Coronavirus crisis spotlights Kasargod's poor health facilities after border battle cuts off patients from Mangaluru hospitals

While the Kerala government is receiving global acclaim for its efforts at fighting the coronavirus and its excellent health facilities, the border blockade imposed by Karnataka has shone a spotlight on the woeful healthcare infrastructure in Kasargod district.

Mrudula Bhavani April 12, 2020 16:39:18 IST
Coronavirus crisis spotlights Kasargod's poor health facilities after border battle cuts off patients from Mangaluru hospitals

While the Kerala government is receiving global acclaim for its efforts at fighting the coronavirus and its excellent health facilities, the border blockade imposed by Karnataka has shone a spotlight on the woeful healthcare infrastructure in Kasargod district.

Kerala may have seen just three patients pass away due to the coronavirus, but thirteen critically ill non-COVID patients have died at the Thalappady checkpost on the Kerala-Karnataka border since the blockade began.

Coronavirus crisis spotlights Kasargods poor health facilities after border battle cuts off patients from Mangaluru hospitals

Representational image. Image source: Getty Images.

Kasargod, a COVID-19 hotspot, does not have a medical college or super speciality hospital, leaving the people of the district to rely on healthcare facilities in Mangaluru. The construction of a 300 bed medical college in Kasargod, which began in 2013, has still not been completed  (the deadline was 2015). The government has turned the under construction medical college into a makeshift COVID-19 hospital.

While the Karnataka government has allowed patients meeting certain criteria access to hospitals, the blockade has already resulted in thirteen people having lost their lives. On 26 March, Abdul Hameed, a middle-aged asthma patient, was being rushed to a Mangaluru hospital from Kunjathur by car when his vehicle was halted at Thalapady village due to the blockade. He was taken to a hospital in Uppala, but the doctors insisted he be taken to Mangluru. Hameed's family took him home, hoping they'd find a way to get him to Mangluru the next day. But he passed away that night. The story of a woman from Uttar Pradesh who lives in Kasargod having to give birth in an ambulance has also come to light.

Aslam, an ambulance driver who has taken patients to the border, said he has seen five patients breathing their last in his vehicle. Aslam said when he pleaded with the police to let the pregnant woman through they said "we will not. Even if she dies that's not a problem."

Aslam said he has been facing death threats for even attempting a dialogue with the Thalapady police. Aslam, fed up with the state of affairs, is demanding that Kerala politicians speed up the work on the medical college and is urging the people of Kasargod to come together.

Ali, a resident of Thalapady's Thuminad,  took his father Yousuf, who was suffering from chest pain, to a doctor in Manjeshwar.  “The doctor told us to get an ECG done,” Ali said. “He advised us not to waste time trying to get to Mangaluru. As my father was in a critical condition, he advised us to go to Kasargod or Uppala. But we didn't know any cardiologist in Kasargod. Finally, we took him to a doctor at Carewell Hospital in Kasargod town. But he breathed his last on his way in the ambulance. The doctor said had we come a few minutes earlier it could have made a difference.” Ali’s father is the ninth patient who died due to the blockade.

Ali says though there are several medical clinics in Kasargod, there aren't enough skilled professionals. Ali said there are many hospitals with excellent facilities across the border from Thuminad and that no one wants to visit the government hospital in Manjeshwar in an emergency.

“They only have tablets for fever and cough. Is Kasargod not a district in Kerala? Aren't we human? It seems no one really wants Kasargod,” Ali said.

The Kerala High Court called Karnataka’s blockade a fundamental rights violation on 1 April  and urged the Centre to intervene. The division bench issued the order stating that the Karnataka government was violating citizens’ right to move freely under Article 19. The court upheld disaster management guidelines by Central government which said travel for urgent medical treatment is permitted.

Karnataka filed a petition against this order in the Supreme Court, which urged both states to reach a consensus. The chief secretaries of both states agreed to the following list of conditions that had to be met for patients to be allowed to pass: The patient must be brought in a sterilized government ambulance; a government doctor must certify that the patient is not infected with COVID-19; the hospital must be denoted; and that the patient can’t access medical facility in the neighbouring district of Kannur.

Mustafa Adyawar, block panchayat member of Manjeshwar, who attended the screening of a patient on 7 April, wondered about the practicality of some of the suggestions. For example, how could a patient in critical condition wait to get back the results of a COVID-19 test, he asked.

Mustafa said Manjeshwar has one government ambulance at the community health centre which is being used to ferry COVID-19 patients. "The closest hospital is ten kilometres away. I tried to take a picture at the Thalapady border, but the police threatened to beat me and then shoot me. We need to set up a rapid test centre at the border to screen patients. Two patients tried to get across the border to Mangaluru today. The first was sent back. The second, a patient who'd had a heart attack, reached the hospital but no one from the facility came out to tend to the patient. The ambulance driver loaded the patient on the stretcher and took the patient inside. But the hospital authorities told the patient they could not begin treatment until a COVID-19 test had been done at another hospital."

On 1 April, a notification by Dakshina Kannada district health and family welfare officer was sent to eight hospitals in Mangaluru, asking them not to admit any patient from Kerala “due to CoVID-19 positive cases rapidly increasing in Kerala state/ Kasargod district.”

The copies were sent to district collector Mangaluru, and chief operating officer of district panchayat. Later, after the SC order, the district administration reserved an entire floor of KS Hegde medical college for patients from Kerala. But the experiences of patients attempting to get medical care shows that the notification is being followed. Despite repeated attempts, the district collector remained unavailable for comment.

Rishana, a patient at KS Hegde hospital, said she was denied access to the toilet. Her husband Azhar said she was asked to urinate in the corner of the casualty ward, a clear message to other patients.

Rajmohan Unnithan, who represents Kasargod in Parliament, in a petition in the Supreme Court, said Karnataka is sticking to its stand despite the courts calling this action "inhumane". Unnithan said Karnataka government is accepting patients to show it acknowledges the Supreme Court verdict.

"They are humiliating Kerala government by saying that these patients are COVID-19 positive," Unnithan claimed. "Kerala government didn’t have an all inclusive meeting regarding this. On Tuesday, Supreme Court considered Bar Associations’ petition. When the hearing began, Solicitor- General Tushar Mehta told the court that after the consensus between two states there are no issues, so the remaining petitions were not heard. The reality is, the problems remain unsolved."

Kasargod's struggle for better basic health care facilities has had to contend with bureaucratic neglect. One of the recent victims of this development, Ali said the only way out is to be regionally independent.

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