‘Cannon fodder’: Medical students in India feel betrayed

A health worker prepares to administer a dose of the Covishield, Oxford-AstraZeneca coronavirus vaccine, at a vaccination center in Mumbai on April 1, 2021. (File/AFP)
Short Url
Updated 27 April 2021
Follow

‘Cannon fodder’: Medical students in India feel betrayed

  • India spends 1.3% of its GDP on health care, less than all major economies
  • On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, 2,771 deaths in the past 24 hours

NEW DELHI: Since the beginning of the week, Dr. Siddharth Tara, a postgraduate medical student at New Delhi’s government-run Hindu Rao Hospital, has had a fever and persistent headache. He took a COVID-19 test, but the results have been delayed as the country’s health system implodes.

His hospital, overburdened and understaffed, wants him to keep working until the testing laboratory confirms he has COVID-19.

On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, behind only the United States. India’s Health Ministry also reported another 2,771 deaths in the past 24 hours, with 115 Indians succumbing to the disease every hour. Experts say those figures are likely an undercount.

“I am not able to breathe. In fact, I’m more symptomatic than my patients. So how can they make me work?” asked Tara.

The challenges facing India today, as cases rise faster than anywhere else in the world, are being compounded by the fragility of its health system and its doctors.

There are 541 medical colleges in India with 36,000 post-graduate medical students, and according to doctors’ unions constitute the majority at any government hospitals — they are the bulwark of the India’s COVID-19 response.

But for over a year, they have been subjected to mammoth workloads, lack of pay, rampant exposure to the virus and complete academic neglect.

“We’re cannon fodder, that’s all,” said Tara.

In five states that are being hit hardest by the surge, postgraduate doctors have held protests against what they view as administrators’ callous attitude toward students like them, who urged authorities to prepare for a second wave but were ignored.

Jignesh Gengadiya, a 26-year-old postgraduate medical student, knew he’d be working 24 hours a day, seven days a week when he signed up for a residency at the Government Medical College in the city of Surat in Gujarat state. What he didn’t expect was to be the only doctor taking care of 60 patients in normal circumstances, and 20 patients on duty in the intensive care unit.

“ICU patients require constant attention. If more than one patient starts collapsing, who do I attend to?” asked Gengadiya.

Hindu Rao Hospital, where Tara works, provides a snapshot of the country’s dire situation. It has increased beds for virus patients, but hasn’t hired any additional doctors, quadrupling the workload, Tara said. To make matters worse, senior doctors are refusing to treat virus patients.

“I get that senior doctors are older and more susceptible to the virus. But as we have seen in this wave, the virus affects old and young alike,” said Tara, who suffers from asthma but has been doing regular COVID-19 duty.

The hospital has gone from zero to 200 beds for virus patients amid the surge. Two doctors used to take care of 15 beds – now they’re handling 60.

Staff numbers are also falling, as students test positive at an alarming rate. Nearly 75% of postgraduate medical students in the surgery department tested positive for the virus in the last month, said a student from the department who spoke anonymously out of fear of retribution.

Tara, who’s part of the postgraduate doctors association at Hindu Rao, said students receive each month’s wages two months late. Last year, students were given four months’ pending wages only after going on hunger strike in the midst of the pandemic.

Dr. Rakesh Dogra, senior specialist at Hindu Rao, said the brunt of coronavirus care inevitably falls on postgraduate students. But he stressed they have different roles, with postgraduate students treating patients and senior doctors supervising.

Although Hindu Rao hasn’t hired any additional doctors during the second wave, Dogra said doctors from nearby municipal hospitals were temporarily posted there to help with the increased workload

India — which spends 1.3% of its GDP on health care, less than all major economies — was initially seen as a success story in weathering the pandemic. However, in the succeeding months, few arrangements were made.

A year later, Dr. Subarna Sarkar says she feels betrayed by how her hospital in the city of Pune was caught completely off guard.

“Why weren’t more people hired? Why wasn’t infrastructure ramped up? It’s like we learnt nothing from the first wave,” she said.

Belatedly, the administration at Sassoon Hospital said last Wednesday it would hire 66 doctors to bolster capacity, and this month increased COVID-19 beds from 525 to 700.

But only 11 new doctors have been hired so far, according to Dr. Murlidhar Tambe, the hospital’s dean.

“We’re just not getting more doctors,” Tambe said, adding that they’re struggling to find new technicians and nurses too.

In response to last year’s surge, the hospital hired 200 nurses on a contractual basis but fired them in October after cases receded. Tambe said the contract allowed the hospital to terminate their services as it saw fit.

“Our primary responsibility is toward patients, not staff,” the dean said.

Cases in Pune city have nearly doubled in the last month, from 5,741 to 10,193. To deal with the surge, authorities are promising more beds.

Sarkar, the medical student at Sassoon Hospital, says that’s not enough.

“Increased beds without manpower are just beds. It’s a smokescreen,” she said.

To handle the deluge, students at Sassoon said authorities had weakened rules meant to keep them and patients safe. For instance, students work with COVID-19 patients one week and then go straight to working with patients in the general ward.

This increases the risk of spreading infections, said Dr. T. Sundararaman of the University of Pennsylvania’s National Health Systems Resource Center.

Students want hospital administration to institute a mandatory quarantine period between duty in the COVID-19 and general wards.

Over the last month, 80 of the hospital’s 450 postgraduate students have tested positive, but they only get a maximum of seven days of convalescence leave.

“COVID ruins your immunity, so there are people who are testing positive two, three times because their immunity is just so shot, and they’re not being allowed to recover,” said Sarkar.

And after a year of processing COVID-19 tests, she says she knows everything there is to know about the virus, but little else. Nationwide, diverting postgraduate students to take care of COVID-19 patients has come at a cost.

At a government medical college in the city of Surat, students said they haven’t had a single academic lecture. The hospital has been admitting virus patients since March of last year, and postgraduate medical students spend almost all their time taking care of them. The city is now reporting more than 2,000 cases and 22 deaths a day.

Having to focus so heavily on the pandemic has left many medical students anxious about their future.

Students studying to be surgeons don’t know how to remove an appendix, lung specialists haven’t learned the first thing about lung cancer and biochemists are spending all their time doing PCR tests.

“What kind of doctors is this one year going to produce?” said Dr. Shraddha Subramanian, a resident doctor in the department of surgery at Sassoon Hospital.


Pakistan test fires ballistic missile as tensions with India spike after Kashmir gun massacre

Updated 03 May 2025
Follow

Pakistan test fires ballistic missile as tensions with India spike after Kashmir gun massacre

ISLAMABAD: Pakistan test-fired Saturday a ballistic missile as tensions with India spiked over last week’s deadly attack on tourists in the disputed Kashmir region.
The surface-to-surface missile has a range of 450 kilometers (about 280 miles), the Pakistani military said.
The launch of the Abdali Weapon System was aimed at ensuring the “operational readiness of troops and validating key technical parameters,” including the missile’s advanced navigation system and enhanced manoeuvrability features, according to a statement from the military.
Pakistan’s President Asif Ali Zardari and Prime Minister Shehbaz Sharif congratulated the scientists, engineers and those behind the successful missile test.


Russia declares state of emergency at port after Ukrainian drone attack on Novorossiysk

Updated 03 May 2025
Follow

Russia declares state of emergency at port after Ukrainian drone attack on Novorossiysk

  • There was no immediate comment from Ukraine

MOSCOW: The mayor of the Russian port city of Novorossiysk declared a state of emergency on Saturday after he said a Ukrainian drone attack had damaged residential buildings and injured at least five people, including two children.
Andrei Kravchenko, the mayor, announced his decision on his official Telegram account which showed him inspecting the damage to apartment buildings and giving orders to officials.
Kravchenko said one of the injured people, a woman, was in hospital in a serious situation.
There was no immediate comment from Ukraine, whose air force said Russia had attacked Ukraine overnight with 183 drones and two ballistic missiles.


US worker safety agency notifies employees of firings

Updated 03 May 2025
Follow

US worker safety agency notifies employees of firings

WASHINGTON: The Trump administration sent termination notices late on Friday to employees of a worker health and safety agency that provides research and services for coal miners, firefighters and others, despite appeals by a lawmaker from Trump’s Republican Party to preserve its programs.
Employees of the National Institute for Occupational Safety and Health received reduction-in-force notices that said the job losses were necessary to reshape the workforce of the Department of Health and Human Services, according to a copy of the notices reviewed by Reuters.
Nearly all NIOSH employees were placed on administrative leave in February but around 40 who worked on coal-mining and firefighter safety were asked to return temporarily to work several days ago, the union for the agency’s employees said. At least two of those employees have now been notified of termination.
US Senator Shelley Moore Capito, a Republican from West Virginia, had lobbied Health Secretary Robert F. Kennedy Jr. to restore the programs, including the coal-focused work of its Morgantown, West Virginia, office.
The Department of Health and Human Services, which oversees NIOSH, did not immediately respond to a request for comment after regular business hours. A spokesperson earlier this week said NIOSH’s functions would join the new Administration for a Healthy America, alongside multiple agencies. It was not clear whether any of the terminated employees would be transferred elsewhere.
Reuters reported last month that the halting of NIOSH’s key services ended vital health and safety programs for coal miners, such as mobile health and lung screenings, and a program to relocate miners afflicted with black lung disease to less dusty parts of a mine.
There has been a resurgence of black lung disease in the last decade, including among young coal miners. At the same time, President Donald Trump has led a high-profile campaign to revive coal mining and use, which had been declining in the US. 


Lives on hold in India’s border villages with Pakistan

Updated 03 May 2025
Follow

Lives on hold in India’s border villages with Pakistan

  • Relations between the neighbors have plummeted after India accused Pakistan of backing an attack in disputed Kashmir region
  • Islamabad has rejected the charge of aiding gunmen who killed 26 people, with both countries since exchanging diplomatic barbs

SAINTH: On India’s heavily fortified border with arch-rival Pakistan, residents of farming villages have sent families back from the frontier, recalling the terror of the last major conflict between the rival armies.
Those who remain in the farming settlement of Sainth, home to some 1,500 people along the banks of the broad Chenab river, stare across the natural division between the nuclear-armed rivals fearing the future.
“Our people can’t plan too far ahead,” said Sukhdev Kumar, 60, the village’s elected headman.
“Most villagers here don’t invest beyond a very basic house,” he added.
“For who knows when a misdirected shell may fall from the other side and ruin everything?”
Relations between the nuclear-armed neighbors have plummeted after India accused Pakistan of backing the worst attack on civilians in Indian-administered Kashmir in years.
Indian police have issued wanted posters for three men accused of carrying out the April 22 attack at Pahalgam — two Pakistanis and an Indian — who they say are members of the Pakistan-based Lashkar-e-Taiba group, a UN-designated terrorist organization.
Islamabad has rejected the charge of aiding gunmen who killed 26 people, with both countries since exchanging diplomatic barbs including expelling each other’s citizens.
India’s army said Saturday its troops had exchanged gunfire with Pakistani soldiers overnight along the de facto border with contested Kashmir — which it says has taken place every night since April 24.
Muslim-majority Kashmir has been divided between India and Pakistan since their independence from British rule in 1947, with both governing part of the disputed territory separately and claiming it in its entirety.
Sainth, with its open and lush green fields, is in the Hindu-majority part of Indian-run Jammu and Kashmir.
Security is omnipresent.
Large military camps dot the main road, with watchtowers among thick bushes.
Kumar said most families had saved up for a home “elsewhere as a backup,” saying that only around a third of those with fields remained in the village.
“Most others have moved,” he said.
The region was hit hard during the last major conflict with Pakistan, when the two sides clashed in 1999 in the high-altitude Himalayan mountains further north at Kargil.
Vikram Singh, 40, who runs a local school, was a teenager at the time.
He remembers the “intense mortar shelling” that flew over their heads in the village — with some exploding close by.
“It was tense then, and it is tense now,” Singh told AFP.
“There is a lot to worry since the attack at Pahalgam... The children are scared, the elderly are scared — everyone is living in fear.”
International pressure has been piled on both New Delhi and Islamabad to settle their differences through talks.
The United States has called for leaders to “de-escalate tensions,” neighboring China urged “restraint,” with the European Union warning Friday that the situation was “alarming.
On the ground, Singh seemed resigned that there would be some fighting.
“At times, we feel that war must break out now because, for us, it is already an everyday reality,” he said.
“We anyways live under the constant threat of shelling, so, maybe if it happens, we’d get to live peacefully for a decade or two afterwards.”
There has been a flurry of activity in Trewa, another small frontier village in Jammu.
“So far, the situation is calm — the last cross-border firing episode was in 2023,” said Balbir Kaur, 36, the former village head.
But the villagers are preparing, clearing out concrete shelters ready for use, just in case.
“There were several casualties due to mortar shelling from Pakistan in the past,” she said.
“We’ve spent the last few days checking our bunkers, conducting drills, and going over our emergency protocols, in case the situation worsens,” she added.
Kaur said she backed New Delhi’s stand, with Prime Minister Narendra Modi vowing “to punish every terrorist and their backer” and to “pursue them to the ends of the Earth.”
Dwarka Das, 65, a farmer and the head of a seven-member family, has lived through multiple India-Pakistan conflicts.
“We’re used to such a situation,” Das said.
“During the earlier conflicts, we fled to school shelters and nearby cities. It won’t be any different for us now.”


Woman dies when a bomb she is carrying explodes in the Greek city of Thessaloniki, police say

Updated 03 May 2025
Follow

Woman dies when a bomb she is carrying explodes in the Greek city of Thessaloniki, police say

ATHENS: A woman was killed early Saturday in the northern Greek city of Thessaoloniki when a bomb she was carrying exploded in her hands, police said.
The 38-year-old woman was apparently was carrying the bomb to place it outside a nearby bank around 5 a.m., police said.
Several storefronts and vehicles were damaged by the explosion.
The woman was known to authorities after taking part in several past robberies, according to police, who said they are investigating her possible ties to extreme leftist groups.