Mustakeem Shaikh, 65, was more unfortunate. 

A small farmer with just under an acre of land in
Ghazipur district’s Jalalabad village, Mustakeem suffered a paralysis stroke
days before the outbreak of Covid-19 in March 2020. It weakened his left side,
forcing him to walk with a limp. “I need a stick to walk around. But I can
barely hold it properly with my left hand,” he says.No longer able to work in his farmland, he couldn’t hope
to do any labour work either. “It made me totally dependent on the thousand-rupee
pension I get from the state for being a senior citizen,” says Mustakeem. “In
my condition, nobody would lend me money because they knew I can’t earn at all
to repay them.”  There was no other funding to fall back on. According to
the <a href="http://www.indiaenvironmentportal.org.in/files/file/National%20Health%20Profile%202020.pdf">National Health Profile 2020</a>, 99.5 per cent of people in rural UP
are not covered by any form of health insurance or support for health
expenditure.  

So when Mustakeem’s 55-year-old wife Sairun also had
a stroke – he suspects it was a brain stroke – he could not do much to get her
treated. “She had a stroke and fell down. It damaged her spine,” he says. That
was in April 2020, and the pandemic had just started spreading in the country.
“I took her to a government hospital in Azamgarh, but it had been converted to
a Covid centre.”

The Azamgarh hospital was 30 kilometres away. It cost
him Rs. 3,000 to get there in a private vehicle. “We would have had to go to
Varanasi because the Ghazipur government hospital does not have any
facilities,” he says. “It would have cost me more money in travel [to Varanasi].
I didn’t have it. I asked my friends about private hospitals, but I realised I
would not be able to manage the medical expenses.”Mustakeem brought Sairun back home to their village in
Jakhania block, and decided to get her treated locally. “She also said it would
be the wise thing to do,” he adds. “The jhola
chaap doctor in the village gave her medicines.”

People rely on jhola chaap ‘doctors’, the village quacks, more than
they do on government doctors. “The jhola chaap treat us with respect and answer our
questions,” says Mustakeem. “They were there for us when other doctors were
afraid to come near us.” But jhola chaaps are untrained medical practitioners.


In October 2020, about six months after her stroke, Sairun
died in their one-room hut for want of proper treatment. Mustakeem has come to
terms with it. “Those who died in the hospitals died amidst chaos,” he says. “My
wife’s death was much more peaceful than that.”

Parth M.N. reports on public health and civil liberties through an independent
journalism grant from the Thakur Family Foundation. The Thakur Family
Foundation has not exercised any editorial control over the contents of
this reportage.

In UP: ‘We kept looking for a hospital bed'

ഉത്തർപ്രദേശ്: ‘ഞങ്ങള്‍ കിടക്കയ്ക്കായി കാത്തിരിക്കുകയായിരുന്നു’

উত্তরপ্রদেশ: 'মাথা কুটে মরলেও বেড মেলেনি হাসপাতালে'

উত্তৰ প্ৰদেশ: ক’ভিডকালত দাৰিদ্ৰ্য, ঋণ আৰু হস্পিতাল বেড

ଉତ୍ତର ପ୍ରଦେଶରେ: ଋଣ ଓ ଦାରିଦ୍ର୍ୟ ସହ ସଂଘର୍ଷ କରୁଛନ୍ତି କୋଭିଡ ମୃତକଙ୍କ ପରିବାର ସଦସ୍ୟ

'உத்திர பிரதேசம்: மருத்துவமனைப் படுக்கைக்காக அலைந்தோம்'

યુપીમાં: ‘અમે હોસ્પિટલની પથારી શોધતા રહ્યા’

ఉత్తరప్రదేశ్‌లో: ‘మేము హాస్పిటల్ బెడ్ కోసం వెతుకుతూనే ఉన్నాము’

یوپی: کووڈ کے دوران ہمیں اسپتال میں ایک ’بیڈ‘ تک نہیں ملا

ಉತ್ತರ ಪ್ರದೇಶ: ʼಆಸ್ಪತ್ರೆಯ ಹಾಸಿಗೆಗಾಗಿ ನಾವು ಕಾಯುತ್ತಿದ್ದೆವುʼ

उत्तर प्रदेश: क़र्ज़ और ग़रीबी के दलदल में फंसे कोविड से मरने वालों के परिजन

ਯੂਪੀ: 'ਅਸੀਂ ਤਾਂ ਹਸਪਤਾਲ ਬੈੱਡ ਹੀ ਲੱਭਦੇ ਰਹਿ ਗਏ ਤੇ...'

Bulandshahr

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In UP: ‘We kept looking for a hospital bed'

Even a year after her husband's death from Covid-19, the cost of the pandemic weighs heavily on Anita Singh. In Uttar Pradesh, the crisis of public healthcare has left many like her poorer, and in debt

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