Amid a surge of COVID cases in Jammu, the Union territory is facing a shortage of oxygen and vaccines

The daily death toll due to COVID-19 is rising in the Jammu area, but the administration of the Union Territory seems to be preoccupied more with controlling the narrative of the situation than dealing with the problems the pandemic has thrown up.

Patients waiting outside the COVID-19 facility of the Chest Diseases Hospital in Jammu on May 8.

AMID a growing surge of coronavirus positive cases in Jammu, well before the afternoon of May 6, the news spread like wildfire across the Shivalik hills, that the Government District Hospital Reasi was giving oxygen cylinders to Shri Mata Vaishno Devi Narayana Superspeciality Hospital in Katra. Agitated local residents rushed to the district hospital in droves. And, undeterred by the heavy police presence, they shouted slogans on the hospital’s premises for at least four hours. Finally, all the 30 cylinders that were already on a police truck ready for transportation were unloaded and taken back inside the hospital.

Sudesh Kumar Puri, chairperson of the Reasi Municipal Council, who participated in the demonstration, said: “The Chief Medical Officer was under pressure from the higher authorities. We protested because they were sending those cylinders to a hospital that charges patients lakhs of rupees. They can arrange oxygen from somewhere else…. Where will the poor go?”

On the same day, distressing visuals emerged of a huge crowd of COVID positive patients and their attendants outside the Government Chest Diseases and Tuberculosis Hospital in the heart of the winter capital city of Jammu, which has been designated as a Level 1 COVID triage centre. The patients with oxygen cylinders were sitting on the hospital stairs or lying in the parking lot, in ambulances or on stretchers. The next day, the Jammu and Kashmir High Court directed the Health Department to nominate nodal officers to ensure that patients got medical oxygen.

With oxygen shortages hitting the hospitals in the region, the Union Territory administration stated that a delay in the e-tendering of oxygen generation plants was responsible for the crisis. The government announced its approval for the plants in September last year when there were incidents of deaths due to COVID-19 in hospitals across the region following disruptions in oxygen supply. However, only a few plants had become operational by May this year.

On April 29, Baseer Khan, Adviser to Lieutenant Governor Manoj Sinha, asked the media not to portray the clinical management of COVID-19 in the Union Territory in a bad light. “Neither there is shortage of oxygen nor there is shortage of any medicine,” he said at a press conference in Srinagar.

Tweets from the National health mission

Between May 1 and May 15, Jammu reported 519 deaths, whereas Kashmir witnessed 288 deaths. As the number of daily deaths spiked in Jammu, a prominent local newspaper carried a report on the front page of its May 13 edition quoting official sources in Jammu and Kashmir government’s apex advisory committee for COVID-19. “Majority of the variants of the disease and Indian Double Mutant are more prevalent in Jammu region as compared to Kashmir and has led to maximum COVID-19 related deaths in this part of the union territory,” the report said.

On May 14, the National Health Mission (NHM), Jammu and Kashmir, posted a series of tweets on COVID mortality between April 15 and May 12. It stated: “93 per cent of positive critical cases who died in this period were unvaccinated, 7 per cent were partially vaccinated; hence, clearly establishing that vaccination hugely reduces chances of death.”

Paradoxically, just like other parts of the country, the Union Territory is reeling under a vaccine famine. “Not a single person has reportedly been vaccinated in recent days. Instead of vaccinating more and more people, the administration in Jammu and Kashmir has left the hapless people in a lurch,” said Mohammad Yousuf Tarigami of the Communist Party of India (Marxist) on May 18, adding that testing levels were lower than what the NHM recommended. “At least 46 per cent of deaths occurred within three days of testing positive, thus indicating that they were well into late stages of infection before they got tested,” NHM had stated.

Inadequate infrastructure

Balwinder Singh, an RTI (right to information) activist, said that inadequate medical infrastructure and staff was the reason behind the growing number of deaths in the region. “Despite the fact that Jammu has given maximum number of Health Ministers to Jammu and Kashmir so far, Government Medical College [GMC] and Hospital, Jammu is the only level one tertiary care hospital in the region against five in Kashmir. The sanctioned staff strength of GMC, Jammu remains the same as [when] it was approved by the government in 1990. While the population has grown exponentially over the years, many sanctioned posts remain vacant.”

The situation in other district hospitals and the newly created GMCs in Jammu is no different. Dr Mohammad Yaqoob Mir, Chief Medical Officer (CMO) Doda, wrote to the NHM Director on May 4 demanding adequate staff for COVID care responsibilities. In Doda district, he stated in his letter, “70 posts of medical officers from regular side [those engaged by the Health Department of Jammu and Kashmir] and 14 from NHM side [those engaged under the Centre’s NHM] are lying vacant”.

On April 19, citing the resurgence of COVID-19 that required infrastructure and human resource, the GMC Hospital, Jammu, stopped all elective surgeries and started registering only 50 patients per speciality for the outpatient department on a daily basis through mobile phones. While the Defence Research and Development Organisation (DRDO) has started work on a 500-bedded COVID-19 hospital at Bhagwati Nagar in Jammu city, the private hospitals that were requisitioned under Section 34 of the Disaster Management Act, 2005, on April 25 and May 7 are yet to admit COVID patients. These hospitals, according to local residents, are mostly run with the help of government doctors on an ad hoc basis.

On May 23, the recruitment process for temporary posts for the DRDO’s upcoming hospital turned into a potential superspreader event. While the GMC, Srinagar, had invited applications online, the Jammu division asked aspirants to submit documents in person. Consequently, hundreds of job aspirants converged on the GMC, Jammu—where the daily COVID-19 death count is higher than at any other hospital in the Union Territory—throwing all norms of physical distancing to the winds.

‘Babu-shahi’

Sham Lal Sharma, a senior leader of the Bharatiya Janata Party (BJP) and a former Health Minister of Jammu and Kashmir, however, blamed what he called the “ babu-shahi ” (bureaucracy) for everything that was wrong with Jammu’s health care sector at present. Speaking to the media on May 7, he said: “Some non-local bureaucrats are reigning supreme here. They feel that everyone in Jammu is corrupt. Owing to over bureaucratisation, there is a communication gap between the Health Department and the top authorities. And there is absolutely no monitoring mechanism. It’s a pity that they can’t arrange a thing as basic as oxygen.”

Following the hue and cry over missing senior doctors from COVID care wards at the GMC and its associated hospitals, Atal Dulloo, the Financial Commissioner of Health and Medical Education, wrote to Dr Shashi Sudan, Principal GMC and Hospital, Jammu, on May 17. “It is desirable that the senior faculty members of the concerned departments of your institution be directed to increase their presence by making frequent rounds of wards where the COVID positive patients are admitted so that such patients are properly looked after and treated which will help us in reducing the mortality rate.” Three days later, the situation remained the same. “There is absolutely no improvement in patient care. Hardly any senior doctor visits the COVID wards. It’s only MBBS interns, PG [postgraduate] students, registrars and paramedical staff who are looking after patients,” said an attendant at the GMC Hospital on condition of anonymity. “However, the nursing staff strength had improved in the past few days.” Lt Governor Manoj Sinha’s promise to provide patients and attendants with food packets was yet to be fulfilled, according to many other attendants.

Sham Lal Sharma said that the situation was worse in the rural areas. “The bureaucrats are not even listening to the elected representatives of panchayati raj institutions like members of block and district development councils,” he said.

Even though the virus has exposed the broken public health system, reports critical of the state of affairs are largely missing in local newspapers.

However, reporters from the mobile journalism community—these are media practitioners who use smartphones and social media to cover stories—have relentlessly been reporting on issues such as unused ventilators still in their packaging (these were provided to all the hospitals under the Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund, or PM CARES Fund, in August last year); attendants looking after patients in COVID wards without wearing personal protective equipment; the pathetic condition of the mortuary at the GMC, Jammu; local parliamentarians missing in action; the shortage of medicines and disposables; overcharging by profiteers; and the delay in the installation of oxygen plants.

A shocking video emerged recently showing cows sitting inside the waiting area of the district hospital in Ramban. Instead of taking cognisance of the laxity on the part of the hospital administration, the Deputy Commissioner was quick with a rebuttal. “The video was surreptitiously shot on Sunday [May 16] to malign the image of hospital administration,” he said in a written statement on May18. “A complaint has been lodged with the police station in Ramban so that the miscreants who shot the video are booked under the relevant provision of the law.”