Kerala expands medical infrastructure to fight COVID; religious, social institutions offer facilities

As of 26 March, Kerala has atleast 126 confirmed COVID-19 cases. ARUN CHANDRABOSE
27 March, 2020

When the first case of COVID-19 was reported in Kerala on 30 January, the state government immediately activated the first two stages of its action plan to provide medical care and contain the pandemic. This included 121 government hospitals and 57 private hospitals, which have a combined total of 2,328 isolation beds. In a press conference on 22 March, KK Shailaja, the state’s health minister, said that if the situation escalated, the state would move to the third stage of its plan, which would bring in several more government and private hospitals.

As of 26 March, Kerala has at least 126 confirmed COVID-19 cases. According to figures shared in a 26 March press conference by the chief minister Pinarayi Vijayan, atleast 1,20,003 persons are currently under observation, of which 601 are in hospital.

SA Hafiz, a public health expert in the department of health, said that the management of infrastructure and human resources has been key to the government’s action plan. As per data from the Kerala health department, as of March 2017, the state had an existing infrastructure of 38,004 hospital beds at various government facilities ranging from general and district hospitals to primary health centres. “Apart from hospitals, we had identified COVID care centres where people are provided isolation facilities,” Hafiz told me. The government had set up care homes with a capacity of 4,000–5,000 people near its four airports where all international passengers are being kept under observation.

In a press conference on 26 March, Vijayan further outlined the state’s medical infrastructure capacity. “We are well prepared to tackle any situation arising out of the Covid-19 spread,” he said. “Apart from government hospitals, we have at our service 879 private hospitals in Kerala with 69,434 beds and 5,507 beds in ICU.” He added that “716 hostels with 15,333 rooms across the state have also been identified for converting them into isolation centres if required. Emergency maintenance works are being done to make these rooms ready.”

The government has also identified a list of isolation beds available in government and private hospitals in all of the state’s 14 districts. According to a health official, the state government’s latest plan involves having a dedicated public-sector hospital for COVID-19 patients. Further, over 200 buildings including government guest houses, private and government schools, colleges and hostels have been identified to set up care centres.

The participation of private hospitals has been an integral part of the government’s plan in providing treatment and isolation facilities. Private institutions have responded to the government’s call for public support. The Kerala Private Hospitals Association is an organisation that has members from 1,800 private hospitals in the state. “When the pandemic started, we had informed the authorities of our decision to provide all the support required,” Sheba Jacob, the president of the Kottayam unit of the Kerala Private Hospitals Association, told me. “The members conveyed this to their respective district medical officers and the collectors. Since then, the health ministry and district collectors have been working with our district-level committees in making our facilities available. We are ready to get started when the need comes.”

Jacob added, “The district authorities have collected details of facilities and people who are willing to work.” Referring to the district medical officers, she continued, “We have given the list of hospitals to the DMO and district collector. The guidelines have been provided by the DMOs depending on the size and facilities available at the hospital.”

Various religious bodies and trusts which run hospitals across the state have also come forward to provide infrastructure and human resource facilities to the government. Earlier this week, the Catholic Church and Jamaat-e-Islami, an Islamic organisation, announced their decision to make their hospitals and other medical facilities available to enable the government to fight the coronavirus.

The Catholic Church, with 15,100 beds, is the largest provider of health services in Kerala outside the health department. On 24 March, George Allenchery, the head of the Syro Malabar Church, called Vijayan, offering that the state could take their facilities over when it deems it necessary. Vijayan announced this in a Facebook post. Allenchery told me, “The state government is struggling to counter this grave danger. If cases are increasing and people growing in number, I think the government will not be able to cater to their needs. So it is quite natural that we who own so many hospitals in Kerala, offer them our help.”

According to Simon Pallupetta, the executive director of the Kerala unit of the Catholic Hospitals Association of India, as many as 2,660 doctors,10,300 nurses, 5,550 paramedical staff and 6,800 non-clinical staff working with CHAI will be available to provide support to the government’s team. According to Pallupetta, CHAI infrastructure includes 1,940 intensive care unit beds, 410 ventilators and 120 ambulances. Further, the Kerala Catholic Council, an association of Catholic bishops in the state, has over 3,000 educational institutions, including four medical colleges.

I also spoke to T Shakir, a member of the Jamaat-e-Islami’s Kerala media team. “A 300-bed multi-speciality hospital—Santhi—in Kozhikode, run by a trust associated with Jamaat-e-Islami has been taken over by the government. It is being prepared to provide required facilities as part of government’s guidelines for Corona,” Shakir told me. According to him, the organisation would be able to provide 1,000 beds in five hospitals across Kerala. He added, “90 school buildings, 25 college buildings, and 400 madrasas could be utilised if further need for isolation and quarantine facilities are needed.”

The Muslim Educational Society, a social organisation in Kerala, runs around a hundred and fifty institutions in the state, including a medical college. According to Fasal Gafoor, the MES president, the society has proposed to offer some of its facilities to the government if the need arises. The Nair Service Society, an organisation working for the welfare of the Nair community in Kerala, also has over a hundred educational institutions and two allopathic hospitals. According to Harikumar Koyikkal, a board member of the society, it too has been in talks with the government to make its facilities available. The Sree Narayana Dharma Paripalana Yogam, a charitable organisation comprising members of the Ezhava community, is also ready to offer its full cooperation. “We are willing to provide all our facilities,” Vellapally Natesan, the vice president of the trust, said. The trust runs over 100 institutions including schools, colleges and training centres.

It is not clear if the Rashtriya Swaymsevak Sangh and Sewa Bharati, an RSS affiliate working in the areas of healthcare and education, own any hospitals in Kerala. The Bharatiya Janata Party state secretary Gireesan G said that Sewa Bharati is providing ambulances and volunteers.

Correction: An earlier version of this story misidentified SA Hafiz as an assistant director with the directorate of health services. This was his former designation, but he no longer holds that position. He is currently a public health expert in the department of health. The Caravan regrets the error.