On September 10, the Tata Group handed over the keys of its newly built hospital in Kasaragod district, proposed to be used for COVID-19 care, to the Kerala government. Tata has kept its promise, and completed the construction in five months. It has been 19 days since this development, but the hospital is yet to open its doors to the COVID-19 patients.
The much-hyped hospital building in Thekkil village, near Chattanchal of Kasaragod, remains there on the hilltop, still waiting for a start. When this reporter visited the hospital, barring a few staff from the Tata Group who are finishing the documentation works, the entire premises wore a deserted look.
The hospital is not a large building but neatly built cabins. These cabin-like structures have rooms with at least four strong iron cots and two air conditioners, separate cupboards for each bed and attached bathrooms for each room. In other sections, there are rooms for Intensive Care Units (ICUs) and ventilator facilities. There are also single rooms for isolation purpose. In total, the hospital, which was built at approximately Rs 60 crore, provides 540 beds.
All that is required now to start this COVID-19 hospital are the medical infrastructure as well as the medical professionals and other staff.
“But don't you know that this is Kasaragod! It will take ages for this hospital to start functioning," a person who lives near the hospital remarked.
Yes, the health sector in this district has been and is still panting, even as the whole state is focusing on this sector now, and despite the growing number of COVID-19 cases. In fact, the prevailing absence of strong health infrastructure in Kasaragod reared its ugly head with the onset of COVID-19.
A total of 3,705 coronavirus cases have been reported in Kasaragod between September 1 and 24..
Proposal for medical personnel yet to be cleared
It was on April 6 that the Chief Minister and Revenue Minister E Chandrashekharan announced that the Tata Group will set up a specialty hospital in Kasaragod in three months. District Collector Sajith Babu also announced that the project will be completed at the earliest after handing over the appropriate land in the district.
Speaking to the regional media, the Collector recently said that the appointments and the equipment should be arranged by the Health Department and that the District Collector has nothing to do in this regard.
According to the office of the Kasaragod District Medical Officer (DMO), the Tata Group had put forth two proposals to the Health Department. In the first proposal, Tata detailed the required medical personnel and equipment for a multispecialty hospital in Kasaragod. Since the group allegedly did not receive any response, they submitted a proposal to turn the building into an exclusive COVID-19 hospital instead, which required lesser equipment and staff.
There was allegedly no response for the second proposal for medical personnel and the Finance Department, too, is yet to sanction it.
"The government had to simultaneously make arrangements to appoint staff and source other equipment. The District Collector said that he has done his duty and rest has to be done by the Health Department. Is that how a Collector should respond? He has to make this happen," asked NA Nellikkunnu, IUML leader and MLA of the Kasaragod assembly constituency, adding, “This hospital is the need of the hour for the people of Kasaragod.”
COVID-19 amplified Kasaragod’s health crisis
For the last several decades, Kasaragod has been calling the lack of development in all sectors to the government's attention. Among them, health has been the most important."Unlike all other districts, the health sector in Kasaragod is backward. We became even more worried about it when the Karnataka borders were closed during the COVID-19 lockdown, as we were so much dependent on hospitals in Mangaluru for treatment," MLA NA Nellikkunnu said.
The MLA pointed out that the crisis worsened when the number of COVID-19 cases in the district started gradually increasing in April. When the borders were closed, many died without getting proper treatment. Women had to deliver in ambulances as they could not reach Mangaluru in time. Those living in the border villages, especially, struggled as they were not able to reach the Pariyaram Medical College Hospital in Kannur district, which is about 65 kilometres away.
On April 1, Chief Minister Pinarayi Vijayan announced that the Medical College Hospital in Kasaragod’s Ukkinadka will start functioning in another four days.
It indeed started functioning after three floors of the academic and administrative block were converted into a COVID-19 hospital. A medical team comprising doctors and nurses from other districts were deputed there for 14 days each.
However, this Medical College, which had been under construction for the last four years, was turned into a hospital within four days. The academic and administrative block was the only building of the hospital that was constructed in the last four years. As a result, setting up facilities for critical care was impossible. This further spelt out the district’s limitations in the health sector.
Severely symptomatic patients and those who required intensive care had to go to other districts for treatment as there were no facilities in the hospital. In fact, last week, a COVID-19 patient died on his way to Pariyaram Medical College Hospital.
"Now with COVID-19 cases increasing, Pariyaram Medical College Hospital in Kannur, too, is facing limitations as they have to accommodate patients from its own district,” the MLA said.
Currently, 80 patients from Kasaragod district are under treatment in Kannur district and 18 others are in Kozhikode district.
Why there is a severe shortage of staff
A senior doctor from the district, who chose to remain anonymous, said that the shortage of staff is the biggest challenge in Kasaragod's health sector."There are vacancies for more than 60 doctors in the district hospital. This was never filled before COVID-19 or when it struck. As a result, the situation has turned worse," he said, adding that the district needs over 100 doctors more to help contain the crisis.
Incidentally, the Directorate of Health Services recently asked 23 doctors in Kasaragod — posted in District Hospital, the General Hospital, three taluk hospitals and other primary healthcare centres (PHC) — to report to other districts.
In August, 39 doctors were recruited for hospitals in Kasaragod district. However, three days after issuing appointment orders, 23 among them were reappointed for other districts on September 11, the senior doctor said.
Apart from that, in the first week of September, another 22 doctors, who were appointed in Kasaragod Medical College hospital in Ukkinadka, were also sent to other districts based on a certain working arrangement. "They will be paid for the work they do here in Kasaragod, but their service will be available to other districts," said MLA NA Nellikkunnu.
“These doctors were posted to other districts as if we have enough doctors,” he added.
The request for specialist doctors at government hospitals was never met. "We have been asking for a neurosurgeon for the past several years. No action has been taken in this regard yet," he said.
The World Health Organisation has recommended one doctor for 1,000 people. “Kerala, in total, has one doctor for 600 people. This shows that we are much ahead. But, in Kasaragod, we just have one doctor for 1,374 people," the MLA alleged.
Dr Shameen Kattathadka, a doctor from Kasaragod, said that the root cause of the scarcity of doctors in the district is that many don't want to live in Kasaragod because it lacks other facilities."First of all, there are only very few doctors who are from our own district. And, doctors from other southern districts do not want to settle down here because there are no good schools or other facilities in Kasaragod. So, if there should be more doctors in Kasaragod, the education sector should be equally boosted," he said.
The senior doctor mentioned above also added that only half of the appointed doctors actually join duty while many take a transfer.
