Less than four months ago, Prime Minister Narendra Modi spent over seven minutes, heaping effusive praise on Kevadia, the location of the Statue of Unity, the world’s tallest.
Flagging off eight new trains connecting different parts of the country to Kevadia, Modi said the region was no longer a block in a remote part of Gujarat. It was now, “one of the largest tourist destinations in the world and was attracting more tourists than even the Statue of Liberty,” Modi said.
His attention on Kevadia has been consistent – apart from spending Rs 3,000 crore on the statue, the Gujarat government has spent another Rs 400 crore in building a slew of parks, including a “glow garden”. Another Rs 102-crore museum featuring tribal freedom fighters is under construction.
Last year, Modi even inaugurated a sea-plane service connecting Kevadia to Ahmedabad.
None of this is helping currently.
Narmada district, in which Kevadia is located, is reeling under the terrifying second wave of coronavirus infections. Amidst this new surge, many are realising that the district that Modi described as a “complete family package” just months ago, was now falling woefully short of critical infrastructure, tearing families apart, even while it fudges data to keep the true scale of devastation under wraps.
On paper, though, Narmada is one of the least-hit districts in the country – it has recorded only ten deaths due to the coronavirus so far since last year, according to the Gujarat government’s database. Of these, nine have occurred since mid-April, while only one death occurred in the last 12 months preceding that.
Except, at the sole crematorium in the district headquarters of Rajpipla city alone, the death tally since April is likely to be at least 20 times the official data. A local digital media website, Gujarat Exclusive, had reported on April 23 that 74 people had died between April 2 and April 23, including nine on the night of April 22.
Kaushal Kapadia of the Rajpipla Samast Vaishnav Samaj, the organisation that manages the crematorium, said that the crematorium was overworked.
“Before the pandemic, we would cremate one body a day and now, we have five to seven cremations of COVID-19 bodies every day,” he said.
The rush is proving difficult to handle for the crematorium. So dire was the situation that it ran out of wooden logs, used for cremations, and had to reach out to local government authorities for urgent help. “We don’t want such a situation again, so we are now trying to install an LPG-fuelled gas crematorium,” said Kapadia, adding that the organisation was seeking donations to foot the Rs 32 lakh-bill and set it up before a third wave hits.
Gujarat has been severely hit by COVID-19’s second wave. Gujarat government data said it had 131,832 active cases currently, with a total of 8,626 fatalities so far. However, the credibility of these figures is in tatters – media reports have constantly highlighted the extent and scale of under-reporting of COVID-19 deaths in the state. Reporters have had to station themselves outside COVID-19 hospitals and track ambulances to reveal the actual death toll.
A glaring mismatch
Nowhere is this more glaring than in Narmada, which, officially, has the lowest deaths for any district across Gujarat, and one of the lowest in the country.
The district is a predominantly rural district, with over 89% of its population scattered across its 613 villages, according to the 2011 Census. So, most deaths happening in the district’s villages are cremated in and around the villages, said a local health officer.
Sixty kilometres away from Rajpipla, in the Chopadvav village of the district’s Sagbara taluka, sarpanch Raysingbhai Vasava said that death and fear haunts his village.
“Since the beginning of April, there are four to five deaths happening in my village every single day,” he said. “There are times when we cremate one and come back to find another person has died.”
Vasava lost his wife to COVID-19 less than two weeks ago.
Local officials don’t disagree entirely with him.
Dr R.B. Kashyap, the district’s epidemic medical officer, said that the district’s actual death toll “could be” higher than the official data because patients were dying at home.
“There are many bodies which are not coming here to the COVID facility, and are directly taken to crematoriums,” he said, adding that the lack of awareness meant that many in the rural areas were not willing to get tested for COVID-19.
Kashyap said that the district was excluding from its count COVID-19 deaths of patients with comorbidities as well as those who were suspected COVID-19 deaths but could not be tested before death. Such an approach, however, runs contrary to the Indian Council of Medical Research (ICMR) guidelines on recording COVID-19 deaths, which has asked agencies to record both these categories as COVID-19 deaths.
But at the root of this terrifying rampage caused by COVID-19 is a wilful neglect toward critical healthcare facilities, and instead, a focus on creating a “major global tourist destination,” as Modi said, in his January speech.
The Narmada district has been a study in contrasts. Its health and nutrition indices are one of the worst in the country – Niti Aayog data show 47% of the children born here are stunted (low height for age), while 54% are underweight and 36% are wasted (low weight for height).
But over the last few years, the district’s profile has shot up, thanks to it being home to the 182-metre statue of Sardar Vallabhbhai Patel in Kevadia, on the banks of the Narmada district. Inaugurated by Prime Minister Narendra Modi on October 31, 2018, the statue has ensured that Modi remains a frequent visitor to the district. Since then, he has visited the district each year on the day, to commemorate Patel’s birth anniversary.
In fact, last October, with the pandemic still raging, Modi visited and stayed in the district for two days, inaugurating 17 such projects and laid the foundation of four new projects. One of the projects he flagged-off includes a sea-plane service connecting Kevadia and the Sabarmati Riverfront.
But even while this was happening, the district’s fight against the pandemic remained weak and wobbly.
Till last week, the district did not even have its own laboratory to analyse swabs collected from suspected COVID-19 cases. Kashyap, the epidemic medical officer, said that samples had to be sent to labs in Baroda and that would mean a three-day wait for the results.
The district, till the beginning of April, had only one dedicated COVID-19 hospital, with 100 beds. “The infrastructure here is comparatively poor since it is one of the smallest districts in the state,” the district’s collector Dharmendra Shah said. “We have only one COVID-19 hospital and from 100 beds, we have now doubled the beds while increasing oxygen-equipped beds from eight to 80,” he added.
Shah said that the district had now created 1,008 beds at various “COVID-care centres” at taluka level, but sources in Shah’s administration admitted that most of them did not have oxygen supplies and adequate medical staff to treat symptomatic COVID-19 cases.
Until two weeks ago, even private hospitals were not treating COVID-19 patients, forcing every positive or suspected COVID-19 patient to depend on the state government’s sole COVID-19 hospital. Dr Kashyap, the epidemic medical officer, said that private hospitals were scared and had to be convinced to take COVID-19 cases. “But we now have 320 hospital beds and will be creating more, apart from also taking steps to install our own oxygen generation plant,” said Shah.
A tad too late
But all this might already have been too late for many.
Like it was for Manan Tadvi*, who lost his wife Pramila (49) on April 21 because of a crippling delay in diagnosing her infection and poor treatment.
Local officials, Tadvi said, insisted on conducting only an “unreliable” rapid antigen test, where Pramila tested negative. Even after a CT scan showed a severe lung infection, the government-run COVID-19 centre refused to treat her and, instead, made them wait for three days till the RT-PCR test results came back, showing her to be positive.
Now gasping for breath, the hospital admitted her but the family’s nightmare continued. “One night, my son decided to check on her, only to see that her oxygen mask had fallen off and she was unconscious, while the nursing staff had locked the ward and sat outside,” said Tadvi.
At least four other patients were gasping, asking for oxygen, but no one was listening, Tadvi’s son told him.
The next day, she was shifted out to a hospital in Surat but she succumbed to the virus.
‘Have run out of oxygen. Come fast’
That night, lying in the bed opposite Tadvi’s wife was Kanubhai Vasava, a 53-year-old driver with the state forest department, gasping for breath. Between gasps, Vasava was trying to call his son Sandeep.
Sandeep said his father’s voice on the phone that night was faint. “He called and said, oxygen khatam thai gayu che.” The oxygen is out.
His father told him that the staff were sitting outside the ward and no one was attending to him. “Jaldi aao,” he said. Come fast.
Vasava’s oxygen saturation level was hovering around 60 and he needed constant oxygen support.
Harrowed, Sandeep called the hospital’s helpline for families of patients. The staff, he said, told him it was a temporary glitch because they were refilling the oxygen tank. The oxygen was resumed the next morning. Two days later, Vasava called his son again, this time at 5am, sounding even more desperate.
This time, Sandeep rushed to the hospital. “They told me the same thing – that the oxygen supply was being replenished. But when I went down to check, there was no sign of anyone at all replenishing it.”
Ten days after Vasava was admitted, a doctor who knew the family managed to come to the centre and examine him. The doctor told Sandeep that his father desperately needed a ventilator bed. Sandeep was surprised because no one from the hospital had told him anything like this.
On paper, the COVID centre had ventilators, but Vasava was not offered one. A senior doctor from Rajpipla, on condition of anonymity, who has visited the COVID hospital and treated patients there, said that there were not enough doctors to operate the ventilators. “This was the case till a few days ago. That’s why, the ventilators can’t be put to use,” he said.
Sandeep shifted his father to a hospital in Baroda, but the damage had been done. Eight days later, Vasava was dead.
“He wanted to live, he had a lot more to offer. He fought valiantly, but why couldn’t the Rajpipla COVID centre tell us that they were not equipped to treat him?” asked Sandeep.
‘It is murder’
Such negligence has been commonplace through the second wave, said Bharat Varma Vankar, whose father was admitted to the same facility.
Vankar had admitted his father, Manilalbhai (74) to the COVID-19 centre on April 24 after he started feeling increasingly weak. The timing was freaky – it was exactly a week after Vankar’s brothers came back from the same centre after being treated for COVID-19.
But after having him admitted, Vankar felt that the hospital was not being transparent about his father’s condition. So, on the second day, he decided to go into the COVID-19 ward himself, at the risk of catching an infection.
What he saw, he said, shocked him – his father’s medicines were lying on the table, his water bottles were untouched and his pants were soiled.
“My father was so weak that he couldn’t even drink water by himself and the staff had abandoned him completely,” he said. Incensed and heartbroken at seeing his father in the state, Vankar cleaned his father up, changed his clothes and decided to urgently shift him out to a private hospital. Except, none of them had enough oxygen supply.
Vankar made a flurry of calls to find oxygen supplies, asking anyone if they could arrange oxygen for his father. When he finally managed to procure a bed and an oxygen cylinder, he went back to his father’s bed to see that Manilalbhai had passed away.
“It was murder. It was not a natural death. If he had been given food and water, my father would have survived.”
*His and his family members’ names have been changed to protect their identities since he is a serving government officer.
Kunal Purohit is an independent journalist, writing on politics, gender, development, migration and the intersections between them.