COVID-19 active cases reached a total of 5898 with a positivity rate of 22.48% as on May 14, with the highest ever positive cases tally of 726 cases on the same day. In spite of the swelling numbers of infection the district hospitals of Manipur are not manned with required doctors still.
Most of the COVID-19 patients in the hospitals now need oxygen supply and ventilator support badly. Government statements have claimed that D-type and B-type Oxygen cylinders are adequately made available to medical institutions and health facilities of the State Government, and there are also reports of Regional Institute of Medical Sciences (RIMS), Jawaharlal Nehru Institute of Medical Sciences (JNIMS) and Shija Hospitals and Research Institute generating oxygen. Newly installed units at Churachandpur and Thoubal District hospitals are also likely to start functioning by May 17.
However, the state government is still in a fire-fighting mode and fumbling in its response to the deadly second wave of the pandemic. It looks like a futile chase to bring down the daily surge in numbers of Covid-19 infections and deaths and sometimes it feels like a losing battle as we continue to be overwhelmed by the spike in infections coupled with lack of adequate hospital beds and critical care facilities, besides inadequate in-house production of oxygen in the state to meet the increasing demand in the face of rising positive cases.
One senior doctor of a district hospital who doesn’t want to be named told Imphal Review that skilled and expert hands, particularly anaesthetists, are required for application of ventilators on serious COVID-19 patients. If there is an anaesthetist, he can demonstrate and train the junior doctors and nurses. Unfortunately, some of the district hospitals lack anaesthetists and even if they are available, they are due for retirement.
On the other hand, reliable sources say that a number of anaesthetists are now being utilised as administrators instead of having a posting at the hospitals.
It may be mentioned that the Chief Medical Officer of Ukhrul, Dr. KA Shimray was complaining to the Health Director that 6 doctors whose transfer to the hospital were issued in place of 7 doctors who were transferred out are yet to report for duty. The Ukhrul district hospital is a 50-bedded hospital with provision for expansion to a 100-bedded one. While the hospital is supposed to have 30 doctors, it is currently functioning with only 15 doctors.
Reports added that 7 doctors were transferred from Ukhrul District Hospital (UDH) on April 12 and in their place 6 doctors were named to join the district hospital but they are yet to give their joining report till date. Two transfer orders to UDH were issued for the doctors, the first on January 27 and the latter one on April 12 this year. The failure to report for duty has been officially intimated to the Health Director, said the CMO and added that he is hoping for a positive response.
“What we need right now includes specialists in anaesthesia, sinology, orthopedics, blood bank, surgery etc, but amongst them we immediately require an anaesthetist as no operation can be performed without anaesthesia,” said one doctor who asked not to be named.
While UDH is supposed to have 30 doctors (21 Specialist doctors and 9 Medical Officers), it is currently functioning with just 15 doctors, i.e. 8 Medical Officers and just 7 Specialist Doctors.
The ill equipped district hospital plus the lack of required man power has forced many to travel to Imphal for treatment, which means a lot of extra cost for the poor people and the hospitals in Imphal are also already overcrowded. Absence of a Blood Bank clearly shows the negligence and the ECG and Ultrasound equipment though installed have no one to man them, reports added.
Meanwhile, the Tangkhul Mayar Ngala Long (TMNL)/Tangkhul Youth Council has urged the 6 doctors who have been transferred to UDH to report for duty by May 15. In a statement, TMNL said that the 6 doctors have not reported till date, which is unfortunate.
Expressing concern, TMNL condemned the negligence of the doctors amid the alarming COVID-19 situation in the state. The TMNL also appealed to the authorities concerned for immediate suspension of the 6 doctors in the interest of the public if they fail to report for duty on or before May 15.
Similarly, the same thing has been happening in the remote district of Tamenglong. The District Hospital at Tamenglong has a sanctioned strength of 36 doctors including specialists and yet, only 15 were posted. Recently, one doctor was suspended while two were on leave. So, the effective strength is only 12 at the moment. At this critical juncture, the Chief Medical Officer was transferred out of the district to a senior position in Bishnupur, while the next senior doctor was given charge of CMO, Tamenglong.
Reports said that many have decried the move of transferring the CMO, himself a native of Tamenglong, who had single-handedly managed to revamp health infrastructure in the district. Instead of transferring out doctors, the state should have posted adequate number of doctors in the district hospitals.
Meanwhile, the Manipur government on May 13 ordered all doctors and other health staff of district hospitals, CHC, PHC, HWC and PHSC in the state to remain in their places of duty without fail to meet medical emergencies round the clock.
All the public health facilities should remain alert round the clock to meet health emergencies, stated an order issued by the reengaged Director of Health Services, Dr. K Rajo. It also asserted that the day-wise duty roster system is strictly prohibited for doctors and health staff.
Directing all chief medical officers and medical superintendents to take necessary action in this regard, it added that non-compliance of the above orders shall be strictly dealt with as per rules.
The order was issued in view of the rising trend in the spread of COVID-19 infections which have become steeper and more widespread all over the state, it added.
In this critical situation, the public health administrators need to look for signs of the expected onslaught of the second wave. The hospitals should be well equipped and manned with required doctors and expert hands. The public health administrators need to come up with fresh ideas to advice and convince the political leadership boldly in the fight against COVID-19.
Senior Editor: Imphal Review of Arts and Politics