On 14 April, Nidhi Juneja waited for seven hours outside the COVID-19 ward of the New Civil Hospital in Surat, Gujarat to get an update on her father-in-law. “I was here at 6 am and now it is past 1,” Juneja said. She worked as a staff nurse at a private hospital in the city. Her 70-year-old father-in-law tested positive on 7 April. His oxygen level sank to 85 percent the following day, much below a healthy adult’s level of at least 95 percent. Juneja and her husband struggled to secure a bed with oxygen support for him, despite Juneja herself being a healthcare worker. They finally got him into the government hospital, which was the only hospital that still had ventilators available.
Juneja did not hear anything about her father-in-law’s condition in the week since he was admitted. Hospital staff refused to give her updates. She worried that his health was deteriorating fast. “They told me to stop calling them,” she told me. “They said that they were waiting for patients to die so that a bed clears up for the next patient in line.” As I spoke to her, hospital attendants ran past us with a body on a stretcher and slid it into an ambulance headed for the Ashwini Kumar samshan, the city’s largest crematorium. “Every ten to fifteen minutes an ambulance comes with a patient, and then another ten minutes later, an ambulance leaves with bodies,” Juneja added. “I am losing hope.”
Across Gujarat, in cities such as Surat, Ahmedabad, Vadodara and Rajkot, hospitals are being overwhelmed with a large number of severely ill COVID-19 patients. The surge of infections in March and April across India, which has been described as the country’s second COVID-19 wave, has also shown up in Gujarat as a large number of dead overloading the state’s crematoriums. Surat officially recorded 24,215 COVID-19 infections between 12 March and 14 April and 215 COVID-19 deaths in the same time, as per data from covid19.org, a volunteer-driver crowdsourced COVID-19 tracker.
Scores of people like Juneja gathered around the hospital’s COVID-19 building on 14 April, arguing with attendants, pleading with them to send food and other essentials to the patients’ wards, and asking for updates. Meanwhile, hundreds of people lined up at the out-patient block in the scorching afternoon heat to buy Remdesivir, an antiviral drug doctors are using to treat hospitalised COVID-19 patients. The hospital was selling the drug at a subsidised rate. “I was here for a full day yesterday and since 5 am this morning, and will probably wait till the end of the day again,” Nikunj Dewani, a young man standing in the line to secure an injection for his father, said.
Dr Ashish Naik, the deputy commissioner with the Surat Municipal Corporation, claimed that the city’s government hospitals had enough beds with oxygen support. “We have enough vials for Remedesivir as well,” he said. When asked about the high number of deaths, which indicated that the second wave was spiralling out of control in the state, Naik only said, “As for the deaths, many of them are non-COVID-19 or suspected COVID-19 deaths. The situation is bad, but it is under control and manageable.”
Jitendra Bhai Patel, the former president of the Indian Medical Association, who runs a 28-bed COVID-19 hospital in Ahmedabad, refuted these claims that the state had things under control. “The situation is worse than you can imagine and it is getting worse every day,” he said. “The government has done nothing to manage it. Simply increasing the number of beds will do nothing. We need oxygen, we need staff, we need more medicine. People are waiting for days in a line to access a vial of Remdesivir here, then waiting to get a bed with oxygen support and then waiting to get cremated. It’s inhumane. No one should have to go through this.”
On 14 April, the lines were long at the Ashwini Kumar crematorium, which is ten kilometres away from the hospital. One group of people had been waiting for more than six hours to get their deceased relatives cremated. “Everyone here knows that only dead bodies are discharged from the hospital, but we still clung on to hope,” Mayur Parmar, a 24-year-old man who was waiting to get his father cremated. Parmar’s father died late at night on 13 April. After waiting for five hours to collect his father’s body, Parmar waited for seven more for a gas-fueled pyre reserved for the COVID-19 deceased. Prahlad Patel, a 33-year-old engineer whose father had died in the early hours of 14 April, was twenty-seventh in line. “They said it will take a minimum of six hours more,” he told me. His father suffered significant lung failure before he died at the civil hospital. “We had tried to get him admitted to a private hospital,” Patel recounted. “My wife and I made calls to 27 hospitals at least. All of them said they had thirty to forty people already waiting for a bed and that there was no point waiting.”
Inside the crematorium, a group of workers in PPE kits huddled in a corner next to the gas furnaces reserved for COVID-19 bodies. Moeen Shiekh, the 37-year-old manager, shuttled around barking orders to his staff, trying to speed up processes. “We are working almost all around the clock,” he said. “We get an average of fifty to sixty bodies a day. A few days ago, it was up to eighty or ninety even.” Sheikh said that until 12 April, families had been cremating bodies of relatives who died from other ailments in open grounds just outside the city, near the towns of Bardoli and Navsari. “But the local villages protested since they barely have space to burn their own bodies there, so now they are back here,” he said. “They will just have to wait, what else can they do?”
The two other crematoriums in Surat where hospitals have been sending COVID-19 bodies are the Kurukshetra crematorium and the Ramnath Ghela crematorium. At the latter, Sheikh Javed had been recently contracted to manage the increasing burden of dead bodies. In the past week, pyres have burnt round the clock at this crematorium. Javed told me that the crematorium had four gas furnaces, out of which only two remain functional. “The heat from the constantly burning furnace melted the grill on the gas ones,” he said, pointing to the melted grills of the furnace.
By lunchtime on 14 April, at least thirty bodies of COVID-19 victims had arrived at the crematorium. A guard posted at the entrance held 31 tokens in his hand, one for each person already cremated. Meanwhile, many more families had lined up to get their tokens.
Javed found a way to cut down on the waiting time at the Ramnath Ghela crematorium. He led me through the congregation of relatives and bodies wrapped in white cloth lying outside the defunct furnaces to an open field. “We set up thirty wooden pyres here in the open field day before. Now it’s a much smoother process. You should come at night, all of the pyres will be burning, and the bodies will keep coming in,” he said.
The bodies piling up at Surat’s crematoriums are a clear indication of the failure of Gujrat’s health system, as Patel indicated. “Gujarat’s health infrastructure cannot cope with this,” he said. “And too little has been done to strengthen it.”
This reporting was supported by a grant from the Thakur Family Foundation. Thakur Family Foundation has not exercised any editorial control over the contents of this reportage.