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Doctors in covid-19 wards at risk of burnout

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  • Government hospitals are poorly staffed and under-funded, and appointments are not always on merit. The fact that India has not invested enough in public health is showing up now during the pandemic

BENGALURU: A video a resident doctor made inside a covid-19 ward in Mumbai went viral recently. Nurses were on a protest for shorter hours, and the doctors shot a video to prove that they can’t care for patients alone. For the last three months, the medical fraternity has been pushing the limits to care for an ever-increasing tide of covid-19 cases.

“Doctors working on covid-19 wards are exhausted and burnt out. We must push at least one lakh young doctors into the system immediately. That is the only way to handle this emergency as India’s cases are surging every day," said noted cardiac surgeon Dr Devi Shetty.

Dr Dhruv Chaudhary and his daughter, who is also a doctor, have been working in covid wards for the past two months, and recently recovered after testing positive for the novel coronavirus. “For doctors, mental endurance is far more important than physical endurance. Healthcare workers have not seen their families for a long time and feel like their work is not appreciated," said the covid-19 nodal officer for Haryana and head of pulmonary and critical care medicine at PGIMS Rohtak. “We don’t know how long we can go on like this."

Far more than the shortage of doctors and nurses is the fact that the guidelines and rules are often contradictory, and the system does not support them, said president of Indian Medical Association (IMA) Dr Rajan Sharma. “Doctors have not been paid, basic allowances have been cut. We don’t have legal immunity in many states. There is no single set of guidelines for healthcare workers in India. Each state has its own agenda. Doctors are victims of political slugfests and arbitrary orders. All this exhausts and demotivates us more," he said. “And nobody talks about sanitation workers, the most important cog in this wheel. They have been working day and night but are so poorly paid. How can we expect them to continue working?" said Dr. Sharma.

Dr Adarsh Pratap Singh, President, AIIMS Resident Doctors’ Association, said, “It is one thing to applaud and shower flower petals on healthcare workers but more important is to provide them proper facilities and safety." India has more that 3 lakh coronavirus cases, and number is rising daily. “Doctors, nurses and other hospital staff are putting in long hours at work but don’t have proper quarantine facilities near hospitals. Doctors are also facing assaults, like the recent one in Hyderabad. All this puts stress on doctors, leading to exhaustion and demotivation," he said.

Government hospitals are poorly staffed and under-funded, and appointments are not always on merit. The fact that India has not invested enough in public health is showing up now during the pandemic. India spends a little over 1% of its GDP on public health despite an increase in health expenditure since 2009. “Added to this is the medical education system which has not changed for decades. The pandemic is showing us what we have not done all these years. I hope we learn the lesson at least now," said Vishal Bali, executive chairman of Asia Healthcare Holdings.

Medical seats in radiology, anaesthesia and other crucial verticals are limited for a population of 1.3 billion. “For decades, we had just a handful of specialists graduating every year. Today, we are facing the shortage, resulting in an exhausted medical fraternity. Even 600-bed district hospitals have just one or two anaesthetists. You can imagine the pressure on them," said the vice-chancellor of medical university in Tamil Nadu.

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