In times of Covid-19, mohalla clinics, small hospitals take lead in treating other illnesses
With major hospitals focusing on treating patients with the coronavirus disease (Covid-19), secondary care hospitals, dispensaries and mohalla clinics have taken the lead in providing health care services to patients with health problems other than Covid-19.
At the 100-bed Lal Bahadur Shastri hospital in East Delhi’s Khichripur area, doctors still treat around 1,200 patients daily in out-patient clinics. “Earlier, we used to get cases only from neighbouring areas; now people from all over Delhi are coming to our clinics. There is a lot of rush in the out-patient clinics, which should have reduced during the lockdown. We try to tell people to maintain one-metre distance, but it is becoming very challenging,” a senior doctor at the hospital said on condition of anonymity.
At the mohalla clinics, doctors over the age of 60 years have been given the option of not working, as older people are at a higher risk of developing the infections. Yet, many continue to work.
Around 360 of the 450 clinics across the city are still operational .
“Around 180 to 200 patients are still coming to my clinic—a little more than the number I get usually—most of them from far off places. The bigger hospitals in the area have either closed their OPDs or curtailed them; those patients are also coming to me,” a doctor from a mohalla clinic in East Delhi said on condition of anonymity. The doctor said he dons a mask and gloves and uses sanitiser constantly.
To maintain social distancing among patients, he asks them to queue one metre apart from each other outside the portacabin.
“Most private clinics across the city are still shut because doctors find it difficult to take adequate measures to prevent infections. The fear set in after some of the doctors from clinics started testing positive. Now, many provide telephonic consultation or patients go to the emergency departments of hospitals,” Dr Girish Tyagi, president-elect of Delhi Medical Association, said.
In Shahdara district, the government is still operating more than 40 mohalla clinics despite the district having seven containment zones, including Dilshad Garden—one of the first 10 Covid-19 hotspots in the country.
“Of the 45 mohalla clinics, 42 are operational and we see close to 100 patients in each clinic. The mohalla clinic in Babarpur, where the doctor tested positive, is also operating. We provide all the necessary equipment, including face shields, to our doctors and staff and advised them to ensure social distancing at the clinics,” a district medical officer said on condition of anonymity.
In another West Delhi clinic, a doctor has been interacting with residents of a nearby slum to explain to them what “social distancing” is and why it is important.
“People do not understand why they should not step out of their houses, they do not understand why they shouldn’t talk to their neighbours. I have spoken to several people in the locality to try and explain the infection to them. Now, at least, they make it a point to cover their faces and sit at a distance even when they step out of their homes in the evening,” the doctor said, asking not to be identified
But all is not well at the mohalla clinics. The clinics are facing issues in getting medicines on time and testing people. “There have been some issues in getting the medicines to the clinics—logistical issues because of the lockdown,” the district medical officer said.
“All tests have stopped since the lockdown in March because the technician who collected the samples is unable to do so. We are yet to get reports of the samples collected in March,” a second doctor who asked not to be named said. A third doctor added: “Even if they could come, it is impossible to maintain a one-metre distance while taking samples and the technicians do not have personal protective gear.”