On 30 April, the district hospital in Bihar Sharif, the headquarters of Nalanda district, did not have any beds for COVID-19 patients. There was no ICU, no ventilator or oxygen. The hospital staff told me that they were only collecting samples of COVID-19 suspects which would be sent to the Vardhman Institute of Medical Science that was about thirty kilometres away. VIMS had the only laboratory for testing COVID-19 samples. I met patients suspected of having COVID-19 at the district hospital who had not got their test results even a week after they were swabbed. They would come and check with the staff there every day, they told me.
At least three kilometres from the district hospital is the Beedi Hospital which served as a Dedicated COVID Health Centre. The government had claimed in court that the hospital had “assured oxygen” equipped beds to treat moderate cases. The hospital had a capacity of over 500 beds and yet there were hardly two dozen patients admitted. Veena Prabha, a nodal officer there, told me the entire hospital had been non-functional until a week before. “I fixed the entire place, got staff to arrange some beds and then oxygen cylinders,” Prabha told me. She said the hospital was only for moderate cases and if any patient turned “severe,” the hospital would refer them to VIMS, 30 kilometres away with no regular transportation available. Prabha, however, was happy that at least oxygen had been arranged by the government. But patients at the Beedi Hospital had other complaints. They told me the doctor came to see them only once in 24 hours. They also had to carry their own cylinders if they needed another one.
On 1 May, when I visited VIMS, I could not see a single doctor in the COVID-19 ward. Nurses would change patients’ saline drips or distribute medicines every now and then but patients’ attendants told me that doctors never visited them. The government had claimed, in a hearing at the Patna High Court, that VIMS would have a functional oxygen plant by 1 May. The hospital set up its oxygen plant only at the end of May. When I was there at the beginning of the month, paramedic staff told me that there were no anaesthetists or technicians to even operate the ventilators. The government had claimed in court on 16 April that VIMS had 14 functioning ventilators. However, on 30 April, the health department invited private hospitals to take the ventilators for their own use. Mangal Pandey, Bihar’s health minister, said that the government could not hire suitable anaesthetists even after three rounds of recruitment. The move put critical COVID-19 care further out of reach of people who could not afford private hospitals.
During my two hour stay at VIMS, I saw two patients dying of COVID-19. The hospital had handed over their bodies to their relatives without following protocol. The bodies were not wrapped in white sheet and were carried bare to personal vehicles by the families. The episodes at the three hospitals in Bihar Sharif in the middle of the second pan-India coronavirus wave demonstrated the failures of Nitish Kumar’s government, both administrative and political.
Rural Bihar is worse off with fewer health facilities than even the dysfunctional ones at Bihar Sharif. Before the 2015 and 2020 state legislative elections Kumar set out a personal political agenda called the saat nischay—the seven determinations. In both he promised to improve the health facilities at panchayat and sub division level. In 2020, it mentioned that, “facilities at primary health care centre, community health care centre, sub division hospital and district hospital will be improved and expanded.”