Are India’s “forgotten victims” of COVID? | Coronavirus pandemic


Rae Bareli, Uttar Pradesh – Richa Gupta believes her father would still be alive if he had only received treatment before.

The 17-year-old who recently graduated from high school lives in Sultanpur Kheda, a village with a population of about 6,000 located about 11 kilometers from the city of Rae Bareli and about 385 kilometers southeast of the capital of India, New Delhi.

Her father, Awadhesh Gupta, 47, was previously healthy, but died on April 27, according to Richa, according to COVID-19. However, because he was never tested for the virus, no one can be completely sure.

“My dad was totally in shape and he was fine,” he says. But on the evening of April 16 it developed a temperature. “The next day he started coughing,” Richa recalls.

She says she bought some drugs at the local pharmacy, but they didn’t work and “the temperature went up.”

According to Richa, his father consulted the local “charlatan,” an unregistered “doctor” who was often attended by villagers to save time because public health services are remote and often overcrowded. These doctors are not officially licensed, but in rural India people often depend on them. This “doctor” prescribed more medications, Richa says, adding that he “took them for two days but nothing worked.”

On April 22, Awadhesh went to a private hospital in Rae Bareli, but was told to go to the city government hospital because he had symptoms similar to COVID. There, doctors prescribed him even more medication and advised him to stay in quarantine at home.

Richa cries as she explains that she was not tested for COVID-19 in the hospital. She is certain, however, that it was the virus that killed him.

Richa Gupta has a photo of her late father [Saurabh Sharma/Al Jazeera]

Awadhesh began to experience shortness of breath on April 24 and, on the advice of a friend who was a doctor, went for a computed tomography scan at a private laboratory of Rae Bareli. “After that, we learned that my father’s lungs were very infected and [we were sure] I had COVID, ”explains Richa.

“The computed tomography report said one of my father’s lungs was completely damaged while the other had 50% damage. My maternal uncle immediately took him to the district hospital from where he was taken. refer to the L2 hospital dedicated to COVID in Lal Ganj. [around 20 miles from Rae Bareli city].

“My father was admitted there on April 25, but he received no treatment other than oxygen support. He was pronounced dead on April 27, “he said.

Due to the safety of the family that COVID had, Awadhesh’s death was recorded as a COVID death. However, in many cases where a sick person has not undergone COVID screening tests, authorities have attributed his or her death to “unknown” or “natural” or “comorbid” causes (underlying health conditions).

Richa believes she knows when and where her father hired COVID.

“I am very sure that my father became infected when he went out to vote for the panchayat (village council) elections,” he says.

People’s council elections in India’s most populous state, Uttar Pradesh, were held for four non-consecutive days in April; the first of these was on April 15, when Awadhesh went to the polls. The failure to apply social distancing and the use of masks during election campaigns and during voting has been criticized.

The home of Awadhesh Kumar Gupta, who died on April 27th [Saurabh Sharma/Al Jazeera]

A “mysterious fever”

Vinod Tiwari was the leader (or gram pradham) of the people until he was removed from the recent elections. He says he has heard of 12 people who have died in the village in the last three weeks, but that only two of the deaths were recorded as a cause of COVID-19.

“Not all the deaths that have happened in the village are [officially] due to COVID-19, “he says.” Two people from the village died in hospitals that were COVID-positive, while two or three people had similar symptoms to COVID. The cause of death is unknown to other people, but people say they were comorbid people [those with underlying health issues]”.

Others believe the death toll is higher. Sudeep Shukla, a village farmer, has been keeping an informal record of every person who has died. Put the number at 18 in the last three weeks. Everyone is sick and yet nothing is being done to solve this “mysterious fever” that is taking on life after life, he says. It is sure to be COVID-19.

“My cousin is ill. The neighbor is ill. The boy from the flour mill is sick. The owner of the grocery store is ill. The man on the street is ill. Everyone is sick. Everyone is coughing and so far 18 people have died in a span of three weeks. We have never seen such a large number of deaths in such a short time. Older people who die seem normal, but middle-aged people who die are not normal. That should end now. There is enough fever and viruses, ”says Sudeep.

Sudeep Shukla says 18 villagers have died in the last three weeks [Saurabh Sharma/Al Jazeera]

Vinod Tiwari says villagers suspect the rise in deaths is related to village council elections. “A lot of people were seen during all the activities related to the elections, whether it was the presentation of the candidacy, the campaign, the voting or even the counting of the elections,” he explains.

“The natives of the village who live in other cities came to the village to exercise their franchise. They traveled by public transportation and there were no tests or trials. God knows if they carried the virus with them, but soon after, people began to die.

The nearest state medical center is the community health center in the village of Jatua, about six miles away. But it is not equipped to handle complex cases like COVID. Those with symptoms are referred to Rae Bareli City Government Hospital or COVID Hospital in Lal Ganj, where Awadhesh died. It has 10 fans and 250 beds, 112 of which have oxygen support, according to the director of the facility, Dr. BR Yadav. There are 15 doctors and 30 paramedics, enough to treat everyone, says the director.

A female patient is supported by her children while the companions carry an oxygen cylinder behind her as she enters the hospital dedicated to COVID in Lal Ganj in Rae Bareli district [Saurabh Sharma/Al Jazeera]

Small businesses, such as grocery stores and agriculture, constitute the main economy of the village, the north of which is occupied mainly by villagers of the most privileged castes, while in the west they live to a large extent. members of less privileged castes.

The village also houses three “charlots,” but all three have “disappeared” from the village, locals say. They believe these unregistered doctors have gone into hiding for fear that health department officials will come because of the COVID cases. The village’s only pharmacy has become a one-stop shop for villagers seeking instant medical help for their COVID-like symptoms. It is owned by Manoj Verma, who is about 30 years old.

“The state facilities are not very useful because the villagers have been in the habit of visiting local doctors, but they are unregistered doctors. These doctors have stopped looking at patients due to the pandemic and rising cases of COVID-19 and now people come to my store to look for medication, ”he explains.

“To get medicine, [a] prescription is a must, but now people come and ask for medications like painkillers, aspirin, antibiotics, antiparasitics and for these medications [a] no prescription is required and I give them to them, but with a warning to visit the doctor first and take the medicine only if the doctor has advised it ”.

But there is another problem Manoj says he is witnessing: “People are afraid to get tested for COVID-19, even after developing severe symptoms such as shortness of breath. [and] cough … because they feel they can be shunned by society, ”he explains.

Despite the increase in deaths, some villagers do not wear masks [Saurabh Sharma/Al Jazeera]

“They took the virus with them”

Official information on the number of deaths in the village is confusing. When asked about the increase in deaths in the village, Anshika Dikshit, a district administrative officer assigned to Rae Bareli district, told Al Jazeera: “According to my information, people have died but not in the last two or three weeks, but in the last two months. Few of the deaths were due to COVID, while the rest of the deaths were natural and in many cases people had comorbidities. “

However, Rae Bareli district chief physician Dr Virendra Singh told Al Jazeera by phone that he had only four or five deaths in the village, three of which were due to COVID.

Many states in India have imposed strict blockades over the past month, while others have put a stop to movements and closed cinemas, restaurants, pubs, schools, educational institutes and shopping malls.

A worker unloads oxygen cylinders at the L2 hospital in Lal Ganj [Saurabh Sharma/Al Jazeera]

Brian Wahl, an epidemiologist with the International Department of Health at the Johns Hopkins Bloomberg School of Public Health of the New Delhi Department of International Health, says India’s rural health infrastructure is not equipped for this increase in cases.

“We know that in rural areas, access to quality services is a challenge and these areas only depend on front-line health workers. We know that a mass meeting has the potential to be a widespread event.” he said.

Dr Harjit Singh Bhatti, national chairman of the Progressive Doctors & Scientists Forum (PMSF) in New Delhi, agrees.

“Before, people came to cities in crisis, but now, seeing the number of cases increase, they have nowhere to go. The saddest thing is that we will never be able to know how many people have died and what was the cause of their death “, he explains.

“In the previous wave, Indian peoples were safe, but this time, because of the village council elections and also because of the Kumbh Mela festival [which around 3.5 million people attended], COVID has arrived in the field “.

Bhatti believes this situation could have been avoided and saved many lives if the timely decision had been made to postpone the election.

“Elections strengthen democracy … [But] the people of the big cities went to their villages to exercise their franchise and with them the virus also traveled and now we are seeing the result in the form of a large number of deaths, ”he says.

“They said his shortness of breath was asthma”

Meanwhile, in Sultanpur Kheda, another tragedy unfolds. Across the street from the Gupta family home, a middle-aged woman in a gray saree cries under a thatched hut outside a two-story house. Her 12-year-old granddaughter tries to comfort her. They run home again when asked what is going on.

But the woman’s son, Indrajeet Sahu, 26, says her father, Ram Sajeevan Sahu, 52, died on April 27.

“He fell ill after the village council elections,” Indrajeet explains.

“He had a high temperature and, from April 23, he started complaining of breath. Because of his temperature, he took medication from the local pharmacy, but was advised to consult a doctor immediately. “

Indrajeet Sahu and her mother away from home in the village [Saurabh Sharma/Al Jazeera]

On April 25, the family took Ram Sajeevan to the community health center in the village of Jatua. But the health center did not test it to detect COVID; the family says they don’t know why.

“The doctors gave him medicine, saying that his shortness of breath could be due to asthma, so we took the medicine and went home. The problem continued and we learned that other nearby hospitals had no oxygen and on the morning of April 27 he died at home, ”says Indrajeet.

He explains that his father helped him carry a food cart to the street, but that he is now dead, Indrajeet has to support the whole family financially.

“It is very painful to see your father die before your eyes. The more painful [thing is not being able to help him [in] anyway. There was no oxygen in any of the hospitals and things were very bad. Now my dad is gone, it looks like everything is gone, ”he says, with tears in his eyes.

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