It’s about 3 p.m. and patients accompanied by their kin continue to trickle into the district hospital in Sitapur.
Several police guards are stationed at the gate but no thermal screening is done for visitors, which includes a stray bull that heads straight to the dustbin within the hospital compound to forage for anything edible. At the hospital, only the emergency services are running.
Some patients arrive in ambulances. At the entrance to the main hospital building, Nandlal Prajapati and a relative push a wheeled stretcher bearing his brother towards an ambulance. A female relative fans the patient to provide him some respite from the searing afternoon heat.
Mr. Prajapati’s brother is suffering with an abdominal lump and has been referred to the Medical College in Lucknow, 90 km away. The family does not know what has caused the lump.
This is the second time that Mr. Prajapati’s brother is set to be transferred to another hospital during the lockdown. A migrant worker in Delhi, he was brought to Sitapur in an ambulance after doctors in the national capital refused to operate on him as his family was not around. They could not travel to Delhi.
“ Toh phir isko ambulance karke sidha ghar pe laya gaya. Yahan kehte hai, iska ilaaj nahi hai (He was then brought home in an ambulance. Here (district hospital) they are telling us they can’t treat him),” said Mr. Prajapati, looking despondent.
He said the hospital told him there were not enough beds to admit his brother. Several other patients, including a father-son duo who had suffered injuries after a roof collapsed on them during a recent thunderstorm, narrated similar stories of being referred to Lucknow for treatment that they had expected to get at the district hospital.
In another corner of the hospital compound, which was built in 1886, Kamruddin and his family were sitting under a tree, their heads bowed in grief.
A few hours earlier, his mother Raessa had died of internal injuries she suffered after being run over by a tractor trolley in a field. On Sunday evening at about 5:30 p.m., when a heavy thunderstorm hit parts of U.P., Kamruddin’s mother was out tending to the family’s goats as they grazed. Kamruddin alleges that after spending a night in the hospital when he stepped out for a cup of tea at 6 a.m., he was not allowed to re-enter the premises till 11 a.m. ostensibly to comply with social distancing norms. His mother reportedly died at 8 a.m. “They did not let me in even after the death. They said only one attendant can be with the patient. But there was no male present there,” he said, as he waited for his mother’s mortal remains.
Kamruddin also alleged that the hospital lacked proper medical facilities to treat his mother. “You can complain as much as you want, but nothing happens,” he asserted.
As he was speaking, Shubham Shukla, a student whose family owned the tractor that hit Raessa, tried to defend the hospital. He said the woman was provided all possible emergencyy services at the hospital but was too badly injured to survive. Perhaps out of a sense of obligation, Mr. Shukla had accompanied the family to the hospital. The injured woman was brought there on the same tractor from their village in Auliya block, 26 km away.
While the people of U.P. observe the lockdown enforced to tackle the COVID-19 pandemic, they must also simultaneously deal with general illnesses and mishaps that are common in these parts. While touring the district, locals threw up anecdotes of how the restrictions during the lockdown were compounding their difficulties. Not only were doctors not always available at the community health centres and primary health centres due to COVID-19 duties, locals, especially those from rural areas, were facing logistical inconvenience due to the travel restrictions.
Mr. Shukla had his own grievance. After his dog fell ill for four days, he attempted to take it to the hospital in his car but was stopped each time, after travelling barely kilometre. The police had told him to call the veterinarian home, he claimed.
“ Hospital jao toh ilaj nahi milta, ghar mein kaun ayega (We don’t get proper treatment even in a hospital, who is going to come home now),” he said.
A few metres away, Ram Het, his wife Neelam and her mother-in-law were sitting outside on benches waiting for a motorcycle to arrive and take them home in Sanda, 50 km away. Neelam had fallen unconscious a few days earlier, following which she was brought to the district hospital in an ambulance. Her CT scan report was normal, much to the family’s relief. However, they now face the challenging prospect of journeying back home given the absence of public transport. “The bike will have to make two trips to take all of us,” said Mr. Het. “So I will call another bike. Till it arrives, I will walk,” he added.
Many patients complained of being forced to walk a few miles in the sun if their homes were in the containment zone. The Khairabad kasba in Sitapur has been sealed as a hotspot. Residents in and around the area are the most inconvenienced. A week ago, Shamsuddin’s wife fell from the roof and fractured her hip. She was rushed to the district hospital from Khairabad in an ambulance. Shamsuddin says that not only does he have to step out to fetch medicines as they are not available locally, he has also been unable to get food directly supplied from his house for the patient as the route is cut off. However, he is lucky to have relatives, living not far away, who bring him food.
“I have not been home for eight days. There is nobody else to stay here with her. They are not allowed to leave their area,” he said.
The sealing of Khairabad has led to problems for many locals in the region, including Rajendra Kumar, who runs a small licensed medical shop in a village 6.5 km away. He is forced to travel 14 km to the district headquarters on cycle to get his supplies of medicine. Since he is unable to do it regularly, he doesn’t have enough stocks of essential medicines like paracetamol and painkillers. The barren shelves behind him reflect his predicament.
“I can’t stock too much as they will expire. This is a rural area. These days I just refuse people if I don’t have the medicine they want,” he said.
Unlike the district hospital, where visitors were not screened at the gate, at the entrance to Khairabad’s privately run BCM hospital every visitor’s temperature is checked digitally by staff in proper protective gear.
Outside the gate, Murli, a farmer is forced to rest with his grandchild under the roof of a vacant roadside stall. His son is ill and being treated in the hospital but he has not been allowed to enter due to the social distancing restrictions. “My daughter is with him,” said Murli, who had to walk five km to reach the hospital. The patient, however, was brought on a two-wheeler. Only emergency OPD services are running at the hospital.
“Crowding will increase if the OPD is open. We won’t be able to refuse people then,” explained a hospital staff.
While the Sitapur Chief Medical Officer was unavailable for comment, District Hospital Superintendent Ajay Shukla dismissed allegations and complaints by patients that they were being turned away and referred to Lucknow unnecessarily. The procedure that existed earlier was in operation, he said. “We are not rejecting anyone. We only refer those with neurological problems or those who cannot be treated here,” he asserted.
When asked why there was no thermal screening at the hospital, he said only those people who came and reported that they were running a fever were being screened.
“This can’t be done for everyone. It is for those people who are coming from outside areas,” he said.
To meet the paucity of available medical personnel, the district administration has released a list of doctors and their phone numbers to cater to the OPD requirements of people. The list includes psychiatric help. Mohini Jhawar, an activist who runs a mental health care organisation, listed by the administration for counselling during the pandemic, said she was mostly receiving calls from girls in shelter homes and transgender community people. Ms. Jhawar said many people were also calling her for counselling over the telephone, as they were unable to meet their appointments. “But we don’t provide telephonic treatment. We ask them to come in person, somehow,” she said.
Ms. Jhawar also said that many people were reporting stress due to the uncertainty induced by the lockdown. For those living in rural areas of Sitapur and around, the latest thunderstorm had brought additional stress as many people’s homes had sustained damage to their roofs, she said.
Chatrapal Yadav, a local lawyer, also said that he had been receiving distress calls from people alleging that they were not receiving treatment at the hospitals even for general illnesses.
“People are having to return from the hospitals and health centres. Doctors are not available. They are considering only serious cases these days,” Mr. Yadav asserted.
