New Delhi:

It is the silent toll of India’s deadly second wave.

After a terrifying month that saw Covid-19 overwhelm the country’s run down health system, doctors and nurses on the pandemic frontlines say they were pushed into physical and mental exhaustion as they fought to keep their patients alive.

Mousimi Das had to treat her own mother in her Kolkata hospital as countless patients including a colleague’s father died around her, working 48 hours in one stretch without a break. She has one message for the government of Prime Minister Narendra Modi.

“We are exhausted, frustrated, and depressed.” Das said over phone, her voice breaking with fatigue.

“Please see us. Please hear us. If you don’t listen to doctors, nurses and staff working on the ground, you will never be able to improve the health infrastructure.”

Das is not alone. Bloomberg spoke to a dozen doctors who described a nightmare scenario: continued high-risk exposure to the virus, a never-ending flow of patients and deaths and long hours in sweat-drenched PPE kits that made even washroom breaks difficult. It’s leading to burnout, anxiety and insomnia among a large number of India’s 1.3 million doctors and complicates the fight to contain the world’s worst coronavirus outbreak.

More than 1,200 doctors have lost their lives so far in a country that’s reported nearly 27 million Covid-19 cases, according to a toll maintained by the Indian Medical Association.

Chronic underfunding
Even before the pandemic hit India, its health sector was ranked 110 out of 141 countries, behind Bangladesh, Indonesia and Chile, the World Economic Forum’s Global Competitiveness Report 2019 found. The South Asian nation’s rural towns and villages, home to nearly 70% of India’s 1.4 billion population, have only a skeletal health infrastructure.

The number of doctors for every 10,000 people in India has fallen to around nine in 2019 from 12 in 1991, according to data on World Health Organization’s website, while the country’s health expenditure was just 3.54% of GDP, lower than countries including Iraq, Afghanistan, Egypt, China and Kenya.

India must now strengthen its health system by investing in hard infrastructure and human resources and making its data transparent, said Yamini Aiyar, the president of the New Delhi-based Centre for Policy Research.

“We are fighting pandemic on the back of an extremely creaky and broken system,” Aiyar said, noting state and federal governments had missed the opportunity to improve health care and governance during the lull between the pandemic’s first and second wave. “That is one of the crucial reasons why health workers are under deep strain.”