Acute Health Crises In India

The people of India are reeling under an unprecedented health crisis since the last two weeks as the Pandemic Covid 19 rages all around. The official machinery which tests and counts the number of infected persons, recoveries and deaths has collapsed so that we do not even know the extent of the gravity of the situation. All around we hear only of people getting infected in droves, hospitals unable to handle the patients for want of beds and staff and emergency medical equipment, medicines and people literally left to die on the streets. Something as elementary as oxygen supply is in great shortage as patients literally gasp for breath.

Unlike in the previous phase the pandemic has spread deep into the countryside affecting the rural and semi urban population. Even in the metropolitan areas it has spread rapidly among the entire population, creating the current crises situation.

The Indian state had got complacent after the subsiding of the first wave and the relatively smaller impact of the second wave of the pandemic. It imagined a relatively slow process of vaccination in the metropolitan areas will take curb the spread of the pandemic and tried to roll out a minimal vaccination program to cover people aged more than 60 initially and extended to those above 45 just as the third wave was breaking out. The vaccination facilities were available widely only in the metropolitan areas and the rest of the country the smaller towns and villages had minimal coverage.

That is when the first warnings of the third wave came in and some states like Maharashtra saw acute spread of the virus indicating that it could spread across the country in more lethal form. The medical-scientific bodies warned the government of an impending catastrophic wave of the virus spread. The situation called for immediate steps to prepare by building Covid combat facilities in all districts and blocks and involving local bodies and population in handling the crises effectively. In an act of criminal negligence, the government abdicated its responsibility and actually dismantled covid units in hospitals in the months preceding March 2021.

Instead of preparing for the impending disaster, the Modi government got busy in undertaking intensive political conquest of provinces which were under opposition political parties. This resulted in highly contested elections in several states and electoral mass meetings, electoral violence etc, It also tried to pander to religious passions by permitting the gathering of millions of people for Hindu religious festival called Kumbh Mela after the third wave started. This diverted the attention of the government and also allowed large gatherings without caring for health safeguards.

The initial lock down forced on the country by the central government in 2020, left the economy in tatters with millions of urban poor and middle class facing loss of income and employment. This enabled the state and the capitalists to suspend the operation of laws protecting labour and the farmers and minorities to enable increase in investments and profits for the capitalists who were already making super-profits during the first year of the pandemic. The government was hoping to ‘revive’ the economy and rate of growth to attract international capital. Thus the government has been reluctant to implement a complete lock down even when the current wave of the pandemic has gone out of control.

Despite the progress made over the last decades, India lags far behind world standards in providing for universal health care. The state spends less than 1.3% of GDP on health and has left the field open for private health care systems which cater to the super rich in the urban areas. Instead of investing in the public health care system for all in both rural and urban areas, the present government has initiated a policy of supporting the private sector and the insurance sector by promising medical insurance cover for the poorer sections of the population.

Most of the Indian health care system, doctors, nurses, hospitals and medical shops are concentrated in urban areas in a country where 70% of the population lives in villages. 60% of the medical personnel are stationed in urban areas which have only 30% of the population. Thus the Indian health care system is now predominantly private and urban in character. Given this skewed picture, the extremely low cover of any medical care for the vast population is apparent from some simple data. There are only 0.9 qualified medical doctors per thousand population (compare this to Cuba’s figure of 8:1000). The ratio of nurses and paramedical staff to the population is 1.7:1000. The number of hospital beds is barely 0.5:1000 (compared to 5.3:1000 in Cuba). One can thus see that the current disaster was actually waiting to happen. The acute shortage of doctors, paramedical staff, hospital beds, medicines and medical oxygen, is to a large extent the result of long years of structural neglect and pandering to the super rich and the medical insurance companies.

The Modi Government used the pandemic situation, first to suspend labour protection laws and then to hurriedly pass laws replacing all existing labour laws without adequate discussion or consulting the trade unions. Similarly, it used the pandemic situation to pass laws relating to agricultural marketing, essentially paving the way for deregulating agrarian markets and removing the price protection guaranteed by the state to some of the key crops and to enable corporate houses to control agricultural markets and eventually wrest control over land from the small and medium farmers. Lakhs of farmers have been camping in a sit in protest outside the boundaries of New Delhi the capital of India demanding the scrapping of the new farm laws. All that the government was willing to offer was to suspend their operation for a year to enable the farmers to adjust to the new regime.

Needless to say there have been widespread protests and struggles over specific issues all over the country, despite the heavy repression of dissent (in the social media, on the field, in the universities) and the pandemic conditions. Mr. Modi’s party, the BJP and its allies were resoundingly defeated in three of the four major states where the elections were held. This is a strong indication of the disapproval of the government’s handling of the crises by the masses.

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