‘Cannon fodder’: Medical students in India feel betrayed

A health worker prepares to administer a dose of the Covishield, Oxford-AstraZeneca coronavirus vaccine, at a vaccination center in Mumbai on April 1, 2021. (File/AFP)
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Updated 27 April 2021

‘Cannon fodder’: Medical students in India feel betrayed

  • India spends 1.3% of its GDP on health care, less than all major economies
  • On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, 2,771 deaths in the past 24 hours

NEW DELHI: Since the beginning of the week, Dr. Siddharth Tara, a postgraduate medical student at New Delhi’s government-run Hindu Rao Hospital, has had a fever and persistent headache. He took a COVID-19 test, but the results have been delayed as the country’s health system implodes.

His hospital, overburdened and understaffed, wants him to keep working until the testing laboratory confirms he has COVID-19.

On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, behind only the United States. India’s Health Ministry also reported another 2,771 deaths in the past 24 hours, with 115 Indians succumbing to the disease every hour. Experts say those figures are likely an undercount.

“I am not able to breathe. In fact, I’m more symptomatic than my patients. So how can they make me work?” asked Tara.

The challenges facing India today, as cases rise faster than anywhere else in the world, are being compounded by the fragility of its health system and its doctors.

There are 541 medical colleges in India with 36,000 post-graduate medical students, and according to doctors’ unions constitute the majority at any government hospitals — they are the bulwark of the India’s COVID-19 response.

But for over a year, they have been subjected to mammoth workloads, lack of pay, rampant exposure to the virus and complete academic neglect.

“We’re cannon fodder, that’s all,” said Tara.

In five states that are being hit hardest by the surge, postgraduate doctors have held protests against what they view as administrators’ callous attitude toward students like them, who urged authorities to prepare for a second wave but were ignored.

Jignesh Gengadiya, a 26-year-old postgraduate medical student, knew he’d be working 24 hours a day, seven days a week when he signed up for a residency at the Government Medical College in the city of Surat in Gujarat state. What he didn’t expect was to be the only doctor taking care of 60 patients in normal circumstances, and 20 patients on duty in the intensive care unit.

“ICU patients require constant attention. If more than one patient starts collapsing, who do I attend to?” asked Gengadiya.

Hindu Rao Hospital, where Tara works, provides a snapshot of the country’s dire situation. It has increased beds for virus patients, but hasn’t hired any additional doctors, quadrupling the workload, Tara said. To make matters worse, senior doctors are refusing to treat virus patients.

“I get that senior doctors are older and more susceptible to the virus. But as we have seen in this wave, the virus affects old and young alike,” said Tara, who suffers from asthma but has been doing regular COVID-19 duty.

The hospital has gone from zero to 200 beds for virus patients amid the surge. Two doctors used to take care of 15 beds – now they’re handling 60.

Staff numbers are also falling, as students test positive at an alarming rate. Nearly 75% of postgraduate medical students in the surgery department tested positive for the virus in the last month, said a student from the department who spoke anonymously out of fear of retribution.

Tara, who’s part of the postgraduate doctors association at Hindu Rao, said students receive each month’s wages two months late. Last year, students were given four months’ pending wages only after going on hunger strike in the midst of the pandemic.

Dr. Rakesh Dogra, senior specialist at Hindu Rao, said the brunt of coronavirus care inevitably falls on postgraduate students. But he stressed they have different roles, with postgraduate students treating patients and senior doctors supervising.

Although Hindu Rao hasn’t hired any additional doctors during the second wave, Dogra said doctors from nearby municipal hospitals were temporarily posted there to help with the increased workload

India — which spends 1.3% of its GDP on health care, less than all major economies — was initially seen as a success story in weathering the pandemic. However, in the succeeding months, few arrangements were made.

A year later, Dr. Subarna Sarkar says she feels betrayed by how her hospital in the city of Pune was caught completely off guard.

“Why weren’t more people hired? Why wasn’t infrastructure ramped up? It’s like we learnt nothing from the first wave,” she said.

Belatedly, the administration at Sassoon Hospital said last Wednesday it would hire 66 doctors to bolster capacity, and this month increased COVID-19 beds from 525 to 700.

But only 11 new doctors have been hired so far, according to Dr. Murlidhar Tambe, the hospital’s dean.

“We’re just not getting more doctors,” Tambe said, adding that they’re struggling to find new technicians and nurses too.

In response to last year’s surge, the hospital hired 200 nurses on a contractual basis but fired them in October after cases receded. Tambe said the contract allowed the hospital to terminate their services as it saw fit.

“Our primary responsibility is toward patients, not staff,” the dean said.

Cases in Pune city have nearly doubled in the last month, from 5,741 to 10,193. To deal with the surge, authorities are promising more beds.

Sarkar, the medical student at Sassoon Hospital, says that’s not enough.

“Increased beds without manpower are just beds. It’s a smokescreen,” she said.

To handle the deluge, students at Sassoon said authorities had weakened rules meant to keep them and patients safe. For instance, students work with COVID-19 patients one week and then go straight to working with patients in the general ward.

This increases the risk of spreading infections, said Dr. T. Sundararaman of the University of Pennsylvania’s National Health Systems Resource Center.

Students want hospital administration to institute a mandatory quarantine period between duty in the COVID-19 and general wards.

Over the last month, 80 of the hospital’s 450 postgraduate students have tested positive, but they only get a maximum of seven days of convalescence leave.

“COVID ruins your immunity, so there are people who are testing positive two, three times because their immunity is just so shot, and they’re not being allowed to recover,” said Sarkar.

And after a year of processing COVID-19 tests, she says she knows everything there is to know about the virus, but little else. Nationwide, diverting postgraduate students to take care of COVID-19 patients has come at a cost.

At a government medical college in the city of Surat, students said they haven’t had a single academic lecture. The hospital has been admitting virus patients since March of last year, and postgraduate medical students spend almost all their time taking care of them. The city is now reporting more than 2,000 cases and 22 deaths a day.

Having to focus so heavily on the pandemic has left many medical students anxious about their future.

Students studying to be surgeons don’t know how to remove an appendix, lung specialists haven’t learned the first thing about lung cancer and biochemists are spending all their time doing PCR tests.

“What kind of doctors is this one year going to produce?” said Dr. Shraddha Subramanian, a resident doctor in the department of surgery at Sassoon Hospital.

Liz Truss pledges to steer Britain through ‘stormy days’

Updated 56 min 59 sec ago

Liz Truss pledges to steer Britain through ‘stormy days’

  • Truss: Conservatives must unite to kick-start stagnant growth and tackle the many problems facing Britain

BIRMINGHAM: British Prime Minister Liz Truss on Wednesday urged her fractious party to stick together and help transform the economy and the country, fighting to restore her dwindling authority after a chaotic first month in office.
Addressing Conservative lawmakers and members at an annual conference overshadowed by internal bickering and confusion over policy, Truss said the party needed to unite to kick-start stagnant growth and tackle the many problems facing Britain.
So far, however, her misfiring attempt to cut $51 billion (£45 billion) of taxes and hike government borrowing has sent turmoil through markets and her party, with opinion polls pointing to electoral collapse rather than a honeymoon period for the new leader.
“We gather at a vital time for the United Kingdom. These are stormy days,” she said, referring to the COVID-19 pandemic, war in Ukraine and the death of Britain’s longest reigning monarch, Queen Elizabeth.
“In these tough times, we need to step up. I’m determined to get Britain moving, to get us through the tempest and to put us on a stronger footing.”
As she started to speak, two protesters held up a sign asking “Who voted for this?” before they were escorted away by security personnel as the crowd chanted “out, out, out.”
Truss, elected by party members and not the broader electorate, was addressing the party faithful after she was forced to reverse plans to scrap the top rate of tax. She acknowledged that change brings “disruption.”
That U-turn has emboldened sections of her party who are now likely to resist spending cuts as the government seeks ways to fund the overall fiscal program.
That risks not only the dilution of her “radical” agenda but also raising the prospect of an early election.
Having entered the conference hall to a standing ovation and the sound of M People’s “Moving On UP,” Truss told party members and lawmakers that she wanted to build a “new Britain for the new era.”
“For too long, the political debate has been dominated by how we distribute a limited economic pie. Instead, we need to grow the pie so that everyone gets a bigger slice,” she said in the central English city of Birmingham.
“That is why I am determined to take a new approach and break us out of this high-tax, low-growth cycle.”
The conference, once expected to be her crowning glory after being appointed prime minister on Sept. 6, has turned into a personal nightmare, and a battle for the country’s political future.
As the debate moved on from tax cuts to how the government would fund them, lawmakers and ministers openly clashed, in stark contrast to the sense of discipline on display at the opposition Labour Party conference last week.
Some lawmakers fear Truss will break a commitment to increase benefit payments in line with inflation, something they argue would be inappropriate at a time when millions of families are struggling with the cost of soaring prices.
Ministers say they are yet to take a decision and are obliged to look at economic data later this month.
While markets have largely stabilized after the Bank of England stepped in to shore up the bond market — albeit after the cost of borrowing surged — opinion polls now point to an electoral collapse for the Conservatives.
John Curtice, Britain’s best-known pollster, said before the speech that Labour now held an average lead of 25 percentage points and the Conservatives needed to accept they were “in deep, deep electoral trouble.”


Russia: Moscow should be part of Nord Stream leaks probe

Updated 05 October 2022

Russia: Moscow should be part of Nord Stream leaks probe

  • Four leaks were discovered last week on the Nord Stream pipelines connecting Russia to Germany
  • Russian President Vladimir Putin has accused the West of being behind the blasts

MOSCOW: Moscow said Wednesday it should be part of the probe into leaks on the Nord Stream gas pipelines, after Sweden blocked off the area around the pipelines pending an investigation.
“There should really be an investigation. Naturally, with the participation of Russia,” Russian deputy foreign minister Sergei Vershinin said, as quoted by Russian news agencies.
Four leaks were discovered last week on the Nord Stream pipelines connecting Russia to Germany, raising political tensions already sky high since the Kremlin sent troop to Ukraine in February.
On Friday, the UN Security Council held a meeting on the issue.
Vershinin told the assembly that “the general opinion was that this was sabotage and that it should be investigated” but that “no decision had been made” on an international probe.
Last Wednesday, Russia launched an “international terrorism” investigation.
Kremlin spokesman Dmitry Peskov said such a probe “required the cooperation of several countries.”
He denounced an “acute shortage of communications and unwillingness of many countries to contact” Russia.
On Monday, Sweden blocked off the area around the pipeline leaks in the Baltic Sea while the suspected sabotage was being investigated.
Russian President Vladimir Putin has accused the West of being behind the blasts.
Russia’s Security Council chief Nikolai Patrushev said Wednesday that “it is clear that the United States is the beneficiary, primarily economic” of the leaks.
Both Moscow and Washington have denied involvement.

Trial date set for man accused of threatening to kill Queen Elizabeth

Updated 05 October 2022

Trial date set for man accused of threatening to kill Queen Elizabeth

  • 20-year-old Jaswant Singh Chail is accused of making a threat to kill the late 96-year-old monarch

LONDON: A man accused of making a threat to kill the late Queen Elizabeth after being arrested at her Windsor Castle home on Christmas Day last year will go on trial next year, London’s Old Bailey Court heard on Wednesday.
Jaswant Singh Chail, 20, who has been charged under Britain’s Treason Act, is accused of making a threat to kill the 96-year-old monarch, possessing a loaded crossbow with intent to use it to injure the queen, and possession of an offensive weapon.
Elizabeth, who died last month, was at the castle on the day of the intrusion with her son and now King Charles and other close family members
Chail, who appeared at Wednesday’s hearing via videolink wearing a black hoodie, spoke only to confirm his name and his date of birth.
He was told the trial date was set to March 20 next and would last two to three weeks.
He did not enter a plea, the case was adjourned for further evidence to be obtained and Chail was detained in custody. The next hearing will take place at a date yet to be confirmed in December.

Detained US citizen Baquer Namazi allowed to leave Iran — State Department

Updated 05 October 2022

Detained US citizen Baquer Namazi allowed to leave Iran — State Department

  • Baquer Namazi was detained in February 2016 when he went to Iran to press for the release of his son Siamak
  • UN said last week that the pair had been allowed to leave Iran, after an appeal from its Secretary-General Antonio Guterres

WASHINGTON: Detained US citizen Baquer Namazi has been allowed to leave Iran and his son has been granted furlough from prison, the State Department said Wednesday, confirming their release.

Namazi, a former UNICEF official, was detained in February 2016 when the 85-year-old went to Iran to press for the release of his son Siamak, who had been arrested in October of the previous year.

The United States has been pressing for the release of these two men and two other Americans amid efforts to revive the 2015 nuclear deal between Iran and major Western powers.

“Wrongfully detained US citizen Baquer Namazi has been permitted to depart Iran, and his son Siamak, also wrongfully detained, has been granted furlough from prison,” a State Department spokesperson told AFP.

It added that the older Namazi “was unjustly detained in Iran and then not permitted to leave the county after serving his sentence, despite his repeated requirement for urgent medical attention.”

“We understand that the lifting of the travel ban and his son’s furlough were related to his medical requirement.”

The United Nations said last week that the pair had been allowed to leave Iran, after an appeal from its Secretary-General Antonio Guterres.

Both were convicted of espionage in October 2016 and sentenced to 10 years in prison.

Baquer Namazi was released on medical leave in 2018 and had been serving his sentence under house arrest.

At least two other American citizens are currently held in Iran.

Businessman Emad Sharqi was sentenced last year to 10 years in prison for espionage, and environmentalist Morad Tahbaz, who is also a British national, was arrested in 2018 and released on bail in July.

A drive to salvage the 2015 nuclear deal resumed in late November last year, after talks were suspended in June as Iran elected ultra-conservative President Ebrahim Raisi.

The 2015 deal — agreed by Iran, the United States, China, Russia, Britain, France and Germany — offered Tehran sanctions relief in exchange for curbs on its nuclear program.

But the United States unilaterally withdrew in 2018 under president Donald Trump and reimposed biting economic sanctions, prompting Tehran to begin rolling back on its commitments.

On Sunday, the United States rejected Iranian reports that Tehran’s release of US citizens would lead to the unfreezing of Iranian funds abroad.

“With the finalization of negotiations between Iran and the United States to release the prisoners of both countries, $7 billion of Iran’s blocked resources will be released,” the state news agency IRNA said.

But the State Department dismissed any such link as “categorically false.”

Billions of dollars in Iranian funds have been frozen in a number of countries — notably China, South Korea and Japan — since the US reimposed sanctions. 

Myanmar junta leader not invited to ASEAN summit: Cambodia

Updated 05 October 2022

Myanmar junta leader not invited to ASEAN summit: Cambodia

  • ASEAN has led diplomatic efforts to resolve the turmoil that has gripped Myanmar since the military seized power last year

PHNOM PENH: Myanmar’s junta leader has not been invited to a regional summit next month, host Cambodia said Wednesday, in a fresh diplomatic snub for the isolated military regime.
The Association of Southeast Asian Nations (ASEAN) has led diplomatic efforts to resolve the turmoil that has gripped Myanmar since the military seized power last year.
But there has been little progress on a “five-point consensus” agreed with the junta, and its leader and ministers have been shut out of recent meetings of the 10-member regional bloc.
Linking the invitation to “progress in the implementation of the Five-Point Consensus,” a Cambodian foreign ministry spokesman said the junta had been invited to “nominate a non-political representative for the upcoming ASEAN Summits.”
This means junta chief Min Aung Hlaing would not be allowed to attend, just as his top diplomat was barred from foreign ministers’ gatherings in Phnom Penh in February and August.
The five-point plan, agreed in April last year, calls for an immediate end to violence and dialogue between the military and the anti-coup movement.
There is growing dissatisfaction within ASEAN — sometimes criticized as a toothless talking shop — at the Myanmar generals’ stonewalling.
The junta’s execution of four prisoners in July, in defiance of widespread international calls for clemency, caused further anger.
August’s meeting of ASEAN foreign ministers ended with a rare condemnation from the bloc for the junta’s actions.
The ministers said they were “deeply disappointed by the limited progress in and lack of commitment of the Naypyidaw authorities to the timely and complete implementation of the five-point consensus.”
ASEAN’s own envoy tasked with brokering peace has admitted the scale of the task, saying “even Superman cannot solve” the crisis.
The regional bloc’s snub comes as Washington attempts to exert more pressure on the junta through the United Nations, following outrage over an air strike that killed 11 schoolchildren last month.
US State Department counsellor Derek Chollet held talks with other governments and with representatives of the self-declared National Unity Government — dominated by ousted civilian leader Aung San Suu Kyi’s party — during the UN General Assembly earlier this month.
Myanmar is planning fresh elections in August next year, but Chollet warned there was “no chance” they could be free and fair.
The junta has justified its power grab pointing to alleged fraud in the 2020 elections, which Suu Kyi’s National League for Democracy party won easily.
A military crackdown on dissent in the wake of the coup has left more than 2,300 civilians dead, according to a local monitoring group.
The junta, meanwhile, says the uprising against its rule has left almost 3,900 of its supporters dead.