Sanjay’s family has lived in Shahdara area Jhilmil colony for almost 40 years. It is an area of ​​Delhi which has a population of nearly 60,000. Shahdara and many areas around it like Seelam Pur, Dilshad Garden, and New Seemapuri, are all congested areas with large slums. Most people are petty shopkeepers, sell vegetables on pushcarts or are ragpickers. Sandeep’s family are ragpickers – going through trash to get bottles, plastic, paper – anything that they can sell for recycling. The second wave of the COVID-19
pandemic has created an atmosphere of fear and despair among people in these areas. A late night call Sandhya, a BUDS frontline health worker (FHW) and counsellor, recalls how scared she was when her mobile phone rang after ten o’clock recently. She took the call, and recognized the agitated woman at the other end as a member of a slum community whom she had met quite a long time ago. The young man’s name was Sanjay and his mother was calling to inform Sandhya that her son had high fever and
nausea. Sandhya asked them whether they had taken him to a doctor and if so, what was the diagnosis? Was there a prescription? Although Sanjay’s mother was almost incoherent with shock and was crying loudly, Sandhya found out that they had taken the young man to an untrained medical practitioner (who generally do not have medical qualifications or a license to practice medicine but do give some medicines that often harm rather than heal – as this case study shows. They probably charge less than trained practitioners). Sanjay’s mother said that the man and his assistant were very vague as to the illness Sanjay was suffering from but their constant whispering and insistence that her son be left withthem because they wanted to give him ‘steam’ (inhalation) made Sanjay’s mother very suspicious and she somehow managed to bring Sanjay home where his condition worsened at night. That is when the family decided to call Sandhya. Sandhya quickly ascertained that Sanjay not only had high fever and nausea, but he was also had difficulty breathing, which probably indicated a decreasing oxygen level. She promptly arranged for a pulse oximeter and asked him to check his O2 levels. “When he messaged me that his oxygen level was 88, then I connected him to a doctor online and after diagnosing him, the doctor wrote a prescription and told me that the patient needs oxygen immediately”.
Oxygen! Oxygen!
Sandhya remembers being very worried about Sanjay’s condition and hardly had the courage to console his family – all of whom were illiterate – and had started crying and lamenting and hardly helping Sandhya find an oxygen cylinder. By then Sandhya had informed her colleagues at BUDS and the entire team was looking for an oxygen cylinder to help Sanjay breathe. Till midnight that night Sandhya called suppliers as far away as Rohini and Mayapuri (in West Delhi), in Tughlakabad (South Delhi), asking for oxygen cylinders, while reassuring the family that all would be well, provided they could get oxygen for Sanjay. All through that night Sandhya searched for oxygen cylinders – far and near, going through all her contacts – while the family gave Sanjay steam inhalation and made him as comfortable as they could. Sandhya and the BUDS team were at their wits end when they suddenly got an oxygen cylinder at 4 am that morning− for a hefty price of Rs. 5000! “We thanked God that somehow we got oxygen after so much difficulty. After giving Sanjay oxygen, the level started increasing gradually, then the fear that was in the eyes of the whole family gradually diminished. Today that young man is healthy and well after fighting his war with COVID-19”, says Sandhya – obviously very relieved.
Lessons learnt
This story has two very important components – it demonstrates economically deprived/poor communities’ dependence on ‘quacks’ – untrained providers – simply because they charge less fees than MBBS qualified doctors and are available. And the other is the importance of training FHW, counselors and staff to recognize early symptoms and signs of COVID-19 and act with concerted efforts as a team. BUDS has sought to fill the gap of providing basic, primary care and referrals – especially during the second wave of the COVID-19 pandemic. The NGO has also trained social workers and counselors to respond to medical needs as a team, through an extended network. Such interventions save lives and reflects BUDS commitment to quality and timely healthcare.