Every precious life

 Friday April 30

With news bulletins beaming distressing videos of people in India gasping for air, I receive this message from Dr Dhiraj Ranjan who runs our partner eye hospital in Motihari in north-western Bihar. This area – in the district of East Champaran -  is probably the most deprived area in the most deprived state in India.

‘Ma’am there is an oxygen factory 30km from Motihari, in Harsiddhi. We are buying cylinders with donated money and taking it to the Sadar (government) hospital.’

The ‘we’ are a group of committed and organized local people including social workers, doctors, medical students and others, the kind of people I run into every time I am in Bihar. People who make the world go round. Even when the planet appears to be off kilter.  

And it is because of this group that I can begin with a positive story about an otherwise horrendous week of events in India. It is about a young newly-wed couple called Anku Tiwari and Nutan Kumari from the village of Barharwa Kala.

Anku and Nutan eke out a living as ‘daily wage earners’ usually ending up with roughly 300 rupees (£3) at the end of each long day. They are in their early 30s and Nutan is in the early stages of pregnancy.
Anku developed a fever, bought some tablets at a pharmacy and returned to the dilapidated hut that is their home. His condition worsened so a worried Nutan brought him to the Sadar government hospital. He was admitted. But the hard-working and desperate team of doctors had run out of oxygen.
A hospital employee rang Dr Dhiraj. He sent two of his eye hospital team, well trained and experienced in patient care. They took with them an oxygen cylinder and money for food for Anku.
They returned the next morning to discover that Nutan was now sick. She, too, needed oxygen. After receiving supplementary oxygen for 48 hours and 72 hours respectively, Anku and Nutan were out of danger. They remained in hospital until well enough to be discharged.
Two precious lives, and a life in the making, saved.

 Sunday May 1
‘You safe, we safe’ wrote Dr Faisal Siddiqui from West Champaran district, always concerned for his honorary Bihari friends in the UK. Then: “Situation is very scary. It seems the world is going to end. Oxygen supply here is just manageable.’

From Laxman Eye Hospital boss Thakur Dharmendra Singh, a man with his finger on the pulse of northern Bihar, this message:

‘We have stopped eye surgery, seeing only emergencies, and will watch the situation. In Muzaffarpur there are two active oxygen plants so, so far, there is no oxygen shortage. Our team is safe and we have explained to all patients and their families that we will restart our normal work as soon as we can.’

Monday May 2

Update from East Champaran.
Many villagers are selling their precious bakaree (goat) in order to pay for treatment, any treatment that is available. This is indicative of absolute desperation. I remember the Bihar floods of a few years back. My friend and Canossian Catholic nun, Sister Jessy was involved in trying to rescue villagers in danger of drowning. They refused to step onto the rescue boats unless their most valuable possession – the bakaree was safe in their arms.

Tuesday May 3

Some reassuring news from eye surgeon Dr Utkarsh Bhadwarj. He lost his mother to COVID a few weeks ago and the entire family (which includes two doctors) were infected by the virus.

‘Ma’am we are getting better. Papa is keeping busy with his legal work. While I have been recovering, the eye hospital in Araria was able to continue restoring sight to the blind and seeing patients in the Out Patients department - that is credit to my colleague Dr Navin. Now I am thinking we should start a vaccination centre (in a side building). We should play our part to stop Covid.’

Wednesday May 4

Everyone is talking about oxygen concentrators. I receive numerous appeals by email and WhatsApp from other organisations about sending them out to India. Some confused reporting in the media gives the impression that they are a straight alternative to oxygen delivered from cylinders – they are not.

The very sickest COVID patient can need 10-12litres of oxygen per minute. The concentrators can deliver up to 5litres per minute. So they are useful for less sick patients being cared for at home and to try to stabilise a hospital patient waiting for an oxygen bed to free up. The Bihar state health department has just issued a directive to Covid-designated hospitals - medical staff should utilize concentrators for those patients requiring less than 5litres of oxygen per minute.

But what do they cost?
I am told by social worker Jestin Anthony in Delhi that these machines are now selling for 50,000 rupees (around £500). In Bihar one shop has priced them at 65,000 rupees, a price few can afford in this state.

This concentration on oxygen alone worries me.
In Bihar, the drastic shortage of medical personnel is at least as important as oxygen supplies when it comes to saving patients.
In the past week, four doctors have died in the town of Motihari alone.
There was a new batch of qualified doctors from a local medical college. However, they have not applied for advertised vacancies…and one can understand why.
In return for risking their lives treating Covid patients (not to mention risking the lives of their families) the state government is offering them 5000 rupees a day (around £50) and only a three month contract.

I am reminded of  Spitfire pilots in the Battle of Britain in the second world war – whose life expectancy was just four weeks.

Thursday May 6

Some great news. Almas, wife of Azhar Khan messages from the town of Aurangabad in southern Bihar.

‘Azhar now fine. Can walk and speak freshly. He also wants to talk to you whenever you are free.’

39 year-old Azhar Khan, who runs Drishti Eye Care Hospital, spent 14 days in intensive care in Bihar’s capital city of Patna. He was in a very poor state. Luckily, though, there was no shortage of oxygen in Patna at that stage.
Now back home in Aurangabad, he is the sole patient at his own eye hospital. As Dishti is located amongst green fields and low lying craggy hills, away from main roads and polluting traffic, it is an ideal rehabilitation centre!

Friday May 7
The WhatsApp message I most dread. This time from Dr Amit Anand in Madhepura, north-eastern Bihar.
His father had been admitted to hospital at the beginning of the week.

‘Papa nahi rahe’ wrote Amit in hindi.
Papa is no more.

Apart from his personal grief, Amit, like so many medics all over the world, also expressed a sense of collective helplessness and feelings of failure that doctors are unable to save patients in such circumstances.

‘This virus is very dangerous.’

Four times a year Dr Amit’s hospitable parents allow us to squat in their home, spend hours planning eye screening camps, talking shop and engaging in raucous discussions about politics, global warning, you name it. During the last year, these discussions continued via Zoom. Just a few weeks back we were all looking forward to the inauguration of the new Anand Eye Hospital and Amit was commiserating with us for not being able to be there in person as we were then in lockdown and rural and small town Bihar had been almost unaffected by the Covid virus.

Life on a knife edge.

Saturday May 8

I wake to the sound of rain on my windowpanes and grey skies in the heavens.

I read my first WhastApp message from Bihar.
1857 people had been admitted to the Sadar Hospital in Motihari. (The hospital is officially a 50 bedded hospital but has been admitting 200-300 patients daily till now).

I read that Dr Dhiraj and his friends had already bought and delivered 206 oxygen cylinders that morning.

‘The corona bomb has been fired in Motihari’ wrote Dhiraj. ‘I will make every effort to save my town. We will provide oxygen cylinders for those who have God and no-one else.’

I send money via Western Union. A few hours later I receive email conformation that that cash has been picked up.
‘I am returning to the Harsiddhi oxygen factory right now’ messages Dhiraj.

I suspect that he is travelling in one of the same hospital vehicles that has transported so many of us all over Bihar.
In normal times we would be collecting patients to bring them to hospital for eye surgery – giving sight to those who cannot see.
Did we ever anticipate that we would be transporting oxygen for those who cannot breathe?

Lucy Mathen

#everypreciouslife #communityishumanity #basichumanvalues