MP: No takers for Post of 4,900 Doctors, How Will State Fight Third Wave?

The devastating second wave of COVID-19 and warnings about a third wave on the horizon may made the Madhya Pradesh government keep oxygen, ventilators and beds ready, but is any attention being paid to the biggest gaping hole that the state's health system may be left staring at – the lack of doctors and other health personnel?

Several doctors and health personnel, who have been grappling with the rising number of pandemic cases, have heart-wrenching stories to tell about losing patients who could have been saved, if only there were more hands, apart from other vital medical requirments.

Take the case of Ravi Jaiswal, who found himself at a loss after his brother Uday Jaiswal's (38) repeated calls from a COVID Intensive Care Unit (ICU) of Shahdol Medical College and Hospital, complaining that his call for a glass of water had gone unheard for hours on April 14.

"He was coughing because neither ward boy nor the nurse had given him water despite his repeated request," said Ravi, who rushed there with some water. After squabbling for around half an hour, Uday finally got a glass of water.

Three days after the incident, on the midnight of April 16-17, Ravi received another call from his brother who was continuously coughing, asking him to come over urgently. When Ravi entered the ICU, he saw patients on 60 ICU beds gasping and coughing owing to the oxygen shortage, a few were also struggling to remove their oxygen masks. There was no one to attend them, not even a ward boy, Ravi said.

Uday died that night, along with 21 patients, owing to the shortage of oxygen at the hospital, claimed Ravi, while the official toll was 13.

"The 60-bedded COVID ICU ward was running on one nurse, one ward boy and an on-duty doctor who was busy on his mobile and hardly attended to the patients" Ravi alleged, regretting that had he admitted his brother in a private hospital, at least he would not have died because of "mismanagement".

The Shahdol Medical College, which was started two-three years ago, is running a 438-bed COVID-19 hospital with a strength of over 50 nurses and 79 doctors.

It was only after the news of deaths hit national headlines and the issue of lack of doctors and nursing staff came to fore, that the state government sent over 100 National Health Mission nurses to the hospital. With addition of new nursing staff, the capacity of the hospital was increased to 600 beds, including 20 Neonatal ICU wards for children. Ironically, Shahdol Medical College has no paediatricians.

"The biggest challenge for us was to run a massive COVID-19 facility with a smaller team of doctors and nurses," said Dr. Milind Shiralkar, Dean of Shahdol Medical College.

"In mid-April, when all 438-beds were full, we did not have specialist doctors of anaesthesia and medicine, who are important for treating COVID-19 patients. Three junior doctors of medicine were given the task to treat the patients," he added.

The college has 168 sanctioned posts of doctors and 253 nursing staff. But, the posts of 89 doctors and 238 nursing staff are still lying vacant. "We have been struggling to get good doctors and staff. They don't want to come to Shahdol and many refuse to join after the selection. The reasons are many which need to be rectified on the policy level," Shiralkar said.

Similarly, Khandwa Medical College is also facing shortage of doctors and nurses that led to "mismanagement" at the hospital during when the cases peaked. In the past three years, the college has floated ads for vacancies for the post of doctors and professors 12 times. But no one has turned up. Almost half of out of 168 approved posts are still lying vacant.

"We have been running a 360-bed COVID facility, including 60 ICU beds with the help of two anaesthetists and three physicians. Instead of putting them on the fixed eight-hour duty, I asked them to attend to patients round the clock," said Dr. Anant Pawar, Dean of Khandwa Medical College and Hospital.

Pawar said: "We need a team of expert doctors and nurses to deal with the third wave, but no doctor is willing to come to Khandwa. A little tweak in the policy, addition in the facilities and allowance would help attract new doctors."

In 13 medical colleges, 856 posts were lying vacant out of 2,814 sanctioned posts. Jabalpur has the highest vacant posts at 96, followed by Chhindwara with 92 and Shahdol 89. Bhopal's GMC has the lowest — 37 vacant posts.

MP: Status of medical colleges with vacant posts, as on March 6, 2021

Source – CM Review meeting March 6, 2021

In addition, the post of 2,650 specialist doctors, 1,400 medical officers, 8,000 nursing staff etc., were also lying vacant. Out of 40,000 posts of various medical staff, close to 45% of the seats are lying vacant.

Vacant posts of various medical staff

DOCTORS QUITTING

Incidentally, over 50 senior and specialist doctors have quit the job in the past one year in Madhya Pradesh owing to various reasons. "There would be a long list of doctors who will resign from the job in the upcoming months because of the State government's age-old policies for doctors," said Dr. Rakesh Malviya, Secretary, Central Medical Teachers' Association.

The state government provides benefits to 4.5 lakh employees, such as allowances, residence, grade pay, but these are not offered to doctors. A medical teacher promotion policy 1987 is still in effect in the state, which is the "worst policy" for doctors, pointed out Dr. Malviya, adding that these policies needed to be changed to attract the new doctors.

Dr. Devendra Goswami of MP Health Officers Association pointed out that the state should provide quarters, non-practice allowance and a conducive work environment to doctors who go to three-tier or developing cities, like Khandwa, Shahdol and Chhindwara.

"If the State is recruiting doctors for rural areas and under-development cities, they should provide homes, allowances and other facilities to attract new doctors" said Goswami questioning why a person, who has become a doctor after a much toil, would serve a village leaving a white collar job in a private hospital?

He said the doctors' associations recently met State Health Minister Prabhuram Choudhary with their demands and the Minister assured them that he would address these.