“No entry for those without masks,” there is a note pasted outside the Aam Aadmi Mohalla Clinic (AAMC) in East Delhi. This compact clinic space is cleaner than the scores of private clinics and nursing homes operating in the densely populated residential area. The Mohalla clinics run from minimalist prefabricated structures that can accommodate 20 to 50 people at full capacity.
On normal working days, the space is always bursting at the seams and a large crowd waits outside for their turn at the clinic that runs from 8 am till 2 pm everyday, except Sunday. Now, under the Covid-19 lockdown, only five patients at a time are allowed inside the clinic, they too have to sit keeping a few meters distance between them. The remaining have been requested to wait outside and continue to maintain adequate distance and wear masks. “Yesterday the queue was almost a kilometer long and went almost till the highway behind the clinic,” said a worker in charge of noting down patient details. The staff has been issued masks and gloves and have sanitisers handy but they say they also have extra personal masks in their bags that they use when they go back from the clinic after duty hours.
It is the second day of the near complete lockdown in Delhi, and NCR, and this clinic is a couple of kilometers from the state border with Ghaziabad Uttar Pradesh. It also serves as a clinic for scores of migrant workers who commute between the two areas. The sealed border, and an increased police presence has reduced the inflow of those patients to less than a handful. “I live in Ghaziabad but work here. I have to take regular medicine and this is the only clinic that gives it, I had to come,” said Babu Ram who is in his 40s and had a skin condition. He was wearing a mask even though he had a visible blister near his nose. “It hurts sometimes but I have to wear a mask,” he said.
“We will not turn anyone away. We can take the best precautions possible and educate the patients too. But we are here till the government says otherwise, anyone with a temperature will be directed to go to the designated hospital” said a worker who was distributing medicines as patients queued up outside the window. “We are just screening, and registering patients here and then they are sent outside the clinic to see the doctor in her room accessible from another door, and collect their medicines from this window. This too has ensured that there is no crowding inside the clinic itself.
The staff says they are trained and sensitised to the dangers of how quickly the Coronavirus-19 spreads but say the risks are always there. “We are doing all we can. We need to stay healthy and be able to help those who are unwell. Some patients understand, but some do not realise why we have made wearing a mask and sanitising hands compulsory,” said a young woman pharmacist at the clinic.
Patients can avail free consultation with the doctor, treatment and medication. The clinic is open to everyone who comes with a government issued identification card. “Please read the ID number out loudly, do not place it on the table,” a young assistant instructed a patient who wanted to hand his ID card over as always. This is a part of the no-contact protocol.
Staffed by a senior doctor and four to five assistants who are classified as multi task workers, the clinics are on high alert and have put in protocols to minimise human contact. The clinic staff has put tables between them and the waiting area to ensure patients keep distance. They also scan each visitor with an infrared thermometer and sanitise each patient’s hands. Those without masks are told to cover their mouth and nose with handkerchiefs, gamchas, and dupattas. Those without any cover are asked to step outside.
The staff is also aware that a doctor who works at a Mohalla Clinic in Shahdara, an area a few kilometers away and connected with the now suspended Metro line, recently tested Covid-19 positive. He contracted the infection when he saw a Covid-19 positive patient at his private clinic but had also visited the Mohalla Clinic. According to a report in the Hindustan Times all those who visited that clinic are now being contacted so they can be told to self-quarantine.
“We collect phones, address, ID number, etc and I now realise how this data is crucial in such emergencies,” said a worker at the IP Extension clinic. All prescriptions are now being written behind an information sheet that has information on Covid-19 symptoms and contamination prevention. “This is very important. We are telling the patients to read and understand, and have told them it is compulsory by law to follow these instructions,” said a clinic staff, “some people only understand such language and will follow out of fear of law and police.”
Mohalla, or neighbourhood, Clinics, a Delhi government initiative are unique and have made quality primary health care services available to Delhi residents and those who work here, a walking distance away from their homes. Earlier they had to go to bigger government hospitals which were too far, or were forced to go to private doctors and laboratories whose fees were not affordable to everyone.
These clinics provide medical care, for common illnesses including fever, diarrhoea, skin problems, respiratory problems and first aid. They refer patients to empanelled laboratories for further investigation.
In unprecedented times like this, such clinics are the saviours of the poor who are a vulnerable community. The clinics look like they are small primary schools with colourful exteriors even if they have government branding, the interiors have steel benches and shelves, and even the walls are easy to sanitise, say the staff. It has ramps for easy access, once the patients have managed to enter from the dug up main road that runs outside, this medical facility seems like an oasis of organised calm. For now.
A senior doctor at another such clinic did not mince words and warned that Delhi was still seeing only the tip of the iceberg and more cases are expected as testing increases in the coming months. Clinics, and hospitals, too are sensitive zones he said and a crucial place where crowing should be controlled, “I have seen patients who have come in for minor bruises, or seeking vitamin C, and even asking for masks and sanitisers. We are not distributing those,” he said, “I am begging everyone with folded hands to stay at home and only come to clinics when unwell. Please help doctors, nurses and pharmacists to stay well enough to do our jobs.”
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