In Uttar Pradesh, doctors grapple with triple challenge in war against Covid-19

Vacancies in the Provincial Medical Services have increased the pressure on doctors during the fight against the pandemic, leading to a tussle between the government doctors and administrative officers

It is a triple challenge for government doctors waging a grim battle against Covid-19 in Uttar Pradesh. First, they have lost eight of their colleagues to the coronavirus disease. Second, numerous others are under treatment for the same infection. Third, several doctors have retired from service this year. The result: the number of doctors Uttar Pradesh has is gradually reducing but their work pressure is increasing.

A testing camp organised by the UP government for getting members of the legislative council tested for coronavirus at A Block Darulshafa in Lucknow, Uttar Pradesh.(Dheeraj Dhawan / Hindustan Times)

“Our number is reducing in three ways. The third (way) is doctors retire from service. Every year, 250-300 doctors retire in Uttar Pradesh,” said Dr Amit Singh, secretary of Provincial Medical Health Services Association (PMHSA), a body of government doctors.

He said against the need of 33,000 specialists and 14,000 MBBS doctors as per Indian public health standards, there are only 3,000 specialists and 8,000 MBBS doctors in permanent positions in Uttar Pradesh. The state has a sanctioned strength of 18,382 doctors. Uttar Pradesh has a population of about 23 crore (230 million) and a bed strength of 76,000 (as calculated in February 2020).

“The risk is increasing every day as the number of fresh cases goes up and our strength is limited,” said Dr Amit Singh.

The government doctors who died of Covid-19 are: Dr SP Gautam, chief medical superintendent of the Ambedkarnagar district hospital on June 9; Dr Ajeezuddin of Lucknow’s Avantibai Hospital on July 15; Dr Ganesh Prasad, former district surveillance officer, Prayagraj, on July 25; Dr Subodh Kumar of the Alchhada community health centre at Auraiya on July 25, Dr PN Gupta, Kasganj district TB officer on July 30; Dr RP Mishra (surgeon) of the Joint Hospital, Balrampur, on August 1; and Dr Jung Bahadur, additional chief medical officer, Varanasi on August 12. Dr Nizamuddin, a doctor working on contractual service at Tajpur Moradabad, died on April 20.

“In India, 200 doctors have lost their lives after getting infected by Covid-19 on duty,” said Dr PK Gupta, former president of Indian Medical Association, Lucknow.

In Lucknow alone, about 150 medical staff members have been infected since the pandemic started. About 100 such instances were reported at King George’s Medical University (KGMU), the first hospital to start a Covid-19 facility for patients in Uttar Pradesh. Four faculty members, 25 resident doctors, nurses and other staff were among the 100 who got infected.

Vacancies in the Provincial Medical Services have increased the pressure on doctors during the fight against the pandemic, leading to a tussle between the government doctors and administrative officers. This situation is also affecting the functioning of doctors.

In Varanasi, the disquiet came into the open on August 12 when 27 government doctors resigned from their administrative posts alleging harassment by bureaucrats.

Uttar Pradesh Provincial Medical Health Services Association (PMHSA) demanded a check on bureaucratic interference in the functioning of government doctors posted in Covid hospitals in all 75 districts of the state.

While the government doctors were working round the clock to save lives, some bureaucrats were breaking their morale, the PMHSA said.

The state health department should ensure that administrative officers do not misbehave with government doctors, office bearers of the PMHSA said.

Dr DR Singh, a former president of PMHSA, said successive governments in the state had not given priority to health services.

Covid pandemic had exposed the health facilities, forcing the state government to mobilise its resources to improve the condition in government hospitals, procure modern equipment and establish laboratories, he said.

A large number of posts, including that of directors, additional directors and joint directors were lying vacant and promotions pending.

Doctors should be given free hand in running health facilities and providing treatment to patients, he said.

When asked, director general, medical health, Dr DS Negi said the risk was more for doctors in certain conditions.

“In emergency cases, you can’t wait for Covid-19 test report, hence medical care is given, keeping all precautions in place. But exposure to a positive case for about 30 minutes puts doctors at risk of getting infected and this has happened in several cases.”

He said utmost care was taken to ensure the highest protocol level for doctors on Covid-19 duty, but people were not adhering to protocol.

“At a Covid-19 hospital, you consider everyone a positive case and work as per protocol but in general hospital, people move around and you never know who is a carrier of infection,” said Dr Negi.

Another issue was fresh appointment, said Dr Singh. “This year, no process has been done to make a fresh appointment. Amid the pandemic situation, about 250 doctors have retired this year,” said Dr Singh.

The state has 1605 doctors working on contractual basis and there are 4,416 vacancies at present.