They’ve done nothing: Haryana’s Titoli village lashes out at state’s COVID-19 response
On 27 April, the village of Titoli in Haryana’s Rohtak district witnessed at least nine cremations in a single day. On 5 May, the entire village, which has a population of 13,000, was declared a containment zone after local media reported that there had been 28 “mysterious” deaths in two days. Most of the dead had been suffering from fever, coughs and colds. But when a fellow reporter and I visited Titoli on 17 May, there was no sign of the village being a restricted zone, and the death toll had increased further. A list maintained by the village chowkidaar, or guard noted that there have been 58 deaths in the village between 25 April and 25 May. The only COVID-19 facility in the village, a day-care centre, was empty, and it had no equipment. The only staff member on duty, a doctor, had been appointed on 12 May, and he told me he was “here just to prescribe medicines.”
As I spoke to the residents, smoke billowed from a pyre at one of the three cremation grounds in the village and the dread was palpable. “There have been too many deaths. After so many deaths, there is absolute panic in the village,” Ashok Kumar, a 49-year-old, told me. But alongside the panic, there was grief, and immense anger towards the state government, the administration and private hospitals. All the residents I spoke to, including the village chief, said that neither the state government nor the local administration had done anything to help them. All of them complained of a lack of access to and shortage of beds, oxygen, medicines and critical care in public and private facilities. There was a marked distrust of government facilities. There were also widespread complaints of exploitation and over-charging by private hospitals and pharmacies—one of the families had paid Rs 25,000 for a vial of the anti-viral drug Remdesivir against the printed rate of Rs 3,400.
Various media outlets have reported varying numbers of deaths in the village over the past month—ranging from 40 to 60. Ram Niwas’s list noted all the names of the dead, their addresses, date and cause of death, and place of death, among other details. In this list, from 25 April to 25 May, only 10 deaths were noted as COVID-19 deaths. The reasons for death marked in the remaining 48 cases were as arbitrary as “dhadkan tej”—fast heartbeat, “bimaar”—sick, and even “achanak”—suddenly. At least 22 were noted to have died of “fever” and several more of “khaansi-bukhar,” or cough and fever. A list maintained by a nurse in the health department, who works at a local dispensary, noted that there had been 42 deaths between 1 April and 17 May, of which 10 were marked as COVID-19 deaths, and the rest were attributed to similar categories as those in the guard’s list. The nurse, who did not want to be named, showed me the list—even in this list, fever was marked as the cause of death in at least 18 cases.
Meanwhile, the state authorities have consistently insisted that the situation in the village was under control. On 8 May, the state health minister Anil Vij told Aaj Tak that reports of high numbers of COVID-19 deaths in Titoli were “wrong” and that the deaths “were not from COVID-19.” The sub-divisional magistrate, Rakesh Saini, refused to respond despite repeated attempts to contact him. The chief medical officer of Rohtak, Dr Anil Birla, deflected queries regarding the deaths and the high prevalence of COVID-19 symptoms listed as the cause of death. Birla insisted that the state machinery was providing help, and “isolation centres have been set up in every village now,” but the situation in Titoli was different. “The fire in this cremation ground is visible almost every day and if not here, it is there at the two other cremation sites in the village,” Ram Kishan, a resident, told me.
The day after Titoli village witnessed nine cremations, the deputy commissioner of Rohtak, Manoj Kumar, visited the village and said that all possible assistance would be provided, including a COVID-19 facility at the government primary school. The facility turned out to be merely a day-care centre. Residents said that the nearest primary health centre is in the village of Narwana, around 90 kilometres away. The day-care centre is staffed by just one person, Dr Naveen Kumar, who is posted at the Narwana PHC and was sent to Titoli on 12 May.
“This is just a day-care centre, not an OPD,” Kumar said when I asked if this was an out-patients’ department for patients who might need hospitalisation. Kumar had no authority to refer any COVID-19 patient for hospitalisation. He said that all the 21 beds in another hall were vacant as there was “no support system.” He added, “There is nobody to operate those oxygen transmitters and, as you could see, I am alone here just to prescribe the medicines.” There was not a single patient at the centre when we visited, despite the fact that scores of households still had sick people.
Most of the residents told me that they did not trust the state-run facilities anyway and the day-care centre was just more proof of the government’s false promises. Naveen, a 25-year-old, passed away on 4 May at Maan Hospital, a private hospital in Rohtak. He had topped the exam for the post of a junior engineer in the Delhi Development Authority and was scheduled to join work soon. The family is poor. He was the sole bread earner and is survived by his wife, infant son, parents, a sister, who is in school, and a brother, who is pursuing a bachelor’s degree in law. His father, Mukesh Kumar, told me that both his kidneys were damaged and Naveen used to look after the entire household. As we spoke, Naveen’s mother and wife cried inconsolably.
Naveen’s father-in-law, Rajesh Kumar, said that he spent nearly Rs 9 lakh in order to save him. “I am under heavy debt now as a major chunk of this amount came as credit from my relatives or friends,” Rajesh said. When I asked the family why they chose a private hospital over a government-run hospital, Rajesh said, “We wanted his life saved at any cost.” He added, “We got him admitted at Maan Hospital so that he will be well taken care off unlike in government hospitals.”
Another common situation people spoke of was the lack of facilities in government-run hospitals. In the same lane as Naveen Kumar’s house lived another Naveen who also succumbed to COVID-19. The 32-year-old was a teacher at an Industrial Training Institute and was the sole bread earner in his family. His mother, Sudesh Kundu, told me, “Yaha private mein jageh nahi mili, sarkari mein kaha se mitli?”—there was no space even in the private hospitals, how could we find any at the government hospitals? She added, “He was our only son. We thought we would do whatever it takes to save him.”
Kundu’s husband is bed-ridden. “We changed four hospitals in two days, and he finally gave up on 27 April.” She said, “I got the first shock on finances when they asked me to submit Rs 16,000 for CT scan and other tests at Mansarovar Hospital in Rohtak. Then there was no oxygen over there. So, I took him to another hospital, and then to another, but to no avail.” Birla, the CMO, told me that as of 19 May, the Rohtak Civil Hospital has 41 COVID-19 beds and the Post Graduate Institute of Medical Sciences, or the PGI, in Rohtak had 566 beds. When I spoke to him, he said that both the hospitals were currently full.
But while government-run hospitals were considered a last resort, several residents complained that private hospitals were treating COVID-19 like a gold rush. Kala, a daily wage worker in his mid-twenties, fell sick around 9 May and passed away on 17 May. Kala had been driving a water tanker that served at the farmers’ protest at the Tikri border. His family had a harrowing experience at the RJ Hospital, a private hospital in Bahadurgarh, around 50 kilometres away, where he was admitted for eight days.
Kala’s uncle, Jaibeen Kundu, told me, “That hospital charged Rs 1,000 for every hour of the oxygen supply and Kala’s oxygen level was at 60.” Kundu also showed me a bottle of Remdesivir that he said the hospital asked them to buy. “We bought it for Rs 25,000,” and then he showed me the retail price printed on the bottle—Rs 3,400. Kundu told me that the hospital did not eventually use the drug. On 16 May, the RJ Hospital referred Kala to the Civil Hospital in Rohtak, from where he was referred to the PGI, Rohtak. He died en route to the PGI.
As I watched, the men in Titoli took turns shouldering Kala’s body as they carried it to the cremation ground. The men brought in cow-dung cakes and wood from their homes and lit the pyre themselves, as per the tradition in the village, and they then left the ground. Suresh Kumar, the village sarpanch, or chief, told me, “The government is hiding the figures of COVID-19 deaths.” He added, “You can seek the list of the dead from the village chowkidar and you will come to know how the health department is manipulating to hide the facts.”
The nurse told me, “Our record is as per the medical papers of the dead. I can’t write a COVID-19 death until it is mentioned in the medical record of a patient.” Birla, the CMO, said, “Every death case is recorded with the cause of death as well, and if there is any such case it can be detected from our district level record.” When I asked more questions, he said, “We will prepare a letter for them in case of any such discrepancy,” and refused to answer further.