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The Allahabad High Court Bench of Justices Siddhartha Varma and Ajit Kumar has observed that the entire medical system in the state of Uttar Pradesh pertaining to the smaller cities and villages can only be taken to be like a famous Hindi saying ‘Ram Bharose’ (at the mercy of God).
In the suo motu matter on Covid management, the court took note of the fact that a dead body of one of the patients, Santosh Kumar, who had collapsed in the bathroom and died, was disposed of as an unidentified body in Meerut. The Bench had earlier sought a response on this matter as Santosh was reported to be missing from the hospital.
As soon as the court discovered what had actually happened, it held that it came out to be a case of “high degree carelessness” on the part of the doctors who were on night duty at the time. The Bench remarked, “A patient is admitted to the hospital in an absolute care of doctors and paramedical staff and if the doctors and para medical staff adopt such casual approach and show carelessness in the performance of their duty, then it is a case of serious misconduct because it is something like playing with the lives of innocent people.”
It directed the State Government to take stern action against those responsible, and also compensate the dependents who have suffered the irreparable loss because of such carelessness.
Crumbling infrastructure
The court took a dim view of Bijnor district and its inadequate healthcare system. It said, “In district Bijnor the urban population as per 2011 census is shown to be 9,25,312. We have no doubt in observing that it must have gone up 25% more by 2021, but to our utter surprise there is no level-3 hospital in district Bijnor. The three Government Hospitals have only 150 beds, whereas, the total number of BIPAP machines is 5 and High Flow Nasal Cannula is only 2.”
On the other hand, the rural population in the Tehsils is around 27,55,000 as per the 2011 census and might have also increased by 25 percent now. The court calculated that there are only 10 Community Health Centres, with one health centre taking the load of 3 lakh people with just 30 beds.
“..Meaning thereby, one CHC can cater the need of health care to only 0.01% of the population and there is no BIPAP machine or High Flow Nasal Cannula available. Only 17 oxygen concentrators are available with 250 oxygen cylinders against 300 beds. There is no description as to what is the capacity of oxygen cylinders and whether in CHC there are trained hands to operate these oxygen cylinders and concentrators,” said the court.
The Division Bench also noted that these facilities have not been ramped up since the first wave and the situation has not improved at all in terms of health care. “These facts therefore, are quite opposed to the Government’s claim,” held the court.
On the issue of testing, the District Magistrate, Bijnor informed the court that testing for Covid was being done both by RT-PCR and Antigen kit in a 60:40 ratio. To this, the court responded, “In the population of 32 lakhs, if the testing is done of only 1200 persons and that too in 60:40 ratio then the situation is not happy. The manner in which the pandemic has hit the rural areas of the State, the district administration is required to have a robust way of conducting tests.”
Overall, the court said that “in these few months we have realized that in the manner it stands today, it is very delicate, fragile and debilitated.”
Vaccination in UP
The court took stock of the vaccination drive in the state and commented that the people of this state have faced the pandemic for over three months and are under serious threat of its third wave, which makes two things very clear:
“-We need to vaccinate each and every individual in the country; and
-We need to have an excellent medical infrastructure.”
Further, the court recorded in its order, “We have been informed that a global tender has been invited by the Uttar Pradesh Government. In addition to what the Government is doing, the viability of the following may also be checked.”
In addition to this, the court suggested following aspects for the government’s consideration:
1. The vaccines may be first vigorously tested and only thereafter may be given out for use by the public. For this, various incentives may be announced.
2. Big medical companies which are working in the country may not have their own vaccines but they may take the formula from just any of the vaccine manufacturers in the world and start producing the vaccine. In this way, they would help the country to meet the shortage of vaccines which it is facing today.
“For that matter, one cannot understand as to why the Government of ours which is a welfare state is not trying to manufacture the vaccine itself on a large scale”, the court observed.
3. Such people who might like to buy the vaccines for the have nots, may be allowed to do so and may also be given certain benefits under the Income Tax Act. In the global tenders, the Government after getting the reasonable prices may negotiate with the world manufacturers and try to buy as many vaccines as can be bought from wherever the vaccines are available.
4. Big business houses who take various advantages under the taxation laws by donating to various religious organisations may be asked to divert their funds to vaccines.
Directions issued
The Court directed the appointment of Nodal Officers by the District Judges of districts Bijnor, Bahraich, Barabanki, Shrawasti, Jaunpur, Mainpuri, Mau, Aligarh, Etah, Etawah, Firozabad and Deoria to submit reports of their respective districts about Covid management.
For the development of the medical infrastructure, the Centre and State governments have been asked to report on the current facilities in the State. Both governments have been also instructed to
-increase oxygen facility in all nursing homes
-increase ICU beds in all nursing homes at 40 percent
-of the designated 40 per cent; 25 percent should have ventilators, 25 percent should have High Flow Nasal Cannula and 50 per cent of the 40 per cent reserved beds should have bipap machines.
-construct an oxygen production plant in hospitals that have more than 30 beds
-villages and small urban areas should be given all kinds of pathology facilities and treatments should be made available in Community Health Centres which are at par to the treatment given by Level-2 hospitals in bigger cities.
The matter will be taken up on May 22.
The order may be read here:
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