The Covid Collateral

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While the entire focus is on preventing Covid-19 related fatalities, people are silently dying from treatable medical conditions and also because of the negligence of the medical staff, reports Saima Bhat

A few men and women pulling a hospital trolley carried their dead member and mourning on streets that have no other life visible.

Awake at 2:30 am, a septuagenarian Raja Begum performed ablution and offered Tahajjud, the voluntary wee hour’s prayer. Once done, she laid out food for Sehri, the pre-dawn meals, and went to call her other family members affectionately. The family had meals, prayed and later went to sleep again.

After waking up, Raja got again busy with household chores.  Later in the day she complained of discomfort and started to vomit. Initially, the family took it as mild occurrence due to fasting, says his son, who is working as an agent for a pharmaceutical company.

“She was overweight so we knew she takes less food so that it helps her in reducing the weight,” said Shoaib Ahmad, her youngest son.

Helplessness. As patients were confirmed positive on Monday, May 18, 2020, the SMHS ambulance ferrying them to the CD Hospital dropped them on the roadside in Dalgate. It was after some time that the CD hospital staffers helped them get into the Covid-19 Special Hospital. KL Image by Bilal Bahadur

As rest of her family broke their fast in the evening, Raja was continuously vomiting acidic water. Panicked,  the family despite the Coronavirus fear decided to take her to the SMHS hospital.

 They were admitted in the emergency ward where one more elderly woman was admitted. “No doctor came to see my mother, nor the other woman. We were left at the mercy of Allah. I requested them to check my mother and pleaded that I have come from a green zone, where not a single positive case of Corona has been diagnosed but still they did not come. Instead, doctors  misbehaved with us for disturbing them in their room.”

Left with no option, they returned home. . Concerned about the state of Raja, the family requested a neighbourhood nurse, working at a government hospital to inject intravenous fluids to avoid dehydration.

“For the entire night, we were awake. She had uncontrolled vomiting sessions of acids. She complained of pain in her stomach as well,” said Shoaib.

As the pain started aggravating, he started calling his friends if they could persuade any doctor to check his mother. “Due to Coronavirus no private clinics are functional and at government hospitals, they don’t even bother to check you.”

By the following evening, one of the doctors agreed to see Raja. Happy to have a consultation, Shoaib took his mother at around 5 pm and reached the clinic. As the doctor started examination, blood started oozing from her nose and she collapsed. She passed away that very moment, said Shoaib, helplessly.

“I was with my mother. She had no underlying health problems just that she was hypertensive but she collapsed in seconds. I still don’t know how she died,” he added.

Her death was a shock not only to the family but the entire area. By eight in the evening, she was lowered into the grave without a valid cause of death. Grieving family laments the delay caused by the doctors in the hospital. With no valid reason, they had their own guesses to explain her death. “Everyone asks how she died, said Shoaib, who is still in the shock. We just have one answer that blood was oozing from her nose and maybe she had a brain haemorrhage.

As the coronavirus pandemic started in Kashmir in March after Kashmir got its patient zero, medical advisories urged people to avoid hospital visits. But in case of emergencies patients have to go to hospitals where the doctors neglect them.

On April 27, amid chaos and cries, an ambulance reached the emergency department of SKIMS hospital at Bemina. Four pregnant ladies from Anantnag were inside.

“We came from a red zone in Anantnag district. We went to two hospitals but they shut doors on us”, said Shameema, one of the attendants of the patient at SKIMS Bemina. “Finally, we were taken to SKIMS Bemina. We told them our patients have tested negative but still, they showed us the door. Why were we shifted to Covid-19 hospital when the patients were negative? We had come from a red zone but didn’t mean they will put our lives at risk”.

At SKIMS, declared as a Covid-19 exclusive hospital, no attendant was allowed to accompany the patients inside. “Trust me these pregnant ladies were asked to carry the bags themselves which were heavy and one of them was already in labour. Wasn’t it better if they allowed us to go back and we’ll help them deliver at home,” asked Shameema.

Inside the labour room, these women were admitted in a ward where already a Covid-19 positive case was admitted. “The positive patient might have touched her bed, used the washroom and the door handle. What is the guarantee that these poor women won’t get the infection and who will be responsible?” questioned an insider. “By getting them to Covid-19 positive hospital we have put them at risk and aren’t we helping in community transmission.”

On May 2, panic gripped the lone tertiary maternity care hospital, Lal Ded,  when doctors got to know the woman, who they just helped in delivering a baby was actually Covid-19 positive. As of now two doctors and eight health workers, mostly nurses, are in quarantine.

Outside view of SKIMS Srinagar.

Outside view of SKIMS Srinagar.

Reportedly this positive woman, who hails from a red zone in Trehwani, Achabal, was refused treatment at Maternity Hospital Sherbagh Anantnag and referred to SKIMS Bemina after she went there on Friday evening. “She was also turned away from SKIMS Bemina and referred to LD Hospital for treatment,” alleged her family.

Fearing she might be refused treatment for the third time, her attendants hid her two previous referrals and the fact that she hailed from a red zone area of Anantnag. “Being asymptomatic, she was admitted to the hospital around 3:00 am on Saturday and had a normal delivery in the afternoon. However, we were taken aback when health officials from Achabal informed us that she had tested positive for Coronavirus,” a doctor at the LD Hospital said.

The woman along with her just born baby was shifted to SKIMS Bemina, a Covid-19 designated hospital. But the officials claimed that the attendants of the said patient informed at both the hospitals that the patient was negative and that was why she was referred to LD hospital”.

As various villages of district Anantnag were declared as red zones, at least three cases of pregnant women who died of alleged medical negligence are under investigation.

The first case was reported from the Maternity and Child Care Hospital (MCCH) Sherbagh Anantnag, where Rukaya, 30, a resident from red zone area of Kharpora in Kokernag, passed away. She was expecting her twins.

After her death, a video surfaced on social networking sites where her family alleged that in the hospital, she was not attended to by doctors and was sent from one room to another. First one baby died and then the second. After that, she had blood loss and passed away. The family also alleged that the doctors in the hospital refused to attend or touch her.

But while the family of Rukaya was busy with the burial of her two babies, she also developed complicacy. “We went door to door requesting doctors to see her but nobody came to see her. And then she too passed away,” one of her relatives said. Rukaya’s body was released after taking her swabs and her family buried her normally without following the pandemic SOP. A day later, when her reports came from Srinagar, Rukaya was declared Covid positive posthumously.

The death prompted action as the authorities ordered an inquiry to ascertain the facts. But so far no report has been made public.

Coronavirus: 22 More Patients Recover, Discharged

Six days later, a video clip went viral on social media, showing a dead woman being taken home on a stretcher with her wailing relatives pulling it on the deserted streets in Anantnag. They alleged she was “denied” an ambulance. The incident shocked the people. Condemnation and condolences messages started pouring in from everywhere. The family alleged that the 25-year-old Shakeela, a pregnant woman of Salia Nowpora Panzmulla was admitted in sub-district hospital at Seer Hamdan on May 2, where she died on Sunday morning due to the negligence of doctors.

“In wee hours of Sunday, doctors and other paramedical staff at SDH Seer Hamdan directed us to move her to MCCH Anantnag for advanced treatment after she was found in critical condition. She died on way to MCCH Anantnag.”

At Anantnag, the officials informed the family that the deceased’s swabs have to be taken for tests which will take two days. “But the family left the hospital with the body of the woman without informing the hospital administration,” said officials.

The administration has ordered an enquiry in the matter as well. The medical officer and a staff nurse on night duty on May 2 at Seer Hamdan, have been suspended.

A week later, another death of a woman was reported from the MCCH Anantnag. This woman was identified as Masrat Jan, wife of Riyaz Ahmad resident of Manzmoo Qazigund. Reportedly she had delivered a stillborn baby at her home but as her condition worsened, she was taken to Qazigund hospital. “When her condition got further complicated she was referred to MCCH Anantnag,” said one of her relatives.

Reportedly as she was taken into theatre, she collapsed and passed away. The Principal Government Medical College Anantnag Dr Showkat Jeelani has said that the family had not taken care of the deceased woman before delivery. “She should have been taken to the hospital before delivery. She was almost brought dead to the hospital.”

Worried Warriors

After repeated deaths in the district and alleged medical negligence, a local court of the district took cognisance of the matter and has directed the district police officer to enquire the death of two pregnant women.

The court held that the women died apparently for want of proper medical treatment.  “The SSP Anantnag shall either hold an inquiry by himself or by any other officer but not below the rank of SP,” the court said.

Apparently, because of the hospital managers failure in offering safety to the medical staff or scanning the patients properly, the infection was reported in three major facilities in Kashmir – the Super Speciality Hospital where one patient and his son died of the infection; the Lal Ded Hospital where a Covid-19 patient delivered after hiding her details and the Bone and Joints Hospital, where a couple of attendants were detected carrying the virus.

This has collapsed the entire system. “The senior doctors rarely come to visit the hospital and they have handed it over to the registrars,” one insider in the Bone and Joint Hospital said. “At one point in time, we suggested the authorities go for mass testing of the entire staff but they did not agree to that. We are discouraging surgeries as doctors are scared of contracting the infection.”

Tanveer Ul Ahad

The newspaper editor Tanveer ul Ahad who recently died in the SMHS Hospital after he was admitted for vomiting, there was an element of neglect in his case also. “If I die, you should hold this doctor responsible for this,” Tanveer had told one journalist who saw him a day before his death. Hailing from a village in north Kashmir, that has already been declared a red zone; the doctors avoided getting closer to him.

Terminally sick patients are facing most of the crisis.

“This was expected that visitors to the hospitals will fall,” Dr M Salim Khan, the GMC Spokesman said. “We will have to live with the virus as we are living with its earlier avatar, the H1N1.”

Dr Khan said that emergencies are operational. By an average, he said, almost 1200 people come to the OPD at SMHS daily. “Our doctors at the Super Speciality and other hospitals are using the maximum protective gear while tackling the patients,” Dr Khan said. “In coming days every patient that comes to the hospitals will be seen as a potential Covid-19 patient unless proved otherwise.”

“Right now, we have around 40 health workers in quarantine and if the doctors remain threatened that they can contract the infection, the system will collapse,” Dr Khan said. “After Eid when we expect the footfalls improving in the hospitals, we will take serious measures to ensure the medical staff stays safe.”

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