Contributed by Yusuf

In Part 1 I looked at how the pandemic has impacted the livelihoods of the poorest people in India. Now in Part 2 I take a look at the healthcare system.

Eroded healthcare

While the government is to be commended for several aspects of its coronavirus response – particularly compared to the blunders of highly developed nations like US and UK – the near-exclusive focus on Covid-19 has been a major setback for the struggle against others diseases. Take one example: tuberculosis. While fewer than 1 lakh (100,000) Indians have died from Covid-19 so far, TB kills over 400,000 Indians each year. India’s TB diagnosis rate has dropped dramatically: there were 78% fewer cases detected in April 2020 compared to April 2019. This does not mean that TB infection rates have declined: rather, it means hundreds of thousand cases are going undiagnosed and untreated. Consequently, researchers estimate that there may be up to 500,000 additional tuberculosis deaths in India over the next 5 years. Similar dynamics are at play in many other developing nations.

The reasons behind this explosion of TB – diversion of medical resources, reduction of income, fear of going to hospital – are also exacerbating other illnesses. All basic metrics of public health – deliveries in hospital, vaccinations, diabetic treatments – have taken a severe hit. Government Out-Patient-Departments are still largely closed, or running at much smaller capacity. The poor, who even in normal times often delay going to hospital due to financial constraints, are often unable to afford private healthcare. This treatment-seeking delay is a ticking timebomb. As I look around eerily silent buildings in my local hospital, I can’t help but imagine the thousands of people who would normally be thronging the place, who must be suffering (and dying) at home. Even in the one section which is fully occupied – the Covid ward – medical care for co-morbidities leaves a lot to be desired. Two months ago I contracted Covid and spent 5 days in the ward. Doctors spent minimal time with the patients, instead communicating by whatsapp. When staff did enter, their PPE seriously impeded their eyesight and hearing, making it difficult for them to perform even straightforward medical procedures.

Policy suggestions

1. Drastically increase the healthcare budget, rather than simply shifting resources from away from the struggle against other diseases.

2. Where possible, allocate healthcare workers who have already had Covid-19, and hence have a degree of immunity, to Covid wards.

Conclusion

Coronavirus is a health crisis for everyone, but the poor are at greater risk. The healthcare system, strained at the best of times, has been unable to provide millions of people with the basic services they need. We must urgently act to ensure healthcare for all.

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