At Hyderabad COVID-19 hospital, off-roll cleaners, security guards work without protective equipment as admin shifts blame to contractors
At a state government-run hospital in Hyderabad, many non-clinical hospital staffers say they are woefully unprotected.
Editor's note: This series will focus on the difficulties faced by the medical fraternity at COVID-19 hospitals, their duty hours, access to protective gear, facilities they get during quarantine, how are their families coping with this new reality across different states in the country. This is the fifth part of the series.
"Someone has to clean the mess. If I don't do it, who will?" asks Lakshmi (name changed), a cleaner at Hyderabad's Gandhi Hospital, which is presently a dedicated COVID-19 facility.
The 56-year-old is an off-roll employee and has been working at the state government-run hospital on a contractual basis for the past 13 years. She says the hospital has not provided her with a mask, or any other protective equipment.
“What else can we do? My husband is dead, and my kids are married and living elsewhere. I need this job to feed myself,” she said.
Like Lakshmi, many other cleaners, security guards, and janitors are at a high risk of contracting the novel coronavirus. While the challenges of doctors and nurses have been widely documented, those of contractual workers such as the ones described above do not get enough attention.
Sanitation workers, security personnel at high risk
Contractual employees at hospitals such as sanitation workers and security guards are at a high risk of exposure to the virus but are often expected to work without proper equipment.
Firstpost spoke to some medical and support staff at Gandhi Hospital in Hyderabad, to understand the stress and work conditions of these forgotten workers.
Lakshmi, along with roughly 45 to 50 other staffers, lives in quarters provided by the hospital nearby. They are provided with three meals and are allowed to go to their homes for about two to three hours in the morning, after completing their night rounds.
She is a cleaner in one of the wards of the hospital. “It is my job to clean up the ward after any surgeries or operations. I have neither been given a mask, nor gloves or any proper medical kit. I use a mask that I bought myself. Otherwise, I just wrap a dupatta over my face.”
Lakshmi is not the only one. Many non-clinical hospital staffers say they, too, are woefully unprotected.
A junior doctor in the hospital noted that sanitation workers are not given adequate protection “at all” and said he is fearful for the support staff, who face the same risks as higher-paid clinical staffers.
He told Firstpost, “It breaks my heart to see the cleaners work without any masks. They clean up vomit, blood, anything that spills on the ground. We, as doctors, just go in, check on our patients, and leave. But these workers stay back and clean everything. They are just as exposed as to the virus, if not more.”
Ramesh (name changed), a security guard at the hospital said, “We are not given masks, or even something as basic as soap and water to wash our hands. Doctors and attendants in wards are given masks since they deal with patients. But as a guard working in the building, I come in contact with suspected patients as well. I just use my handkerchief to cover myself.”
Like Lakshmi, Ramesh works at the hospital on a contractual basis.
Another doctor, who is also a senior professor at Gandhi Medical College, highlighted that anyone is susceptible to the virus. “The virus can be on your watch, your glasses. Nobody knows where the virus is, that is why it is called the ‘invisible enemy’.”
But are workers such as cleaners and security guards less susceptible to the ‘invisible enemy’?
According to a BBC report, a Newcastle University analysed the results of 1,000 tests carried out on workers at local hospitals in March.
The staff members fell into three groups:
- those dealing directly with patients like nurses, doctors
- those who do not directly deal with patients but might be at greater risk of hospital infection like cleaners, lab staff
- those who work in the building, non-clinical staff like clerical, admin, IT
The study found out that there was no evidence of a significant difference between the three groups, with rates of infection of 15 percent in the first group, 16 percent in the second, and 18 percent in the third.
Hospital administration claims enough masks for all staffers
An administrator of the Gandhi Hospital categorically told Firstpost that everyone in the hospital is provided with enough working PPE kits and masks.
"We have a table set up on the hospital premises where a staffer can show his/her ID card, and take masks and kits as required. Non-clinical, clinical, all staff members are provided with enough gear. They just have to approach the table, register their name and ID card number, so that there is a record of how many items a staffer has taken."
When asked about Class 4 workers' conditions and the lack of equipment they have, the administrator said, "Even if they are on a contractual basis, they are given masks. We have instructed their respective contractors to hand over the gear to them. If the contractors don't do their part, it is their fault. But the hospital has provided for all medicos working in the hospital premises to have masks and protective gear."
He also pointed out that even though the full PPE kits are given to strictly doctors and nurses who work directly with COVID-19 patients, but other masks, gloves and medical equipment needed to protect frontline workers, even Class-4 workers, are in abundance and there are no restrictions over any staffer, working on the premises of the hospital to not take them.
Workers say they get ration, housing
While contractual employees at hospitals have their share of grievances, they say there are some positive sides too.
For example, Lakshmi said, “I am happy that we are given rations weekly. Lunch and dinner are provided for in the hospital and staying near the hospital help me cut down on travelling expenses.”
Similarly, Ramesh said the hospital provides a minivan to drop security personnel home once their shift ends.
“We have worked in this hospital for more than a decade. It has given us the means to feed ourselves for so long and in a time of crisis we are happy to be there for them,” he said.
Cases in Telangana
Till 27 April, Telangana had reported 1,003 coronavirus cases and 25 deaths, according to official figures provided by the state's health minister Eatala Rajender.
A doctor working at the hospital said, “There was an exponential increase in the number of patients being admitted after the news of the Tablighi Jamaat event broke out. We had entire families — in one case, 11 members — who were admitted at once in the ward.”
The doctor noted that it was sometimes hard to treat such families as they demand that all members of the family be in the same room. The doctor added, “There are some patients who are critical and need ventilators and hence need to be kept away from the rest. Some families protested against this move as they wanted to be in the bed next to a relative.”
The Gandhi Hospital was declared as a COVID-19 hospital in the last week of March. Since then, the government has ramped up preparations to convert it into a COVID-19 hospital, which can accommodate up to 1,000 people, with 200 to 300 ICU beds, according to an estimate by a senior doctor.
After an attack on doctor, govt ramps up security
On 1 April, three COVID-19 patients who had recently lost their relative to the virus, attacked a resident doctor at the hospital, breaking a window.
They blamed the hospital for the death even though the victim had passed away due to co-morbidities.
A doctor who was present at the time recalled, “For almost two hours, we had to fend for ourselves as the police were scared of entering a COVID-19 ward. Most doctors and nurses locked themselves in a room."
Taking cognisance of the attack, the government has now ramped up security in the hospital. Now, there are five police personnel on every floor.
“Post the attack, there is enough security in the building. The security personnel too are given PPE kits and masks as they stand guard at the hospital. It is a relief for us to have them here,” a senior doctor said.
Most doctors are now used to working long hours, wearing surgical masks under N-95 masks, and being in wards without air-conditioners. “At first, it was very suffocating to be inside the ward with our kits. The summer season is on and it is very hot as it is. But now, we are used to it. This is our job and duty comes before everything else,” a resident doctor said.
The shifts are about 8 to 10 hours long. According to government rules, every medic has to be quarantined for five days after working for 15 days. There are three shifts on a rotational basis.
Private hospitals help ease burden on govt
Dr Niranjan Panigrahi, a consultant for Critical Care Medicine with Apollo Health City spoke to Firstpost about how the private hospital is handling the situation.
“The difference between the government hospitals and our wards is that each patient is kept in a different room. The isolation unit has three parts — out-patient section, in-patient section and intensive care unit, “ he said.
Panigrahi said that the private hospital has taken all measures as directed by the Indian Council of Medical Research (ICMR).
Dr Satish Ghanta, a paediatrician and director of Little Stars Children’s Hospital — a private hospital in Hyderabad, also spoke to Firstpost about a special ward the hospital has created to treat children suspected of having COVID-19.
"With the lockdown in place and since the outbreak of the pandemic, running a hospital is expensive as there are no other cases apart from emergency cases. But we had decided to bear the costs, as it was a question of treating underprivileged children,” he said.
The Little Star Children’s Hospital runs an NGO — Choice Foundation — through which the hospital provides healthcare to underprivileged children.
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