TUESDAY, APRIL 16, 2024
Sujay Gupta
As the shadows lengthened, we retraced our steps back home with the setting sun casting its final glow in the azure sky. Night descended rapidly, the lengthy shadows dissolving into the night. In the stillness, there is fear, the doors are bolted, latched, doubly fastened, some with iron padlocks giving inhabitants inside a sense of safety, from either an invisible enemy or a lurking beast. But there’s a lesson to be learned here. The beast does not return to the woods and make peace with the fact the doors are bolted and its path is halted. Secondly, the invisible enemy does not recognise State or district borders. All it needs is porous borders, jungle routes, paths taken by illegal liquor trades or the drug lobby, to sneak in.
This, in short, is the story of Goa’s fight against Coronavirus.
As we become a green zone, here are some very red flags about Goa’s Corona battle. As Goa partially restarts its lives and livelihoods, both its government and its people have to account for the fact this is at best a reprieve. The almost self-congratulatory tone adopted in speech and deportment of both the government and its people is fraught with both danger and disaster.
And before we continue in this vein let us ask ourselves some simple questions. 1. Do we really expect to wait this out by locking ourselves in? 2. Do we really believe that the moment restrictions are lifted in some form or the other, and more Goans return to the State, there won’t be cases? 3. And even if we rightly dismiss such misplaced notions, do we have the infrastructure to deal with mounting cases to deal with even 500 cases simultaneously?
This isn’t a failure of Goa’s health system, which under the circumstances has done the best it could to ward off, slow down and even give its system time to prepare. But everyone from Health Minister Vishwajeet Rane down to the ward boy in GMC knows a thing or two about our tertiary and rural health systems. They are just not equipped to handle the load of the crisis in communities and villages and contain it there should the pandemic reach there, in our Primary Health Care Centres (PHC) and the 4 Community Health Centres (CHC).
Our Community Health Centres are headed by a Health Officer with four specialist doctors and 30 beds each. These need to be equipped with ventilators PPE, and other equipment to deal with cases in those clusters.
Let us take a basic inventory of the health structure of Goa. We have 30 Rural Medical Dispensaries in remote and inaccessible areas headed by a Rural Medical Officer (RMO) and a pharmacist. Are each of the RMDs fully functional and can they serve as the first port of call for testing, and treatment when there are COVID cases?
Then there are 24 PHCs (14 with attached hospitals), 213 Sub-Centres. The three District Hospitals, Hospicio in South Goa, a sub-district hospital in Ponda and the Asilo Hospital in North Goa and three other specialised/general hospitals the Leprosy Hospital, Macazana; the TB Hospital in Margao and the Cottage Hospital, Chicalim make up the full system.
There are in all 1,347 beds in the hospitals under the Directorate of which 469 beds are attached to CHCs/PHCs.
If we add about close to 3,000 beds in GMC, we are still under 4,500 beds for all patients in Goa.
Currently even the hospital for COVID patients, the ESI hospital in Margao has been built and run by the Labour Department and taken over by the Health Department.
This is fine for peacetime skirmishes not for a full-fledged war. And even for argument's sake, if this inventory is all available, do we have the protective equipment, testing kits and ventilators to isolate and treat patients at the PHC or CHC level?
Health Minister Rane understands this. His insistence of wearing of masks and imposing Section 144 is clear that he is on tenterhooks, knowing the magnitude of what lies ahead. He perhaps sensed this even before Chief Minister Sawant did when he insisted on the imposition of Section 144 and calling off the Shigmo parades. Let there be no mistake, Goa has been plain lucky and blessed or both.
Meanwhile there are critical developments at the borders with Maharashtra and Karnataka. In Belgaum the number of COVID cases doubled from 19 to 36 on Friday. A man from Goa, who tested positive for Coronavirus was part of a delegation of ten people who went from Goa to Kudachi in early March to take part in a religious ritual. This team (luckily for Goa) could not return to Goa due to the Junta curfew and the 21-day lockdown which was extended. Imagine if this team were to return to Goa and go to their respective towns and villages on April 15 if the lockdown was lifted and inter travel allowed.
Do readers now get the drift when we say we just lucked out?
Then look at our inter-State check-posts at Dodamarg, Keri and Patradevi in the north and Polem in the South. They are hardly fortresses where no man, machine, tank or virus can pass. Machines and tanks may still be stopped but can men with a purpose and a virus riding piggyback on them be stopped? Drug carriers and illegal liquor smugglers know routes that those in governance don’t or often won’t.
Meanwhile there is a daily contingent of truck drivers, cleaners and handlers arriving in Goa from Karnataka carrying fruit, vegetables and even fish because Goa does not seem to grow or produce anything. We are hoping that putting them through sanitisation channels will cleanse them of the virus. And that’s hoping.
Do we now realise that trains, planes, and buses do not need to start for COVID to land at our stations, airports, and buses?
The gradual lifting of restrictions can be taken as getting back to normal at grave risk with acute debilitating consequences. It's fancy to use terms like ‘WFH’ (Work from Home), ‘the new normal’ and so on. But fighting Corona is neither a fad or a fashion statement.
The real battle lies not in factories which are making sanitisers and masks (even designer and branded ones will now arrive) because of our penchant for making a spectacle even during a crisis of deathly proportions. We have warriors in every village; we have health care workers and brave policemen and women who are fighting that brave fight. The only way we can give meaning to their struggles is to be prepared, be equipped.
Before we conclude this is a big ask. Have we tested enough? Have we opted to believe or look the other way when borderline cases and deaths have happened? These answers need not be demanded and this stage but let these questions not be forgotten. Let it also be understood that massive and rapid testing needs guts and you can do it when you know you have a de-centralised fully equipped system to deal with more cases when you begin to test more.
The government needs the backing and support of people and should be given the freedom to take the hardest of decisions. In return, it must promise and work towards preparing Goa for a situation no one wants us to be in. But living in denial will not keep the beast away. The “victory” achieved by keeping the danger at bay and getting time, must be used to fight the battle head-on if it hits us in the face.
