Beds don’t treat patients, we need medical staff desperately

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By DM Deshpande

The second wave of the pandemic has a created near crisis situation in the entire nation. At the time of writing this column, Goa seems to be the worst affected state in terms of the highest positivity rate. Even with it’s lower total population and relatively better public healthcare facilities, the state is finding it extremely difficult to cope up with the emerging situation.

The pan India position is no better with the nation adding over three lakh cases every day for over a week. Despite sporadic regional lockdowns in several worst affected districts, case load is not showing any sign of coming under control. On the contrary, there is every indication that it will cross the four lakh daily mark.

This is an unprecedented spike in positive numbers suddenly and shockingly. Though the nation is in a better position to combat the pandemic now than a year ago, yet the huge and rising numbers have nearly led to the collapse of healthcare facilities.

Right from hospital beds to ICU, to acute shortage of oxygen, medicines, testing kits, et al the nation and people are virtually teetering by the impact of the spread of virus. As a result, in a policy reversal India has sought aid for the first time in over a decade from foreign nations. This is in terms of supply of oxygen, vaccines, other medicines including the raw material needed to produce vaccines at Indian facilities.

In an overwhelming response, more than 40 countries have pledged support which includes China among others some have even rushed teams and materials without further loss of time.   

It may take some time, but most of the challenges of shortages will be overcome. Besides the foreign aid and imports, it requires the private industry to pitch in, which it has done willingly and without prompting from the government.

One major challenge, though, may remain unless multiple authorities act quickly. This has been highlighted time and again by Dr Devi Shetty who has earned a big name in the field of medicine in India and even abroad. This formidable challenge is about meeting manpower needs to fight the pandemic. Not just the doctors, but also a whole range of para medical staff that includes nurses, ward boys, lab attendants, maintenance staff and others. They have all done a commendable job during the first wave last year.

Now, however, some have lost their lives due to the pandemic and others are simply tired and burnt out by the hectic schedule they have been keeping in most trying circumstances for over a year. They need replacement and there is no one in sight who can do it. We need a few lakh young vaccinated and trained doctors, nurses and para medical staff in double quick time. 

Even before the pandemic set in last year, India was facing a serious shortage of doctors and  nurses. An estimated 76 per cent medical specialists are short in government hospitals alone. ICU facilities are used sub optimally in government hospitals generally speaking and therefore disproportionate burden falls on private hospitals.

The biggest impediment in expanding ICU wards is the shortage of trained nurses. There are an estimated 2.2 lakh students who are awaiting their final exams in their nursing courses in India. They could be immediately pressed in to Covid -government or private service for at least a year. This could be a project for which weightage could be given for future recruitment in government service.

Yet another major issue relates to making available qualified doctors to fight the raging pandemic.  Again an estimated 25,000 final year students are about to complete their course in India. Instead of waiting till their exams get over, they should be drafted to Covid duty immediately. This could as well be treated as their internship of one year which, in any case, is mandated by the Medical Council.

There is a big chunk of young doctors, estimated at 1.3 lakhs, who are presently at home preparing for their NEET, that is, entrance exam to qualify for a post graduate seat. There are only 35, 000 PG seats in the country. Almost a lakh of aspiring doctors will not make it this time. If some grace marks are given for their one year service in a Covid ICU  it will act as a great incentive to attract young men and women.

Then there are 20,000 odd doctors who have obtained their degrees overseas but have not been able to clear the Indian qualifying exam. Ironically, therefore, they can practice medicine elsewhere but not in India, their country of birth! The urgent needs of combating a threatening pandemic should force us to think out of the box.

There will, of course, be criticisms of diluting standards or giving away degrees and the like. To ward off such apprehensions, we need to create robust systems of monitoring, recording and evaluating the services of these doctors, nurses and other staff for one year in a Covid ward. We must get out of the mental block that written final University/Board examination is sacrosanct and that it cannot be replaced by anything else.

Today, the best of the global universities use multiple evaluation methods and tools. Learning and implementing them would actually mean reforms and improvements in our higher education system. More importantly, men and women released from the mere ‘clutches’ of final examination will save thousands of lives in India. That matters and should hold sway in any policy decision. 

The author has four decades of experience in higher education teaching and research. He is the former first vice-chancellor of ISBM University, Chhattisgarh.