THE TEARS OF INDIA…

India’s runaway Covid-19 nightmare needs to be stopped urgently, writes Rajendra Aneja

India is in infinite pain. The Indian people are aghast with the photographs and reports of around 150 bodies, floating onto the banks of the Ganges river. These are corpses of Covid-19 victims, who could not be accommodated in hospitals and later in the crematoriums for their last rites. The bodies were apparently dumped by relatives, into the rivers in Bihar and Uttar Pradesh states. Some of the bodies were half cremated. This is a brutal and inhuman situation.

There have been pictures of mass cremations and burials, which are heart-rending. The tragedy is that the disease has percolated to the villages, with rotten health infrastructure.

These horrible instances show that many district health administrations are collapsing in India. It is indeed gut-tearing, that the fifth largest economy in the world and a purportedly emerging superpower, cannot treat its sick and cannot give them a decent burial or cremation. India will find it difficult to ever forget these macabre times. The bitter part of the situation is that the leaders of many states had proclaimed, that there was no shortage of beds or oxygen.

Basic demand forecasting, with varying scenarios about the severity of the disease and the consequent requirements of beds, ICU units, oxygen, medicines, vaccines could have prevented this grim situation. We failed. We were busy with elections and religious gatherings. India is and will be short of hospitals, ICU units, ventilators, etc. Production of these items cannot be ramped exponentially overnight. A new hospital takes 12 to 18 months to construct.

The spread of Covid-19 has made many government officials insensitive. A Union Minister tweeted, “The incident of corpses found floating in Ganga in Buxar region of Bihar is unfortunate. This is definitely a matter of investigation. The Modi government is committed to the cleanliness of ‘mother’ Ganga (river)”.

The minister’s comment focuses on the commitment of the government to the cleanliness of the river Ganga. He does not mention the plight of the 150 bodies of Covid-19 victims. Why did the local district administration officials not help with hospital admissions, treatment and religious burials or cremations? Why are we becoming so casual about the deaths of our fellow citizens?

A clean river is important. But, what is heart-rending and shocking is the sheer helplessness of a nation, that cannot treat its sick. Even more brutal is that when these Covid-19 patients pass away, their families are slipping the bodies into a river, without any last rites and records. Each of the 150 bodies washed to the banks, needs to be identified. Their last rites should be performed. The incident underscores the real tragedy of India. The actual Covid-19 fatalities, may be five to 10 times higher, than the officially reported of about 4,000 daily, according to epidemiologists.

Covid-19 is now ravaging the villages of India, where about 70 percent of the population resides. Mass graves are being discovered. In villages, health is managed through Primary Health Centres (PHCs). According to the Economic Survey of India, 60 percent of the PHCs have only one doctor, whilst five percent of them do not have any doctor. Infrastructure is weak in these PHCs.

A PHC frequently consists of two or three rooms, with minimal medical equipment. They have no ventilators, oxygen, testing facilities. The PHCs face problems of absenteeism, medicine-shortages and long waits for patients. In addition, villagers have to walk two to five kilometres to reach a PHC. How can a patient, afflicted with Covid-19, walk to a PHC? There are no ambulances in the villages, only the tricycle, called a “rickshaw”, which is also not always available. Covid-19 medicines are difficult to source in the villages. Patients are treated on the floors of hospitals, in the compounds and under trees. Perhaps, the medical units of the Indian army should manage Covid-19 in the villages.

Around 60 percent of Indian medical workers are in the urban areas, leaving the balance 40 percent to tend to the 70 percent rural population, according to a WHO study. Many medical workers lack medical qualifications and skills.

In the post Covid-19 period, India must revamp its health sector completely. It spends about 1.2 to 1.6 percent of the GDP on health. India should spend eight to 10 percent of its GDP on health. The government and municipal hospitals in the towns and PHCs in villages, need to be thoroughly modernised.

Villagers cannot be ignored because they do not scream loudly or they are not covered well by the urban media.

India can manage the Covid-19, only through rapid vaccinations. India must produce, import, borrow, beg at least 10 million vaccines per day and administer them daily. It will be herculean to vaccinate at the rate of 10 million people daily. However, it has to be done, to save the country.

Unfortunately, India will continue to face intense vaccine shortages. Even if India has to vaccinate 1.2bn people to achieve herd immunity, it needs 2.4bn doses. India is producing just 70m vaccines monthly, which is 840m doses per annum. At this rate, India will need three years to vaccinate 1.2bn people.

Now production is being ramped up by the two producers, Serum Institute and Bharat Biotech, to about 200mn doses per month. However, this will happen over the next seven months. At best, India could budget an average of 135m doses per month from June to December, which is 945m doses over a year. Even then, it will be 2.5 years before 1.2b Indians are vaccinated. The Russian vaccine Sputnik V, is expected in June. Seven states are floating global tenders for vaccines.

Thus, Indians will have to be patient and hope to get their vaccines over 18 to 24 months. Countries dependent on India in Africa for vaccines, may also have to wait, unless they find alternate sources. India’s runaway Covid-19 nightmare needs to be stopped urgently, so that other nations do not suffer.

Aneja was the Managing Director of Unilever Tanzania. He is an alumnus of Harvard Business School and the author of books entitled, “Rural Marketing across Countries and “Business Express”. He is a Management Consultant