Maharashtra: Every doctor counts in these dire straits

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Even after the announcement of a package of Rs. 20 lakh crore to stimulate the economy, the Maharashtra government has sought services of doctors “for 15 days” due to the COVID-19 pandemic. A public notice was circulated by Dr T.P. Lahane of the Medical Education and Research department of the Maharashtra government.

Apparently, over 5000 doctors are needed to tackle the pandemic. Hence, the government has sought the services of all medicos – whether allopaths, homoeopaths, ayurvedic-trained practitioners, unani or siddha practitioners. This by itself is strange logic because the pharmacology of each system is different with the Supreme Court laying down that ayurveda-trained doctors or homeoeopaths could not prescribe allopathic drugs without training.

For those who came in late, the COVID-19 has infected over 2.6 million people across the globe and killed a quarter million, more than the US soldiers killed in Vietnam during the 19-year US-Vietnam war. Mumbai city appears to be the worst-hit by this pandemic among all the big metros in India. Dr T.P. Lahane, who issued the letter on behalf of the Directorate of Medical Education and Research of the Maharashtra government requisitioned the services of doctors because “we need 5000 doctors to work between six and eight hours for the COVID-19 pandemic.” Dr Lahane clarified that those who were already working in their private hospitals and clinics could continue to do so.

Other doctors who are ophthalmic surgeons apart from other specialities, pointed out they had no experience in treating COVID-19 asymptomatic patients as they were experienced in varied disciplines not related to COVID-19. “It does not matter. You were MBBS graduates before acquiring post-graduate degrees. So, you are expected to know the basics,” Dr Lahane clarified.

A PIL was filed in the Bombay High Court by Abhinav Bharat Congress, reportedly a think-tank about the takeover of the Wadia hospitals for designating it as a COVID-19 centre, according to a report in Medical Dialogues.

A division bench of Chief Justice Dipankar Datta and Amjad Sayyed took part in a tele-conference and sought the response of the state government and the MCI by way of affidavits. While this case highlights how medics have approached the courts, the doctors who are willing to serve in COVID-19 centres have been insured upto Rs. 50 lakhs against contracting this deadly virus. An MBBS graduate is paid Rs. 50,000 per month while specialist doctors who have expertise in virology which is directly connected to the COVID-19 pandemic are paid between Rs. 75,000 to Rs. 250,000 per month. These doctors have to serve for a minimum 15 days while pregnant women doctors and those who are of advanced age are exempted.

When contacted for his version, Dr Lahane told FPJ that 21,000 doctors had applied and 4500 who were less than 45 years of age had been selected. “There has been no resentment among these doctors to work for society. It is a noble profession, so why should they be resentful when their services are requisitioned?” he asked. He refused to reply to more questions because he was in a meeting.

The Essential Services Maintenance Act, 1897 has been invoked by Dr Lahane in his capacity as the director of Directorate of Medical Education and Research (DMER). Although it is enacted by Parliament, it comes under entry 33 of the concurrent list and depends for its implementation on individual states and not on the Centre. The Maharashtra ESMA which was amended in 2017 like its counterpart in other states can be invoked to prevent strikes in essential services like public transport, public health such as government hospitals. This is the very first time this law has been invoked to deal with a pandemic like COVID-19 due to shortage of doctors. Some of the doctors have pointed out there is a shortage of beds as well as doctors.

A state government official disclosed to another reporter that ICMR dithered on allowing private laboratories to do COVID-19 testing. “We wrote to the ICMR on March 11 but they replied on March 17 whereas Maharashtra had its first COVID-19 case on March 9. We sought permission for three government medical colleges and seven private laboratories to do the testing. If the ICMR had immediately responded, the situation in Maharashtra may have been different,” he said.

Former Maharashtra Medical Council member Dr Suhas Pingle said between 72 % and 80% of pathology laboratories were private which was why permission should immediately have been given to permit these private pathology laboratories to permit testing. “This is a new virus for which no anti-viral therapy or vaccine has been found till date. Hence, testing asymptomatic patients and putting them in quarantine is the only way to stop COVID-19 from spreading,” he clarified.

His viewpoint is vindicated when we accept that Mumbai reported its first positive case on March 6. It was that of a businessman who had returned from abroad. By March 11, nearly 10 persons had been affected. But today, Mumbai has emerged as a major red zone with Maharashtra reporting over 23,922 patients and 975 fatalities.

The Brihanmumbai Municipal Corporation whose annual budget of Rs 33,441 crores surpasses small states like Sikkim and Goa, has sanitised 75,020 public places, 280 hospitals, 45 areas owned by companies, 3322 common areas. The BMC has used over 300 litres of sodium hypochloride with hydrogen peroxide, isopropyl alcohol and zoom Z-71 microbial scrub to ensure that Mumbaikars can literally enjoy their right to life and livelihood although their right to liberty has been bypassed due to the epidemic.

Statistics apart, a doctor claimed that a petition was filed in the high court challenging the state government’s move to conscript private doctors to tackle the pandemic. But it was dismissed as withdrawn by the high court after the petitioner was warned with being imposed by costs.

While doctors in Ahmedabad allegedly went on a flash strike claiming they were not given Personal Protection Equipment and N-95 masks due to an alleged shortage, the position in Mumbai and Maharashtra was not the same. Doctors in Ahmedabad said they were told to wear two or three ordinary face masks which is inadequate protection during this pandemic.

Doctors and paramedical staff also enjoy the same right to life as the common citizen.

The writer holds a Ph.D in Media Law and is a journalist-cum-lawyer of the Bombay High Court.

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