LK, a nurse in a private, non-COVID Mumbai hospital, has forgotten how many times she has cried in the last three months: when her society asked her to choose job or them; when management forced her to reuse PPE and N95 masks; when her measly salary didn’t come on time; when the family asked her to quit and left for village angry that she didn’t; when she got a bad hostel accommodation etc. Worst was when a fellow nurse died of COVID-19 in another hospital and she could neither help nor attend the last rites.
LK is lucky. Many of the over 3 million nurses in India are going through worse during the coronavirus pandemic. Ambika P K, a nurse in Kalra hospital, Delhi was allegedly asked to buy her own mask, besides reusing PPE kits. She contacted COVID-19 and died on May 24. Nurses refused to work after Ambika’s death until adequate safety measures were instituted in the hospital.
In KEM hospital, Mumbai after a bed couldn’t be found for a nurse who had contacted the virus on duty, nurses went on strike demanding a separate ward for COVID-19 infected colleagues and shorter shifts. 3 doctors at the hospital released a heart-wrenching video about having to care for 25 critical patients alone.
Across the country, hundreds of nurses and doctors have got infected - like Ambika and LK’s colleague – even in non-COVID hospitals. Nurses are quitting en masse - not just because they are scared (we all are), but as a protest against them being led to slaughter by deliberate, criminal negligence. Would you send soldiers towards enemy fire without any weapon or shield?
This is much dangerous because unlike in war, here the infected can infect others. 8 of Ambika’s colleagues and her daughter tested positive for COVID-19. Not far from them, over 200 healthcare workers in AIIMS have contacted COVID-19 so far.
In Kolkata over 500 Manipuri nurses resigned and left for home early May after facing racial abuses like being called corona, people spitting on them, low pay for overwork, management apathy, PPE reuse etc. that caused over 160 of them to get infected. 22-year-old Somichon ignored racial abuse on Kolkata streets, but when early May she told management she had COVID-19 symptoms, they called it flu, gave her antibiotics, and didn’t even test her. It was only when she quit, reached Imphal, that a test was conducted and she was found to be positive.
In Mumbai, LK has been tested only once in the last three months since the outbreak worsened despite a colleague dying of it. Mumbai Mirror reported that “in April and May over 300 nurses from various hospitals including Wockhardt, Bhatia, Jaslok, Bombay hospital, Nanavati, Lilavati, Hiranandani and Hinduja hospital tested positive. In Wockhardt, 80 nurses were infected while 57 at Jaslok and 45 in Bhatia tested positive.” Around 80 nurses from Kerela quit their job then. Hundreds have quit since then, many not even waiting for their salaries and in some cases where management had kept their original certificates in a sort of modern-day slavery, not even taking them.
Nurses in India seem to be quitting because the nation – including all of us i.e. its citizens and the many governments in it – are trying to kill them. Despite no longer having major PPE shortages because government ramped up production aggressively and even put price caps on them to prevent black marketing, they seem not to be reaching nurses in adequate numbers.
Doctors have been exempt from re-using PPE. But it puts both doctors and patients at risk if nurses are forced to reuse PPE. That’s why a doctor in Kalra hospital tore discarded PPE when he learned nurses were being forced to wash and reuse. In normal circumstances ‘Crush After Use’ is repeated millions of times daily for drinking bottles. Why not the same for the much dangerous PPE kits?
Romalyn Ante, a Filipino origin nurse working for the United Kingdom National Health Service, who is also an award-winning poet, laments about nurses:
“These invisible women,
goddesses of caring and tending,
But no one hears when their skulls pound,
like coconut shells about to crack.”
Having spent over three months living in and sleeping in hospitals while caring for people, I have seen first-hand what Romalyn evokes. The intimacy nurses share with patients and their families, the immense pressure, the emotional pain caused by attachments, the intensity of the care, the STSD – Secondary Traumatic Stress Disorder most nurses experience… it’s enough to make “their skulls pound, like coconut shells about to crack.”
Doctors instruct, nurses implement. While doctor’s attention span can falter for they can have time to recover, nurses – especially in critical care – are like high performing athletes: a moments distraction could cost them a race for survival.
Most people consider doctor’s gods, and nurses as angels. I consider nurses gods, and doctors the occasionally visiting, albeit crucial, angels. If you saw how the brightest of them light up the day for a patient with their positivity and optimism in the face of grimness, how they console and consult families, how they often cry secretly for a patient they grow fond of, how they continue to work through their own physical or emotional pain… you would too.
Hence it causes me STSD to read what Abraham Mathai, who formed the All India Nurses Association, said in a Mumbai Mirror story, “Nurses are one of the most important pillars of the medical fraternity and they are profiled abroad as just one below the doctor while unfortunately in our country the profile of a nurse is just one above the ward boy. ”
I’d say it’s not a stretch to rate a civilization based upon how it cares for its nurses. It’s common sense right, that you care for those who care for you at your worst time? What do you say to a nation which does not even get that basic principle? Barbaric? Cruel? Inhuman?
Asking nurses – who interact much more with people than doctors and hence are much more at danger – to reuse PPE during a pandemic is akin to attempting to kill them and I seriously feel manslaughter charges should be applied to those who ask this. Worst of all most hospitals don’t even pay them minimum stipulated wages, even while World Health Organisation has asked hospitals to pay extra for the occupational hazard they face.
Tellingly, neither the Delhi government nor the Centre that asked people to bang pots and pans to thank people like Ambika P K, even tweeted their condemnation or condolences on her death. It is ‘alleged’ that the center has pumped 20 lakh crore stimulus into the economy. Is there some loose change in there for nurses and hospital staff?
With India illogically coming out of lockdown just when the number of infections is rising to dangerous levels, we’ll need every single nurse we can get, armed and ready at her/his battle stations. Unless we want the nation to be plunged into chaos, we need to woo our nursing staff with every trick in the book. Money should be the least of our concerns at this time. And while we are at it, why not fix the entire system permanently for them?
In the midst of the COVID-19 crisis in March, poet-nurse Romalyn Ante had written:
“She walks an unlit road on her own, yet not alone.
Look at her now – night after night, shift after shift.”
Meanwhile, LK in Mumbai continues to wear reused PPEs and washed N95 masks, well aware that this is like playing Russian roulette. But she says she’s no longer afraid for she has left her fate at the hands of god. Talking to her I can’t help but wonder if the government has also chosen to do the same with the fate of its 1.35 billion citizens.
Satyen K Bordoloi is a scriptwriter, journalist based in Mumbai. His written words have appeared in many Indian and foreign publications.)