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Are India’s official Covid-19 mortality numbers grossly under-reported?

Gaslighting the victims of Covid-19 is an all-time political low for any government; official machinery now denying independent data analysis too

03 Aug 2021

data analysis

It was only the RJD MP Manoj Jha, who took Parliament by storm when he stood up in the Rajya Sabha on July 20 to remember those who succumbed to Covid-19 that the government seems to have forgotten.

His speech that went viral was in fact an apology, that he reiterated his recent Indian Express column saying, “It is the responsibility of the House to apologise to all those whose bodies were floating in the Ganga. Never in Parliament’s history, between two sessions, we have had to read obituaries of 50 people” adding “This pain is personal, I don’t want to talk about numbers. My number, your number. Look for numbers in your grief.”

However, it is these very numbers that are at the cause of these problems. The Covid-19 reportage, via the official websites, pages and social media handles of the Ministry of Health and Family Welfare (MoHFW), have been challenged by various studies as being grossly under-reported. The most glaring discrepancies have been highlighted by various studies with regard to the total number of deaths that have been reported during Covid-19 peaks in the country, including those who died due to the shortage of ventilators and Oxygen supply in hospitals, and the unavailability of oxygen cylinders for individuals who were critically ill. 

However, according to the government, which has issued denials on the Press Information Bureau (PIB) website, headlining them as “Myth Vs. Facts” India follows ICMR guidelines which in turn “are based on WHO recommended ICD-10 codes for correct recording of all Covid-19 deaths”. The MoHFW states that “Civil Registration System (CRS) ensures institutionalised registration of births and deaths in the country” and as that has been in force “for decades in India, missing out on Covid-19 deaths unlikely”.

This was the government's stand on July 27 in which it completely denied “media reports, based on a yet-to be peer-reviewed study which was uploaded on MedRxiv recently, alleging that at least 2.7 to 3.3 million Covid-19 deaths happened during the two waves of Covid-19 in India, quoting three different databases ‘pointing towards at least 27% excess mortality over a year.’” This alluded to the report authored by Abhishek Anand, Justin Sandefur and Arvind Subramanian, who had reiterated in their IE column that “confronting the scale of the tragedy will help India draw lessons and etch them deep into the nation’s collective consciousness to foster a ‘never again’ resolve.”

The data analysis report by Arvind Subramanian from the Center for Global Development and Brown University, Justin Sandefur from Center for Global Development and Abhishek Anand from Harvard University, concluded that India under-counted deaths. It stated that the actual deaths during the Covid pandemic are likely to “be in the several millions not hundreds of thousands”. This made this “arguably India’s worst human tragedy since partition and independence.”

What does the independent study say?

The study by Subramanian, Sandefur and Anand excess mortality estimates from three different data sources from the pandemic’s start through June 2021. As per the report published on the Center for Global Development website, “First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian seroprevalence data implies a higher toll of around 4 million.” Finally, the “analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 8,00,000 individuals across all states, yields an estimate of 4.9 million excess deaths.”

Thus, the government’s official figure of around 4,00,000 deaths is way under, not one, but three figures arrived at by examining three different sources of data.

Here’s a comparative table comparing alternative estimates of All-Cause Excess Mortality (in millions)

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

Inherent flaws in each model

The study acknowledges that “uncertainty afflicts all estimates,” and that “the three estimates are quite divergent in their assessment of the timing of Covid-related mortality (keeping in mind that the duration of the two waves is very different, 11 and 3 and a half months, respectively).” It also acknowledges that all three “point to significantly greater deaths than the official estimates.” The authors also conclude, “Relatedly, it seems that the first wave was also more lethal than is widely believed.”

State-wise figures

The authors found data collection challenging because, “Official data on mortality are not collected and reported in a timely manner that would allow excess mortality to be estimated. India’s Sample Registration System (SRS), managed by the central government, conducts annual mortality surveys but has only published numbers through 2019.”

It adds, “In the second wave, as the death toll rose, investigators forced state governments to release data on civil registration of deaths (CRS). As of June 29, 2021, excess deaths in 2020 and 2021 based on death registrations.” The study finds that the disaggregated data for the seven states (Andhra Pradesh, Bihar, Chhattisgar, Karnataka, Kerala, Madhya Pradesh, Tamil Nadu and Uttar Pradesh) accounts for about half of India’s total population.

Here’s a table with data for the seven states:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

Now, even when it comes to this data the authors are cautious because, “First, even for these seven states excess mortality may be mismeasured because CRS typically under-counts final estimated deaths in the SRS. Based on 2019 data, under-counting relative to SRS varies from zero for the Southern states to 37 percent for Uttar Pradesh and 48 percent for Bihar. NFHS-5 data for 2019-20 (but available for only 4 of the seven states) suggests that even the CRS is under-stating the magnitude of the problem: for example, NFHS indicates that the under-counting of deaths in Bihar is 67 not 48 percent and for Andhra Pradesh is 20 percent not zero.”

The authors also find, “Second, in terms of Covid mortality, it is possible that the rest of India is different from the seven states. Sero-prevalence could be different between more rural Bihar and dense, urban Maharashtra. Fatality rates could similarly be different between Kerala’s well-run health system and Rajasthan’s which is more challenged.”

The authors are also wary about UP’s statistics. They say that “the number for Uttar Pradesh in the second wave does not appear to pass the smell test.” Finally given how “CRS data for most states stops in May, so that they almost certainly fail to capture all of the second wave.”

With all these riders, the authors arrive at the following figures:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

When it comes to Infection Fatality Rates (IFR), the study acknowledges that many states had conducted seroprevalence studies. It specifically points out “the third sero-survey done in December 2020- January 2021 and a recent WHO-AIIMS survey covering the period mid-March to early June. The former placed India’s infection rate at about 22 percent. The latter placed India’s infection rate at 57.7 percent, and 63.5 percent in the age group below 18 and above respectively.” But concludes that in the absence of reliable mortality data, they authors were compelled to rely on international estimates of IFRs.

They used the United States’ Center for Disease Control (CDC)’s best estimates of age-specific IFRs which were based on the meta-analyses of Levin et. al. (2021), and combined them with Indian demographic characteristics and the age-pattern of Indian infection rates to derive a plausible measure of IFR for India. The results are tabulated below:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

The authors conclude, “Combining the Indian sero-prevalence data and applying the best estimate of international age-specific IFRs to Indian demography and sero-prevalence patterns, yields excess deaths of 1.5 million and 2.4 million in the two waves, respectively. Together, the toll of Covid until June 2021 is estimated at 4 million. Even though the second wave encompasses three months compared to eleven months for the first, the estimated death toll is significantly greater.”

Government dismisses findings

The MoHFW said that this “mis-informed reports are totally fallacious” to state that India’s Covid death rate may be about 7-8 times higher than the officially reported toll. The ministry stated that the Government “has been transparent in its approach to Covid data management and a robust system of recording all Covid-19 related deaths already exists.” The Centre also put the onus on states and Union Territories who it said had “been entrusted with the responsibility to update the data on a continuous basis.” It stated that the states were “advised to conduct thorough audits in their hospitals and report any cases or deaths that could have been missed with a district and date-wise details so as to guide a data-driven decision making.” Adding that “in addition to this reporting by States/UTs, the robustness of statute based Civil Registration System (CRS) ensures all the births and deaths in the country get registered. The CRS follows a process of data collection, cleaning, collating and publishing the numbers, which although is a long-drawn process, but ensures no deaths are missed out. Because of the expanse and the amplitude of the activity, the numbers are usually published the next year.”

On the delays being alleged in recording the deaths in the devastating second wave of Covid-19, the government stated that “the health system across the country was focused on effective clinical management of cases requiring medical help due to which correct reporting and recording of Covid deaths could have been delayed but later was reconciled by the States/UTs.” It maintains that while some cases could go undetected as per the principles of Infectious Disease and its management, missing out on the deaths is unlikely” and said this was expected as “there shall always be some differences in mortality recorded during a profound and prolonged public health crisis such as COVID pandemic.” 

The complete statement may be read here: https://pib.gov.in/PressReleasePage.aspx?PRID=1739439

The  Union Health and Family Welfare Minister, Mansukh Mandaviya had also informed the Rajya Sabha via a written answer that State Governments and Union Territories did not specifically report any deaths due to lack of oxygen and lack of hospital facilities during the second wave of the coronavirus pandemic. Health Minister Mansukh Mandaviya’s answer read:

“Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states/UTs. Accordingly, all states/UTs report cases and deaths to the Union Health Ministry on a regular basis. However, states have at times reported backlog deaths in case of late reporting from hospitals and districts but, no such reports of patients dying due to shortage of oxygen and lack of hospital facilities in the country have been received by the Ministry from any State/UT.”

This when in May 2021, social media was abuzz with SOS calls for oxygen, and alerts of shortages even from the biggest hospitals in the national capital. Deaths due to shortage were also recorded from Jaipur Golden Hospital in Delhi. Hospitals like Maharaja Agrasen, Batra, Max had moved the Delhi High Court citing lack of oxygen supply. Eight Covid patients including the gastroenterology department’s head died in Batra Hospital due to oxygen shortage just on May 1.

The entire report by Arvind Subramanian, Justin Sandefur and Abhishek Anand may be read here: 

Related:

No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS
Are obituaries in Gujarat newspapers a better indicator of real Covid-deaths?
Madhya Pradesh falsely reporting Covid deaths? 
EXCLUSIVE: Hundreds die of Covid and data goes missing, UP gov’t remorseless

Are India’s official Covid-19 mortality numbers grossly under-reported?

Gaslighting the victims of Covid-19 is an all-time political low for any government; official machinery now denying independent data analysis too

data analysis

It was only the RJD MP Manoj Jha, who took Parliament by storm when he stood up in the Rajya Sabha on July 20 to remember those who succumbed to Covid-19 that the government seems to have forgotten.

His speech that went viral was in fact an apology, that he reiterated his recent Indian Express column saying, “It is the responsibility of the House to apologise to all those whose bodies were floating in the Ganga. Never in Parliament’s history, between two sessions, we have had to read obituaries of 50 people” adding “This pain is personal, I don’t want to talk about numbers. My number, your number. Look for numbers in your grief.”

However, it is these very numbers that are at the cause of these problems. The Covid-19 reportage, via the official websites, pages and social media handles of the Ministry of Health and Family Welfare (MoHFW), have been challenged by various studies as being grossly under-reported. The most glaring discrepancies have been highlighted by various studies with regard to the total number of deaths that have been reported during Covid-19 peaks in the country, including those who died due to the shortage of ventilators and Oxygen supply in hospitals, and the unavailability of oxygen cylinders for individuals who were critically ill. 

However, according to the government, which has issued denials on the Press Information Bureau (PIB) website, headlining them as “Myth Vs. Facts” India follows ICMR guidelines which in turn “are based on WHO recommended ICD-10 codes for correct recording of all Covid-19 deaths”. The MoHFW states that “Civil Registration System (CRS) ensures institutionalised registration of births and deaths in the country” and as that has been in force “for decades in India, missing out on Covid-19 deaths unlikely”.

This was the government's stand on July 27 in which it completely denied “media reports, based on a yet-to be peer-reviewed study which was uploaded on MedRxiv recently, alleging that at least 2.7 to 3.3 million Covid-19 deaths happened during the two waves of Covid-19 in India, quoting three different databases ‘pointing towards at least 27% excess mortality over a year.’” This alluded to the report authored by Abhishek Anand, Justin Sandefur and Arvind Subramanian, who had reiterated in their IE column that “confronting the scale of the tragedy will help India draw lessons and etch them deep into the nation’s collective consciousness to foster a ‘never again’ resolve.”

The data analysis report by Arvind Subramanian from the Center for Global Development and Brown University, Justin Sandefur from Center for Global Development and Abhishek Anand from Harvard University, concluded that India under-counted deaths. It stated that the actual deaths during the Covid pandemic are likely to “be in the several millions not hundreds of thousands”. This made this “arguably India’s worst human tragedy since partition and independence.”

What does the independent study say?

The study by Subramanian, Sandefur and Anand excess mortality estimates from three different data sources from the pandemic’s start through June 2021. As per the report published on the Center for Global Development website, “First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian seroprevalence data implies a higher toll of around 4 million.” Finally, the “analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 8,00,000 individuals across all states, yields an estimate of 4.9 million excess deaths.”

Thus, the government’s official figure of around 4,00,000 deaths is way under, not one, but three figures arrived at by examining three different sources of data.

Here’s a comparative table comparing alternative estimates of All-Cause Excess Mortality (in millions)

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

Inherent flaws in each model

The study acknowledges that “uncertainty afflicts all estimates,” and that “the three estimates are quite divergent in their assessment of the timing of Covid-related mortality (keeping in mind that the duration of the two waves is very different, 11 and 3 and a half months, respectively).” It also acknowledges that all three “point to significantly greater deaths than the official estimates.” The authors also conclude, “Relatedly, it seems that the first wave was also more lethal than is widely believed.”

State-wise figures

The authors found data collection challenging because, “Official data on mortality are not collected and reported in a timely manner that would allow excess mortality to be estimated. India’s Sample Registration System (SRS), managed by the central government, conducts annual mortality surveys but has only published numbers through 2019.”

It adds, “In the second wave, as the death toll rose, investigators forced state governments to release data on civil registration of deaths (CRS). As of June 29, 2021, excess deaths in 2020 and 2021 based on death registrations.” The study finds that the disaggregated data for the seven states (Andhra Pradesh, Bihar, Chhattisgar, Karnataka, Kerala, Madhya Pradesh, Tamil Nadu and Uttar Pradesh) accounts for about half of India’s total population.

Here’s a table with data for the seven states:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

Now, even when it comes to this data the authors are cautious because, “First, even for these seven states excess mortality may be mismeasured because CRS typically under-counts final estimated deaths in the SRS. Based on 2019 data, under-counting relative to SRS varies from zero for the Southern states to 37 percent for Uttar Pradesh and 48 percent for Bihar. NFHS-5 data for 2019-20 (but available for only 4 of the seven states) suggests that even the CRS is under-stating the magnitude of the problem: for example, NFHS indicates that the under-counting of deaths in Bihar is 67 not 48 percent and for Andhra Pradesh is 20 percent not zero.”

The authors also find, “Second, in terms of Covid mortality, it is possible that the rest of India is different from the seven states. Sero-prevalence could be different between more rural Bihar and dense, urban Maharashtra. Fatality rates could similarly be different between Kerala’s well-run health system and Rajasthan’s which is more challenged.”

The authors are also wary about UP’s statistics. They say that “the number for Uttar Pradesh in the second wave does not appear to pass the smell test.” Finally given how “CRS data for most states stops in May, so that they almost certainly fail to capture all of the second wave.”

With all these riders, the authors arrive at the following figures:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

When it comes to Infection Fatality Rates (IFR), the study acknowledges that many states had conducted seroprevalence studies. It specifically points out “the third sero-survey done in December 2020- January 2021 and a recent WHO-AIIMS survey covering the period mid-March to early June. The former placed India’s infection rate at about 22 percent. The latter placed India’s infection rate at 57.7 percent, and 63.5 percent in the age group below 18 and above respectively.” But concludes that in the absence of reliable mortality data, they authors were compelled to rely on international estimates of IFRs.

They used the United States’ Center for Disease Control (CDC)’s best estimates of age-specific IFRs which were based on the meta-analyses of Levin et. al. (2021), and combined them with Indian demographic characteristics and the age-pattern of Indian infection rates to derive a plausible measure of IFR for India. The results are tabulated below:

Data

Source: Report by Arvind Subramanian, Justin Sandefur and Abhishek Anand

The authors conclude, “Combining the Indian sero-prevalence data and applying the best estimate of international age-specific IFRs to Indian demography and sero-prevalence patterns, yields excess deaths of 1.5 million and 2.4 million in the two waves, respectively. Together, the toll of Covid until June 2021 is estimated at 4 million. Even though the second wave encompasses three months compared to eleven months for the first, the estimated death toll is significantly greater.”

Government dismisses findings

The MoHFW said that this “mis-informed reports are totally fallacious” to state that India’s Covid death rate may be about 7-8 times higher than the officially reported toll. The ministry stated that the Government “has been transparent in its approach to Covid data management and a robust system of recording all Covid-19 related deaths already exists.” The Centre also put the onus on states and Union Territories who it said had “been entrusted with the responsibility to update the data on a continuous basis.” It stated that the states were “advised to conduct thorough audits in their hospitals and report any cases or deaths that could have been missed with a district and date-wise details so as to guide a data-driven decision making.” Adding that “in addition to this reporting by States/UTs, the robustness of statute based Civil Registration System (CRS) ensures all the births and deaths in the country get registered. The CRS follows a process of data collection, cleaning, collating and publishing the numbers, which although is a long-drawn process, but ensures no deaths are missed out. Because of the expanse and the amplitude of the activity, the numbers are usually published the next year.”

On the delays being alleged in recording the deaths in the devastating second wave of Covid-19, the government stated that “the health system across the country was focused on effective clinical management of cases requiring medical help due to which correct reporting and recording of Covid deaths could have been delayed but later was reconciled by the States/UTs.” It maintains that while some cases could go undetected as per the principles of Infectious Disease and its management, missing out on the deaths is unlikely” and said this was expected as “there shall always be some differences in mortality recorded during a profound and prolonged public health crisis such as COVID pandemic.” 

The complete statement may be read here: https://pib.gov.in/PressReleasePage.aspx?PRID=1739439

The  Union Health and Family Welfare Minister, Mansukh Mandaviya had also informed the Rajya Sabha via a written answer that State Governments and Union Territories did not specifically report any deaths due to lack of oxygen and lack of hospital facilities during the second wave of the coronavirus pandemic. Health Minister Mansukh Mandaviya’s answer read:

“Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states/UTs. Accordingly, all states/UTs report cases and deaths to the Union Health Ministry on a regular basis. However, states have at times reported backlog deaths in case of late reporting from hospitals and districts but, no such reports of patients dying due to shortage of oxygen and lack of hospital facilities in the country have been received by the Ministry from any State/UT.”

This when in May 2021, social media was abuzz with SOS calls for oxygen, and alerts of shortages even from the biggest hospitals in the national capital. Deaths due to shortage were also recorded from Jaipur Golden Hospital in Delhi. Hospitals like Maharaja Agrasen, Batra, Max had moved the Delhi High Court citing lack of oxygen supply. Eight Covid patients including the gastroenterology department’s head died in Batra Hospital due to oxygen shortage just on May 1.

The entire report by Arvind Subramanian, Justin Sandefur and Abhishek Anand may be read here: 

Related:

No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS
Are obituaries in Gujarat newspapers a better indicator of real Covid-deaths?
Madhya Pradesh falsely reporting Covid deaths? 
EXCLUSIVE: Hundreds die of Covid and data goes missing, UP gov’t remorseless

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Covid orphans: Mismatch in figures provided by WCD Ministry and NCPCR

While WCD Min says only 645 children lost their parents, NCPCR pegs the number at over 3,000!

31 Jul 2021

OrphanImage Courtesy:thewire.in

Minister of Women and Child Development, Smriti Irani, has informed the Parliament that a total of 645 children have lost both their parents to Covid-19 in the second wave of the pandemic between April and May 28, 2021. But the information provided by National Commission for Protection of Child Rights (NCPCR) in their affidavit before the Supreme Court on June 7, stated that there are a total of 30,071 children who have lost either one or both parents or been abandoned up to June 5, 2021.

As per Irani’s written response on July 30, the maximum number of children who lost their parents to Covid-19 are from Uttar Pradesh (158) and Andhra Pradesh (119). Maharashtra comes next where 83 children were orphaned, followed by Madhya Pradesh (73). Haryana, Goa, Chandigarh, Bihar, Chandigarh, Tripura, Mizoram, Sikkim, Nagaland, Ladakh, Lakshadweep, Arunachal Pradesh and Andamans and Nicobar Island have recorded no orphans according to the information provided by the Centre.

Surprisingly, her answer stated that the data collected on the ‘Bal Swaraj Portal’ launched by National Commission for Protection of Child Right regarding orphans is not specific to those children who have lost their parents to Covid-19. 

But NCPCRs affidavit in the matter In Re: Contagion of Covid-19 virus in Children Homes (Suo Motu Civ. No. 4 of 2020), disclosed that out of the 30,071 children, 3,621 have been orphaned, 26,176 children have lost one parent and 274 children who have been abandoned since the beginning of the pandemic.

The Supreme Court had also directed all State and district authorities to upload information on the website of the NCPCR pertaining to all children who have become orphans or lost one of their parents after March, 2020 either due to Covid-19 or otherwise.

The 645 tally is more than what Irani had alleged a few months ago. On May 25, Irani had talked about committed efforts to support “577 children” who lost their parents to Covid-19 between April 1 and May 25, 2021. She tweeted this number while talking about children who had lost both their parents during the second wave of the health crisis.

But while speaking to SabrangIndia, NGO Save The Children had said it was difficult to assess the exact number of children who were orphaned in India. However, the NGO suspected that 577 may not be an accurate number, especially considering recent data on the subject by Andhra Pradesh, Madhya Pradesh and Rajasthan alone that amounted to 402 orphans around May.

Referring to government data, NGO worker Prabhat Kumar told SabrangIndia that Andhra Pradesh reported 135 orphans and 1,716 semi-orphans (lost one parent) in the last two months. Madhya Pradesh reported 250 orphans and 1,200 semi-orphans between April and May. Meanwhile, Rajasthan said 17 orphans were registered between March and May 15, 2021.

“These amount to 402 orphans who have lost both parents in just three states. There are other states that report much higher official Covid-deaths. So, it can be assumed that the number is much higher,” he said.

The Covid fatality rate in India, especially during the second wave was devastatingly underreported by the governments. The Supreme Court on July 27, reportedly pulled up the West Bengal for they submitted that only 27 children were orphaned. LiveLaw quoted the Bench saying, “Can we record it then? We'll record and ask the Secretary to appear. You are so steadfast in saying only 27 orphans are there in such a big State. See figures from other States. We are not prepared to believe this figure at all.”

In another written response, provided by Ms. Irani on July 30, a total of 87 children residing in Child Care Institutions have been infected with coronavirus as on July 23, 2021. But this data is only from 16 States. The Minister also provided figures about the total number of children housed in the Child Care Institutions across all States and Union Territories. In 1,594 homes, 67,864 children are housed. 6,000 children reside in about 250 open shelters and 373 specialised adoption agencies have 3,751 children.

The answers may be read here:

 

Related:

Over 1,500 Children Homes caretakers arrested for child abuse, only 75 convicted
GoI claims 577 Covid-orphans, but numbers may far exceed official data: Outreach workers
9,346 children abandoned, orphaned, lost a parent to Covid-19: NCPCR informs SC
Upload information about children orphaned due to Covid: SC to Districts

 

Covid orphans: Mismatch in figures provided by WCD Ministry and NCPCR

While WCD Min says only 645 children lost their parents, NCPCR pegs the number at over 3,000!

OrphanImage Courtesy:thewire.in

Minister of Women and Child Development, Smriti Irani, has informed the Parliament that a total of 645 children have lost both their parents to Covid-19 in the second wave of the pandemic between April and May 28, 2021. But the information provided by National Commission for Protection of Child Rights (NCPCR) in their affidavit before the Supreme Court on June 7, stated that there are a total of 30,071 children who have lost either one or both parents or been abandoned up to June 5, 2021.

As per Irani’s written response on July 30, the maximum number of children who lost their parents to Covid-19 are from Uttar Pradesh (158) and Andhra Pradesh (119). Maharashtra comes next where 83 children were orphaned, followed by Madhya Pradesh (73). Haryana, Goa, Chandigarh, Bihar, Chandigarh, Tripura, Mizoram, Sikkim, Nagaland, Ladakh, Lakshadweep, Arunachal Pradesh and Andamans and Nicobar Island have recorded no orphans according to the information provided by the Centre.

Surprisingly, her answer stated that the data collected on the ‘Bal Swaraj Portal’ launched by National Commission for Protection of Child Right regarding orphans is not specific to those children who have lost their parents to Covid-19. 

But NCPCRs affidavit in the matter In Re: Contagion of Covid-19 virus in Children Homes (Suo Motu Civ. No. 4 of 2020), disclosed that out of the 30,071 children, 3,621 have been orphaned, 26,176 children have lost one parent and 274 children who have been abandoned since the beginning of the pandemic.

The Supreme Court had also directed all State and district authorities to upload information on the website of the NCPCR pertaining to all children who have become orphans or lost one of their parents after March, 2020 either due to Covid-19 or otherwise.

The 645 tally is more than what Irani had alleged a few months ago. On May 25, Irani had talked about committed efforts to support “577 children” who lost their parents to Covid-19 between April 1 and May 25, 2021. She tweeted this number while talking about children who had lost both their parents during the second wave of the health crisis.

But while speaking to SabrangIndia, NGO Save The Children had said it was difficult to assess the exact number of children who were orphaned in India. However, the NGO suspected that 577 may not be an accurate number, especially considering recent data on the subject by Andhra Pradesh, Madhya Pradesh and Rajasthan alone that amounted to 402 orphans around May.

Referring to government data, NGO worker Prabhat Kumar told SabrangIndia that Andhra Pradesh reported 135 orphans and 1,716 semi-orphans (lost one parent) in the last two months. Madhya Pradesh reported 250 orphans and 1,200 semi-orphans between April and May. Meanwhile, Rajasthan said 17 orphans were registered between March and May 15, 2021.

“These amount to 402 orphans who have lost both parents in just three states. There are other states that report much higher official Covid-deaths. So, it can be assumed that the number is much higher,” he said.

The Covid fatality rate in India, especially during the second wave was devastatingly underreported by the governments. The Supreme Court on July 27, reportedly pulled up the West Bengal for they submitted that only 27 children were orphaned. LiveLaw quoted the Bench saying, “Can we record it then? We'll record and ask the Secretary to appear. You are so steadfast in saying only 27 orphans are there in such a big State. See figures from other States. We are not prepared to believe this figure at all.”

In another written response, provided by Ms. Irani on July 30, a total of 87 children residing in Child Care Institutions have been infected with coronavirus as on July 23, 2021. But this data is only from 16 States. The Minister also provided figures about the total number of children housed in the Child Care Institutions across all States and Union Territories. In 1,594 homes, 67,864 children are housed. 6,000 children reside in about 250 open shelters and 373 specialised adoption agencies have 3,751 children.

The answers may be read here:

 

Related:

Over 1,500 Children Homes caretakers arrested for child abuse, only 75 convicted
GoI claims 577 Covid-orphans, but numbers may far exceed official data: Outreach workers
9,346 children abandoned, orphaned, lost a parent to Covid-19: NCPCR informs SC
Upload information about children orphaned due to Covid: SC to Districts

 

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Covid-19: VHA demands sufficient beds and Maha gov't help

The Nagpur-based hospital association demands adequate hospital beds and feasible facility and service charges to sustain health infrastructure

29 Jul 2021

Vidarbha Hospital AssociationImage Courtesy:medicalbuyer.co.in

Vidarbha Hospital Association (VHA) has raised two key issues that stand in the way of providing proper care to Covid-19 patients: first, the mismatch in the number of beds available, and second, the difficulty in maintaining economic feasibility in the absence of gov't assistance.

Speaking to SabrangIndia, VHA Secretary Alok Umre voiced concern about Maharashtra government’s recent new hospital rules that called for a huge increase in hospital registration fees. The VHA is set to file a high court petition with Dr. Pradeep Arora to condemn the sudden hike in prices.

“I don’t understand why should fee registration be increased? Where will hospitals recover these costs? From patients? Then, they will say private hospitals have increased costs. They do not know what is happening here,” said Umre.

According to media reports, the new rules increase the earlier fee of Rs. 250 for the entire hospital to a staggering Rs. 1,000 for a single hospital bed. This means that a hospital boasting 100 beds will have to pay an annual amount of Rs. 1 lakh just for the renewal and registration of the same.

Further the rules call for structural changes that will be difficult to implement even for well-functioning private hospitals. As Umre pointed out, the main concern is that the burden of such costs will fall on patients, cutting off certain groups from private healthcare.

A need for a centralised bed allocation system

When asked about a potential third wave of Covid-19, Umre urged everyone to follow social distancing guidelines. He also requested government authorities to increase the number of government hospital beds.

A Covid-19 patient requiring oxygen is bed-ridden anywhere between 5-15 days. This creates a severe shortage of beds for Covid and non-Covid patients even though the medical staff works relentlessly.

As such, the VHA asked the state government to create a centralised bed allocation system like the Huoshenshan hospital in Wuhan, China that was specially designed for Covid-19 patients. District hospitals can be converted to such hospitals and their beds capacity can be increased to 1,000 beds or so.

An additional benefit of this is that patients will not have to travel across the district to avail a bed. In Nagpur, where the VHA is based, private and government hospitals are spread across the city. So, patients ended up travelling where there were no Covid-19 cases.

“We have limited beds and unlimited patients. This imbalance needs to be addressed,” he said.

Hospitals struggling to bear financial costs

The government rules under the January 14 notification are especially worrisome after the second-wave of Covid-19. Hospitals across the country are recovering from the sudden surge in demand for equipment and supplies.

For example, many hospitals complained and condemned the huge increase in oxygen cylinder prices. While the media talked about free oxygen tankers provided by the central government, Umre said that the cost of these tanks was passed on to hospitals. These charges were four-fold of their original amount.

He asked, “Prices increased from around Rs. 170 to over Rs. 500 for oxygen cylinders. They cited transport charges etc. How are we to pay for this?” 

The VHA demanded that the state government either cease the increase of oxygen prices or assist hospitals to incur costs. It may be mentioned that with this as the background, the central government during the Parliament’s monsoon session said “there were no deaths due to lack of oxygen” in India.

Further, the second wave reported more incidents of violence against hospital personnel. All over India, there were reports of mobs breaking into hospital to harm staff or equipment.

On July 23, the VHA sent a letter to Nagpur Commissioner of Police to highlight the attacks on healthcare staff. In it, they cited a recent Bombay High Court decision that called for creation of district-wise committees of doctors.

“We would like to be enlightened about the existence and composition of a valid committee in our city. All field police personnel need to be alerted that any steps or decisions taken without support of appropriate jurisdictive scrutiny by such a constitutionally valid committee will be considered illegal,” said the VHA.

Umre said the organisation received a reassuring response from the city police in this regard and thanked the Commissioner for the noted decrease of hospital violence in Nagpur since then. Incidentally, the VHA had filed an FIR against violence on doctors which was in the interest of all those medical personnel who suffered due to a mob earlier this year.

“Every hospital was trying to do its best. Why did they try to set fire to Hope hospital? We demand a safe environment to work in. I think it is a very legitimate right of any hospital to demand a safe atmosphere,” said Umre.

The mention of fire was in reference to an April incident when family members of a deceased Covid-19 patient tried to set the hospital on fire in a fit of rage.

Bio-Medical Waste management

Aside from such blanket issues, Vidarbha hospitals recently complained of problems on the waste disposal front.  On July 20, the VHA wrote to the Maharashtra Pollution Control Board (MPCB) about the incomplete Bio-Medical Waste (BMW) collection from a few hospitals in Nagpur.

The letter said that the Superb Hygienic Disposals (SHD), responsible for BMW pick-up, transportation and disposal had failed its duties in the past one month. This grossly violated the maximum prescribed time-limit of 48 hours as per BMW Management Rules.

“This prolonged storage of BMW owing to non/partial pick up is potentially very hazardous to health workers and patients/relatives etc. After a lot of communications, the waste is slowly being cleared now. If this continues, we wish to reiterate that Superb Hygienic Disposals, owing to their callous attitude, will be solely responsible for any biohazard that may happen,” said the letter, detailing the company as a repeated offender.

The SHD on its part cited payment issues from hospitals’ end. To this, Umre told SabrangIndia, “They collected over one lakh rupees from each hospital. These prices are capped by the government that the company has priorly committed to. But during Covid-19, they charged us extra.”

Umre said that many hospitals ended up paying the charges due to the pressing circumstances. However, those who refused now reported inefficient services from the SHD. The VHA stated that even if the claim was genuine, the company still cannot suspend its services.

Meanwhile, the MPCB said that such issues are in the purview of the Nagpur Municipal Corporation. According to Umre, NMC Assistant Commissioner Ram Joshi has promised to look into the matter.

The VHA demanded that the SHD return to its original service rates as per the MoU between it and the Indian Medical Association.

“Rather than suspending services partially or completely, the VHA advised the company to seek legal recourse, in larger public interest,” said the medical organisation.

Related:

No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS
Make Right to Health a fundamental right: Oxfam India’s report on unequal healthcare
We need to breathe!
Delhi: The National Capital, is now a city mourning its dead, watching the dying gasp for air

Covid-19: VHA demands sufficient beds and Maha gov't help

The Nagpur-based hospital association demands adequate hospital beds and feasible facility and service charges to sustain health infrastructure

Vidarbha Hospital AssociationImage Courtesy:medicalbuyer.co.in

Vidarbha Hospital Association (VHA) has raised two key issues that stand in the way of providing proper care to Covid-19 patients: first, the mismatch in the number of beds available, and second, the difficulty in maintaining economic feasibility in the absence of gov't assistance.

Speaking to SabrangIndia, VHA Secretary Alok Umre voiced concern about Maharashtra government’s recent new hospital rules that called for a huge increase in hospital registration fees. The VHA is set to file a high court petition with Dr. Pradeep Arora to condemn the sudden hike in prices.

“I don’t understand why should fee registration be increased? Where will hospitals recover these costs? From patients? Then, they will say private hospitals have increased costs. They do not know what is happening here,” said Umre.

According to media reports, the new rules increase the earlier fee of Rs. 250 for the entire hospital to a staggering Rs. 1,000 for a single hospital bed. This means that a hospital boasting 100 beds will have to pay an annual amount of Rs. 1 lakh just for the renewal and registration of the same.

Further the rules call for structural changes that will be difficult to implement even for well-functioning private hospitals. As Umre pointed out, the main concern is that the burden of such costs will fall on patients, cutting off certain groups from private healthcare.

A need for a centralised bed allocation system

When asked about a potential third wave of Covid-19, Umre urged everyone to follow social distancing guidelines. He also requested government authorities to increase the number of government hospital beds.

A Covid-19 patient requiring oxygen is bed-ridden anywhere between 5-15 days. This creates a severe shortage of beds for Covid and non-Covid patients even though the medical staff works relentlessly.

As such, the VHA asked the state government to create a centralised bed allocation system like the Huoshenshan hospital in Wuhan, China that was specially designed for Covid-19 patients. District hospitals can be converted to such hospitals and their beds capacity can be increased to 1,000 beds or so.

An additional benefit of this is that patients will not have to travel across the district to avail a bed. In Nagpur, where the VHA is based, private and government hospitals are spread across the city. So, patients ended up travelling where there were no Covid-19 cases.

“We have limited beds and unlimited patients. This imbalance needs to be addressed,” he said.

Hospitals struggling to bear financial costs

The government rules under the January 14 notification are especially worrisome after the second-wave of Covid-19. Hospitals across the country are recovering from the sudden surge in demand for equipment and supplies.

For example, many hospitals complained and condemned the huge increase in oxygen cylinder prices. While the media talked about free oxygen tankers provided by the central government, Umre said that the cost of these tanks was passed on to hospitals. These charges were four-fold of their original amount.

He asked, “Prices increased from around Rs. 170 to over Rs. 500 for oxygen cylinders. They cited transport charges etc. How are we to pay for this?” 

The VHA demanded that the state government either cease the increase of oxygen prices or assist hospitals to incur costs. It may be mentioned that with this as the background, the central government during the Parliament’s monsoon session said “there were no deaths due to lack of oxygen” in India.

Further, the second wave reported more incidents of violence against hospital personnel. All over India, there were reports of mobs breaking into hospital to harm staff or equipment.

On July 23, the VHA sent a letter to Nagpur Commissioner of Police to highlight the attacks on healthcare staff. In it, they cited a recent Bombay High Court decision that called for creation of district-wise committees of doctors.

“We would like to be enlightened about the existence and composition of a valid committee in our city. All field police personnel need to be alerted that any steps or decisions taken without support of appropriate jurisdictive scrutiny by such a constitutionally valid committee will be considered illegal,” said the VHA.

Umre said the organisation received a reassuring response from the city police in this regard and thanked the Commissioner for the noted decrease of hospital violence in Nagpur since then. Incidentally, the VHA had filed an FIR against violence on doctors which was in the interest of all those medical personnel who suffered due to a mob earlier this year.

“Every hospital was trying to do its best. Why did they try to set fire to Hope hospital? We demand a safe environment to work in. I think it is a very legitimate right of any hospital to demand a safe atmosphere,” said Umre.

The mention of fire was in reference to an April incident when family members of a deceased Covid-19 patient tried to set the hospital on fire in a fit of rage.

Bio-Medical Waste management

Aside from such blanket issues, Vidarbha hospitals recently complained of problems on the waste disposal front.  On July 20, the VHA wrote to the Maharashtra Pollution Control Board (MPCB) about the incomplete Bio-Medical Waste (BMW) collection from a few hospitals in Nagpur.

The letter said that the Superb Hygienic Disposals (SHD), responsible for BMW pick-up, transportation and disposal had failed its duties in the past one month. This grossly violated the maximum prescribed time-limit of 48 hours as per BMW Management Rules.

“This prolonged storage of BMW owing to non/partial pick up is potentially very hazardous to health workers and patients/relatives etc. After a lot of communications, the waste is slowly being cleared now. If this continues, we wish to reiterate that Superb Hygienic Disposals, owing to their callous attitude, will be solely responsible for any biohazard that may happen,” said the letter, detailing the company as a repeated offender.

The SHD on its part cited payment issues from hospitals’ end. To this, Umre told SabrangIndia, “They collected over one lakh rupees from each hospital. These prices are capped by the government that the company has priorly committed to. But during Covid-19, they charged us extra.”

Umre said that many hospitals ended up paying the charges due to the pressing circumstances. However, those who refused now reported inefficient services from the SHD. The VHA stated that even if the claim was genuine, the company still cannot suspend its services.

Meanwhile, the MPCB said that such issues are in the purview of the Nagpur Municipal Corporation. According to Umre, NMC Assistant Commissioner Ram Joshi has promised to look into the matter.

The VHA demanded that the SHD return to its original service rates as per the MoU between it and the Indian Medical Association.

“Rather than suspending services partially or completely, the VHA advised the company to seek legal recourse, in larger public interest,” said the medical organisation.

Related:

No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS
Make Right to Health a fundamental right: Oxfam India’s report on unequal healthcare
We need to breathe!
Delhi: The National Capital, is now a city mourning its dead, watching the dying gasp for air

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Pay heed to Article 21 and its order in the Kanwar Yatra case: SC to Kerala Gov't

Supreme Court has termed Kerala govt’s three-day relaxation in Covid restrictions due to Bakr Eid alarming, other states issue protocols ahead of festival

20 Jul 2021

Eid-ul-AdhaImage Courtesy:indiatoday.in

The Supreme Court came down heavily on Kerala government’s announcement of  a three-day relaxation in Covid restrictions for Eid-ul-Adha (Bakr Eid). The apex court has called this move "wholly uncalled for" and reportedly said the relaxations were a result of the state giving in to “pressure groups".  A two-judge bench of Justices RF Nariman and BR Gavai told the Kerala government, "Pressurehood of any manner cannot infringe upon the most precious right of Right to Life for citizens of India. If any untoward incident takes place due to this relaxation, public can bring to our notice and action will be taken accordingly" reported NDTV, adding the SC however, it did not cancel the government notification easing the lockdown in the state.

The court thanked petitioner PK Nambiar for bringing the issue to its notice and directed the state government to “pay heed to Article 21 and its order in the Kanwar Yatra case.” Last week the SC had cited the fundamental right to life to order the Uttar Pradesh government to stop the annual Kanwar Yatra congregations. According to news reports the SC said, “The Kerala government has given in to the demand of traders to relax lockdown norms,” adding that it “can't quash the Kerala government notification. The horse has already bolted.”

Kerala Chief Minister Pinarayi Vijayan had announced the concessions at a press conference on July 17 and said that in view of Eid al-Adha shops selling textiles, footwear, jewellery, home appliances, electronic items, and essential items etc will be allowed to open on July 18-20 from 7 A.M to 8 P.M in category A, B and C areas. After the SC observations, the CM has greeted the people on the eve of Eid and asked them to “celebrate responsibly, following Covid protocols.”

Meanwhile, the Uttar Pradesh government announced strict directives to be followed for the festival that will be celebrated across India on July 21. Chief Minister Adityanath is reported to have chaired a Covid-19 review meeting with senior officials, and issued instructions in view of Bakr Eid. According to news reports, in UP, “not more than 50 people should gather at any place at a given time for any event related to Bakrid.” The UP government has also told its officials to ensure that “no cows, camels or any other banned animals are sacrificed anywhere.” Animal sacrifice can only be carried out at designated spots or within private property. According to reports, the UP government has imposed Section 144 in Gautam Budh Nagar (Noida) till August 30. This is being cited as needed for enforcing covid appropriate behaviour as well as to prevent “a threat to peace and law and order by anti-social elements during the upcoming festivals such as Shivratri, Raksha Bandhan, Bakri-Eid, Janmashtami, Muharram.” Only 50 people will be allowed entry into any religious place at the same time, and all social, political, sports, entertainment, academic and cultural gatherings will need prior permission from the district administration.

In Andhra Pradesh, the state government has issued an advisory for the Eid al-Adha, stating that large congregations must be avoided and prayers must not be offered in Eidgahs or open places, the government also stated in the release. Prayers have been allowed in the state’s mosques with 50 per cent occupancy and mandatory masks and  social distancing in place. According to news reports people have been advised to “carry their own prayer mat to the mosque” and the Imams have been “requested to make the Eid khutbah (sermons) short.” 

In Assam, while the state government has also banned public congregations, India Today reported that a day ahead of  Eid Border Security Force (BSF) and Assam Police seized at least 20 cattle in two separate operations from markets along the Indo-Bangladesh border. According to the report, “BSF personnel raided a cattle market at Fakirabazar area in Karimganj which was illegally set up near the Indo-Bangladesh border and seized 16 cattle.” In a separate operation, Karimganj district police raided another cattle market in Balia area, stated the news report, here the authorities “seized four cattle and apprehended six persons.” Police officials told the media that the market was set up in violation of Covid-19 protocols. 

On July 12, the Assam government introduced the Assam Cattle Preservation Bill 2021 to bring in more stringent measures to check the slaughter of cattle in the state. These include greater scrutiny of the process to obtain a “fit for slaughter” certificate by a Veterinary Officer, stricter rules regarding transport of cattle, especially across state lines, and restrictions on the sale and purchase of beef in areas inhabited by Hindus and other non-beef eating communities.  

Related:

Bakrid and the forced controversy around animal sacrifice
Ghaziabad: BJP MLA forcibly closes meat shops

Pay heed to Article 21 and its order in the Kanwar Yatra case: SC to Kerala Gov't

Supreme Court has termed Kerala govt’s three-day relaxation in Covid restrictions due to Bakr Eid alarming, other states issue protocols ahead of festival

Eid-ul-AdhaImage Courtesy:indiatoday.in

The Supreme Court came down heavily on Kerala government’s announcement of  a three-day relaxation in Covid restrictions for Eid-ul-Adha (Bakr Eid). The apex court has called this move "wholly uncalled for" and reportedly said the relaxations were a result of the state giving in to “pressure groups".  A two-judge bench of Justices RF Nariman and BR Gavai told the Kerala government, "Pressurehood of any manner cannot infringe upon the most precious right of Right to Life for citizens of India. If any untoward incident takes place due to this relaxation, public can bring to our notice and action will be taken accordingly" reported NDTV, adding the SC however, it did not cancel the government notification easing the lockdown in the state.

The court thanked petitioner PK Nambiar for bringing the issue to its notice and directed the state government to “pay heed to Article 21 and its order in the Kanwar Yatra case.” Last week the SC had cited the fundamental right to life to order the Uttar Pradesh government to stop the annual Kanwar Yatra congregations. According to news reports the SC said, “The Kerala government has given in to the demand of traders to relax lockdown norms,” adding that it “can't quash the Kerala government notification. The horse has already bolted.”

Kerala Chief Minister Pinarayi Vijayan had announced the concessions at a press conference on July 17 and said that in view of Eid al-Adha shops selling textiles, footwear, jewellery, home appliances, electronic items, and essential items etc will be allowed to open on July 18-20 from 7 A.M to 8 P.M in category A, B and C areas. After the SC observations, the CM has greeted the people on the eve of Eid and asked them to “celebrate responsibly, following Covid protocols.”

Meanwhile, the Uttar Pradesh government announced strict directives to be followed for the festival that will be celebrated across India on July 21. Chief Minister Adityanath is reported to have chaired a Covid-19 review meeting with senior officials, and issued instructions in view of Bakr Eid. According to news reports, in UP, “not more than 50 people should gather at any place at a given time for any event related to Bakrid.” The UP government has also told its officials to ensure that “no cows, camels or any other banned animals are sacrificed anywhere.” Animal sacrifice can only be carried out at designated spots or within private property. According to reports, the UP government has imposed Section 144 in Gautam Budh Nagar (Noida) till August 30. This is being cited as needed for enforcing covid appropriate behaviour as well as to prevent “a threat to peace and law and order by anti-social elements during the upcoming festivals such as Shivratri, Raksha Bandhan, Bakri-Eid, Janmashtami, Muharram.” Only 50 people will be allowed entry into any religious place at the same time, and all social, political, sports, entertainment, academic and cultural gatherings will need prior permission from the district administration.

In Andhra Pradesh, the state government has issued an advisory for the Eid al-Adha, stating that large congregations must be avoided and prayers must not be offered in Eidgahs or open places, the government also stated in the release. Prayers have been allowed in the state’s mosques with 50 per cent occupancy and mandatory masks and  social distancing in place. According to news reports people have been advised to “carry their own prayer mat to the mosque” and the Imams have been “requested to make the Eid khutbah (sermons) short.” 

In Assam, while the state government has also banned public congregations, India Today reported that a day ahead of  Eid Border Security Force (BSF) and Assam Police seized at least 20 cattle in two separate operations from markets along the Indo-Bangladesh border. According to the report, “BSF personnel raided a cattle market at Fakirabazar area in Karimganj which was illegally set up near the Indo-Bangladesh border and seized 16 cattle.” In a separate operation, Karimganj district police raided another cattle market in Balia area, stated the news report, here the authorities “seized four cattle and apprehended six persons.” Police officials told the media that the market was set up in violation of Covid-19 protocols. 

On July 12, the Assam government introduced the Assam Cattle Preservation Bill 2021 to bring in more stringent measures to check the slaughter of cattle in the state. These include greater scrutiny of the process to obtain a “fit for slaughter” certificate by a Veterinary Officer, stricter rules regarding transport of cattle, especially across state lines, and restrictions on the sale and purchase of beef in areas inhabited by Hindus and other non-beef eating communities.  

Related:

Bakrid and the forced controversy around animal sacrifice
Ghaziabad: BJP MLA forcibly closes meat shops

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No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS

The Health Ministry said that States and Union Territories have not reported any deaths due to oxygen shortage or inadequate medical infrastructure

20 Jul 2021

Covid DeathImage Courtesy:economictimes.indiatimes.com

In the ongoing monsoon session, the Union Ministry informed the Rajya Sabha via a written answer that State Governments and Union Territories did not specifically report any deaths due to lack of oxygen and lack of hospital facilities during the second wave of the coronavirus pandemic.

Questions were asked by Rajya Sabha member M.V Shreyams Kumar on whether a large number of Covid-19 patients died on roads and hospitals due to acute shortage of oxygen in the second wave. The Health and Family Welfare Minister, Mansukh Mandaviya said, “Although Health is a state subject, Government of India has supported the states and undertook a series of action including further strengthening of existing health infrastructure to ensure provisioning of sufficient hospital beds, drugs, medical oxygen and other consumables to aid proper clinical care of Covid-19 patients.”

On the question of whether the Central Government has maintained data about the number of patients who died due to shortage of oxygen and lack of hospital facilities, the minister’s answer read, “Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states/UTs. Accordingly, all states/UTs report cases and deaths to the Union Health Ministry on a regular basis. However, states have at times reported backlog deaths in case of late reporting from hospitals and districts but, no such reports of patients dying due to shortage of oxygen and lack of hospital facilities in the country have been received by the Ministry from any State/UT.”

As per a report in The Wire, around 223 Covid-19 patients died due to a shortage of oxygen in May alone. The compiled database also listed another 70 deaths where families of patients alleged that the lack of oxygen was the factor, but was not confirmed by authorities. Apart from oxygen shortages, people died outside hospitals and clinics awaiting medical attention.

The second wave saw state courts taking suo motu cognisance of the situation and pulling up various governments for faltering in their Covid-19 management. According to a SabrangIndia report, Bihar was reeling under the Covid-19 crisis from dearth of oxygen supply, cylinders, long queues outside hospitals, hoarding, black marketing to police harassment. A local reporter told the publication that a man known to him died outside a hospital waiting for a ventilator.

Bhaisa Kund (Uttar Pradesh) cremation ground’s priest, KK Pandey, while speaking to SabrangIndia in April, had said that his sister-in-law might not survive due to oxygen shortage. He had said, “The primary issue in Lucknow is oxygen. There is an acute shortage. Her levels are dropping, we cannot do anything. We have kept her in the house, where will we take her. There is a big black market, one cylinder is worth thirty thousand, forty thousand, I cannot afford it.”

The second wave that hit India in April and May saw record breaking 4,00,000 cases per day and thousands of deaths. Many hospitals even sent SOS messages on social media about oxygen shortage in their Covid-19 wards. On April 23, Max Healthcare, a large hospital chain, reached out to authorities on social media, saying it was running out of oxygen supply. “Less than an hour’s oxygen supplies at Max Smart Hospital & Max Hospital Saket. Awaiting promised fresh supplies from INOX since 1 am. Over 700 patients admitted, need immediate assistance,” the hospital tweeted.

Some deaths due to shortage were also recorded from Jaipur Golden Hospital in Delhi. Hospitals like Maharaja Agrasen, Batra, Max had even moved the Delhi High Court citing lack of oxygen supply. Eight Covid patients including the gastroenterology department’s head died in Batra Hospital due to oxygen shortage today on May 1.

The answer may be read here: 

Related:

We have ensured nobody was left without oxygen in the country: Centre to Delhi HC
Bihar’s odious and short-sighted response to Covid-19
EXCLUSIVE: Hundreds die of Covid and data goes missing, UP gov’t remorseless
Covid patients die in Jaipur hospital, family moves Delhi HC for SIT probe
Enough is enough: Delhi HC after 8 Covid patients dead due to oxygen shortage in Batra Hospital  

No Covid-19 deaths due to oxygen shortage reported by States/UTs: Centre in RS

The Health Ministry said that States and Union Territories have not reported any deaths due to oxygen shortage or inadequate medical infrastructure

Covid DeathImage Courtesy:economictimes.indiatimes.com

In the ongoing monsoon session, the Union Ministry informed the Rajya Sabha via a written answer that State Governments and Union Territories did not specifically report any deaths due to lack of oxygen and lack of hospital facilities during the second wave of the coronavirus pandemic.

Questions were asked by Rajya Sabha member M.V Shreyams Kumar on whether a large number of Covid-19 patients died on roads and hospitals due to acute shortage of oxygen in the second wave. The Health and Family Welfare Minister, Mansukh Mandaviya said, “Although Health is a state subject, Government of India has supported the states and undertook a series of action including further strengthening of existing health infrastructure to ensure provisioning of sufficient hospital beds, drugs, medical oxygen and other consumables to aid proper clinical care of Covid-19 patients.”

On the question of whether the Central Government has maintained data about the number of patients who died due to shortage of oxygen and lack of hospital facilities, the minister’s answer read, “Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states/UTs. Accordingly, all states/UTs report cases and deaths to the Union Health Ministry on a regular basis. However, states have at times reported backlog deaths in case of late reporting from hospitals and districts but, no such reports of patients dying due to shortage of oxygen and lack of hospital facilities in the country have been received by the Ministry from any State/UT.”

As per a report in The Wire, around 223 Covid-19 patients died due to a shortage of oxygen in May alone. The compiled database also listed another 70 deaths where families of patients alleged that the lack of oxygen was the factor, but was not confirmed by authorities. Apart from oxygen shortages, people died outside hospitals and clinics awaiting medical attention.

The second wave saw state courts taking suo motu cognisance of the situation and pulling up various governments for faltering in their Covid-19 management. According to a SabrangIndia report, Bihar was reeling under the Covid-19 crisis from dearth of oxygen supply, cylinders, long queues outside hospitals, hoarding, black marketing to police harassment. A local reporter told the publication that a man known to him died outside a hospital waiting for a ventilator.

Bhaisa Kund (Uttar Pradesh) cremation ground’s priest, KK Pandey, while speaking to SabrangIndia in April, had said that his sister-in-law might not survive due to oxygen shortage. He had said, “The primary issue in Lucknow is oxygen. There is an acute shortage. Her levels are dropping, we cannot do anything. We have kept her in the house, where will we take her. There is a big black market, one cylinder is worth thirty thousand, forty thousand, I cannot afford it.”

The second wave that hit India in April and May saw record breaking 4,00,000 cases per day and thousands of deaths. Many hospitals even sent SOS messages on social media about oxygen shortage in their Covid-19 wards. On April 23, Max Healthcare, a large hospital chain, reached out to authorities on social media, saying it was running out of oxygen supply. “Less than an hour’s oxygen supplies at Max Smart Hospital & Max Hospital Saket. Awaiting promised fresh supplies from INOX since 1 am. Over 700 patients admitted, need immediate assistance,” the hospital tweeted.

Some deaths due to shortage were also recorded from Jaipur Golden Hospital in Delhi. Hospitals like Maharaja Agrasen, Batra, Max had even moved the Delhi High Court citing lack of oxygen supply. Eight Covid patients including the gastroenterology department’s head died in Batra Hospital due to oxygen shortage today on May 1.

The answer may be read here: 

Related:

We have ensured nobody was left without oxygen in the country: Centre to Delhi HC
Bihar’s odious and short-sighted response to Covid-19
EXCLUSIVE: Hundreds die of Covid and data goes missing, UP gov’t remorseless
Covid patients die in Jaipur hospital, family moves Delhi HC for SIT probe
Enough is enough: Delhi HC after 8 Covid patients dead due to oxygen shortage in Batra Hospital  

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Make Right to Health a fundamental right: Oxfam India’s report on unequal healthcare

A detailed and comprehensive analysis, uses data since 2015-16 to understand the persisting issues of health inequalities in India

20 Jul 2021

Oxfam IndiaImage Courtesy:mediaindia.eu

The right to health should be enacted as a fundamental right, demands Oxfam India in its Inequality Report 2021. The report analyses the country’s weak public healthcare system, health inequalities and the ongoing pandemic.

Titled India’s Unequal Healthcare Story, the report provides a comprehensive analysis of the health status across different socioeconomic groups such as marginalised communities that suffer from ill-health the most.

“The general category performs better than SCs and STs, Hindus perform better than Muslims, the rich perform better than the poor, men are better off than women, and the urban population is better off than the rural population on various health indicators,” said the report in its introduction.

Further in the report there is a closer look at health inequalities during the recent health emergency.

India’s healthcare and Covid 19

While analysing state performance in terms of the global pandemic, the report found that states that attempt to reduce social inequalities and spend more on health reported lower confirmed cases. However, states attempting to reduce inequalities showed lower recovery rate as well. 

According to contributor Apoorva Mahendru, this may be because the ‘Reduced Inequality Index’ used by the report does not take into account factors like social distancing, access to improved water and sanitation. Such access contributes greatly to recovery from Covid-19. These same factors are not easily available for marginalised communities.

Similarly, higher-income groups could easily arrange for transport to hospitals. Among the lowest income bracket, comprising households with a monthly income of Rs. 15,000, the report found that 30 percent had to arrange for transport themselves. In households with income of Rs. 30,000 or less, 14.8 percent and 22.2 percent faced issues of slow response and quality of food served, respectively.

“Percentage of respondents in low-income brackets facing discrimination in the community due to being Covid positive was five times than those in high-income brackets,” said the report.

Further, over 50 percent of people hailing from Scheduled Castes (SC) and Scheduled Tribes (ST) faced difficulties in accessing non-Covid medical facilities compared to 18.2 percent in the general category. In the same way, only 3.9 percent of general category respondents depended on springs or streams for water consumption. The figure for Scheduled Castes was four times that of the open category. This means that more SCs were forced to use unsafe sources of water.

In terms of gender disparity, 33.9 percent of female respondents experienced anxiety, irritation and anger, and sleep-deprivation during the lockdown compared to 18.2 percent males.

“This is because of an increase in women’s unpaid care work burden at home, increase in cases of domestic violence, and probability of re-employment of women lesser than that of men post-lockdown,” said the report.

Experts also pointed out that current vaccination drives are blind to the digital divide in India. At the beginning of the pandemic, only 15 percent rural households had internet connection, smartphone users in rural India were almost half of urban India. More than 60 percent of women across 12 states said they had never used the internet. SCs and STs with smartphones stood at 25 and 23 percent respectively, while 43 percent open category individuals had access to smartphones.

“The number of Covid cases doubled in the second wave. The second wave hit the middle class more with 90 percent of all cases in Mumbai concentrated in high-rise buildings, while 10 percent were in slums,” said the report.

Considering infrastructure, India ranks 155 out of 167 countries on bed availability. It has five beds and 8.6 doctors per 10,000 of its population. However, only 40 percent of beds are concentrated in rural India that houses 70 percent of the population.

Social inequalities and its impact on healthcare

Using National Family Health Survey (NFHS) 3 and 4 data, the report stated that literacy rate for general category women is 18.6 percent higher than SC women and 27.9 percent higher than ST women.

“Education, specifically of women, has a direct effect on improving the health outcome at the level of the household as educated women are known to take informed healthcare decisions,” said contributor Khalid Khan.

Thus, the health inequality is evident in the attainment of female literacy with a gap of 55.1 percent between the top and bottom 20 percent of population in 2015-16.

In case of water and sanitation, two out of three households have access to improved, non-shared sanitation facilities in the general category. Meanwhile, SC households are 28.5 percent behind the open category and ST are 39.8 percent behind them. It is worth noting that poor water, sanitation and hygiene conditions were responsible for 1,00,000 deaths from diarrhoeal diseases in under-five children in 2015 in India.

Moreover, while 93.4 percent of households in the top 20 percent have access to improved sanitation, only 6 percent have access in the bottom 20 percent, a difference of 87.4 percent.

Regarding household expenditure on health, one in every six rupees spent on hospitalization by households is financed through borrowings. Less than one-third of households were covered by a government insurance scheme in 2015-16.

Another indicator of health inequality are institutional and home births. Though the gap in the institutional delivery of rural-urban, caste, religion and income groups has been declining over the decade, inequality prevails across these categories.

Institutional births in ST households were 15 percent below general category births in 2015- 16. There is a 35 percent gap in institutional births between the lowest and highest 20 percent wealth quintile groups in 2015-16.

Further, despite improvement in child immunisation, female-child immunisation rate continues to be below that of the male child. Similarly, more children in urban areas are immunised compared to rural children. Immunisation of SCs and STs is behind that of other caste groups. The child immunisation of the high wealth quintile group is much higher than of low wealth quintile.

Even in terms of nutrition, the difference between stunted children in SC and ST households and those in general category households is 12.6 and 13.6 percent, respectively. One in every two children are anaemic, wherein 60 percent of anaemic children are from SC and ST households.

Efficacy of government intervention

In the last 10 years, around 18 percent Indians have begun seeking some form of healthcare when they report being sick. Still, the current health status is a testament to the unfulfilled dream of ‘Health for All’ said contributor Mayurakshi Datta.

“The right to the highest attainable health is far from being realized. This holds especially true for the socially and economically marginalised,” said Datta.

In the 2021-22 budget, the health ministry has been allocated Rs. 76,901 crore, 9.8 percent less than Rs. 85,250 crore reported from revised estimates of 2020-21. Moreover, public funds for health have also been invested specifically on secondary and tertiary care rather than primary healthcare. Meanwhile, private healthcare providers are thriving, widening inequalities along caste, class, gender and geography.

“Health insurance schemes are being promoted as a way to achieve UHC [Universal Health Coverage] and to reduce OOPE [Out-of-Pocket Expenditure]. But evidence shows that the limited scope and coverage of the insurance schemes cannot address the all-encompassing requirements of UHC,” said the report.

So what next?

Aside from a call for right to health and free vaccine policy, the report called for an increase in health spending to 2.5 percent of GDP at the union and state level.

They also called upon the government to ensure that union budgetary allocation in health for SCs and STs is proportionate to their population while dedicating two-thirds of the concerned budget to primary healthcare. The centre should provide financial support to states with low per capita health expenditure to reduce inter-state inequality in health.

Regions with higher concentration of marginalised population should be identified and public health facilities should be established, equipped and made fully functional as per Indian Public Health Standards (IPHS).

While the report does not endorse Government-financed Health Insurance Schemes (GFHIS) as a way to achieve UHC, it is imperative that GFHIS widens its ambit to include outpatient costs as a way to reduce out-of-pocket expenditure (OOPE).

Experts also called for a centrally-sponsored scheme that earmarks funds for free essential drugs and diagnostics at all public health facilities. Further, rights under the Patients’ Rights Charter should be made enforceable by law.

The private health sector must be regulated by ensuring that all state governments adopt and effectively implement Clinical Establishments Act. They also called for regularisation of women frontline health workers services especially Accredited Social Health Activists (ASHAs), establishing government medical colleges with district hospitals prioritising their establishment in hilly, tribal, rural and other hard-to-reach areas, enhancing medical infrastructure and establishing contingency plans for scenarios such as the second wave of the pandemic.

Report can be read here:

Related:

Is the right to health a forgotten constitutional mandate?
Protect people’s health and life: JSA to gov'ts
Great Number Game of Vaccine Funding: Zero Allotment = Rs. 35000 Crores !!!
Using digital portal for vaccination will impede universal immunisation: SC

Make Right to Health a fundamental right: Oxfam India’s report on unequal healthcare

A detailed and comprehensive analysis, uses data since 2015-16 to understand the persisting issues of health inequalities in India

Oxfam IndiaImage Courtesy:mediaindia.eu

The right to health should be enacted as a fundamental right, demands Oxfam India in its Inequality Report 2021. The report analyses the country’s weak public healthcare system, health inequalities and the ongoing pandemic.

Titled India’s Unequal Healthcare Story, the report provides a comprehensive analysis of the health status across different socioeconomic groups such as marginalised communities that suffer from ill-health the most.

“The general category performs better than SCs and STs, Hindus perform better than Muslims, the rich perform better than the poor, men are better off than women, and the urban population is better off than the rural population on various health indicators,” said the report in its introduction.

Further in the report there is a closer look at health inequalities during the recent health emergency.

India’s healthcare and Covid 19

While analysing state performance in terms of the global pandemic, the report found that states that attempt to reduce social inequalities and spend more on health reported lower confirmed cases. However, states attempting to reduce inequalities showed lower recovery rate as well. 

According to contributor Apoorva Mahendru, this may be because the ‘Reduced Inequality Index’ used by the report does not take into account factors like social distancing, access to improved water and sanitation. Such access contributes greatly to recovery from Covid-19. These same factors are not easily available for marginalised communities.

Similarly, higher-income groups could easily arrange for transport to hospitals. Among the lowest income bracket, comprising households with a monthly income of Rs. 15,000, the report found that 30 percent had to arrange for transport themselves. In households with income of Rs. 30,000 or less, 14.8 percent and 22.2 percent faced issues of slow response and quality of food served, respectively.

“Percentage of respondents in low-income brackets facing discrimination in the community due to being Covid positive was five times than those in high-income brackets,” said the report.

Further, over 50 percent of people hailing from Scheduled Castes (SC) and Scheduled Tribes (ST) faced difficulties in accessing non-Covid medical facilities compared to 18.2 percent in the general category. In the same way, only 3.9 percent of general category respondents depended on springs or streams for water consumption. The figure for Scheduled Castes was four times that of the open category. This means that more SCs were forced to use unsafe sources of water.

In terms of gender disparity, 33.9 percent of female respondents experienced anxiety, irritation and anger, and sleep-deprivation during the lockdown compared to 18.2 percent males.

“This is because of an increase in women’s unpaid care work burden at home, increase in cases of domestic violence, and probability of re-employment of women lesser than that of men post-lockdown,” said the report.

Experts also pointed out that current vaccination drives are blind to the digital divide in India. At the beginning of the pandemic, only 15 percent rural households had internet connection, smartphone users in rural India were almost half of urban India. More than 60 percent of women across 12 states said they had never used the internet. SCs and STs with smartphones stood at 25 and 23 percent respectively, while 43 percent open category individuals had access to smartphones.

“The number of Covid cases doubled in the second wave. The second wave hit the middle class more with 90 percent of all cases in Mumbai concentrated in high-rise buildings, while 10 percent were in slums,” said the report.

Considering infrastructure, India ranks 155 out of 167 countries on bed availability. It has five beds and 8.6 doctors per 10,000 of its population. However, only 40 percent of beds are concentrated in rural India that houses 70 percent of the population.

Social inequalities and its impact on healthcare

Using National Family Health Survey (NFHS) 3 and 4 data, the report stated that literacy rate for general category women is 18.6 percent higher than SC women and 27.9 percent higher than ST women.

“Education, specifically of women, has a direct effect on improving the health outcome at the level of the household as educated women are known to take informed healthcare decisions,” said contributor Khalid Khan.

Thus, the health inequality is evident in the attainment of female literacy with a gap of 55.1 percent between the top and bottom 20 percent of population in 2015-16.

In case of water and sanitation, two out of three households have access to improved, non-shared sanitation facilities in the general category. Meanwhile, SC households are 28.5 percent behind the open category and ST are 39.8 percent behind them. It is worth noting that poor water, sanitation and hygiene conditions were responsible for 1,00,000 deaths from diarrhoeal diseases in under-five children in 2015 in India.

Moreover, while 93.4 percent of households in the top 20 percent have access to improved sanitation, only 6 percent have access in the bottom 20 percent, a difference of 87.4 percent.

Regarding household expenditure on health, one in every six rupees spent on hospitalization by households is financed through borrowings. Less than one-third of households were covered by a government insurance scheme in 2015-16.

Another indicator of health inequality are institutional and home births. Though the gap in the institutional delivery of rural-urban, caste, religion and income groups has been declining over the decade, inequality prevails across these categories.

Institutional births in ST households were 15 percent below general category births in 2015- 16. There is a 35 percent gap in institutional births between the lowest and highest 20 percent wealth quintile groups in 2015-16.

Further, despite improvement in child immunisation, female-child immunisation rate continues to be below that of the male child. Similarly, more children in urban areas are immunised compared to rural children. Immunisation of SCs and STs is behind that of other caste groups. The child immunisation of the high wealth quintile group is much higher than of low wealth quintile.

Even in terms of nutrition, the difference between stunted children in SC and ST households and those in general category households is 12.6 and 13.6 percent, respectively. One in every two children are anaemic, wherein 60 percent of anaemic children are from SC and ST households.

Efficacy of government intervention

In the last 10 years, around 18 percent Indians have begun seeking some form of healthcare when they report being sick. Still, the current health status is a testament to the unfulfilled dream of ‘Health for All’ said contributor Mayurakshi Datta.

“The right to the highest attainable health is far from being realized. This holds especially true for the socially and economically marginalised,” said Datta.

In the 2021-22 budget, the health ministry has been allocated Rs. 76,901 crore, 9.8 percent less than Rs. 85,250 crore reported from revised estimates of 2020-21. Moreover, public funds for health have also been invested specifically on secondary and tertiary care rather than primary healthcare. Meanwhile, private healthcare providers are thriving, widening inequalities along caste, class, gender and geography.

“Health insurance schemes are being promoted as a way to achieve UHC [Universal Health Coverage] and to reduce OOPE [Out-of-Pocket Expenditure]. But evidence shows that the limited scope and coverage of the insurance schemes cannot address the all-encompassing requirements of UHC,” said the report.

So what next?

Aside from a call for right to health and free vaccine policy, the report called for an increase in health spending to 2.5 percent of GDP at the union and state level.

They also called upon the government to ensure that union budgetary allocation in health for SCs and STs is proportionate to their population while dedicating two-thirds of the concerned budget to primary healthcare. The centre should provide financial support to states with low per capita health expenditure to reduce inter-state inequality in health.

Regions with higher concentration of marginalised population should be identified and public health facilities should be established, equipped and made fully functional as per Indian Public Health Standards (IPHS).

While the report does not endorse Government-financed Health Insurance Schemes (GFHIS) as a way to achieve UHC, it is imperative that GFHIS widens its ambit to include outpatient costs as a way to reduce out-of-pocket expenditure (OOPE).

Experts also called for a centrally-sponsored scheme that earmarks funds for free essential drugs and diagnostics at all public health facilities. Further, rights under the Patients’ Rights Charter should be made enforceable by law.

The private health sector must be regulated by ensuring that all state governments adopt and effectively implement Clinical Establishments Act. They also called for regularisation of women frontline health workers services especially Accredited Social Health Activists (ASHAs), establishing government medical colleges with district hospitals prioritising their establishment in hilly, tribal, rural and other hard-to-reach areas, enhancing medical infrastructure and establishing contingency plans for scenarios such as the second wave of the pandemic.

Report can be read here:

Related:

Is the right to health a forgotten constitutional mandate?
Protect people’s health and life: JSA to gov'ts
Great Number Game of Vaccine Funding: Zero Allotment = Rs. 35000 Crores !!!
Using digital portal for vaccination will impede universal immunisation: SC

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Guj gov’t faces heat for submitting report on fire safety in hospitals to SC in sealed cover

Pressure has been mounting to ensure higher safety standards since the tragic Shrey Hospital fire of August 2020

19 Jul 2021

Fire safetyImage Courtesy:deccanherald.com

The Supreme Court has come down heavily on the Gujarat government for a series of decisions regarding fire safety that appear to be contempt of court. The court also appeared flummoxed at the state government’s decision to submit its report in a sealed cover.

“What is this report in sealed cover? It is not a nuclear secret,” Justice DY Chandrachud was quoted as saying by Bar&Bench. Justice Chandrachud was hearing the case along with Justice MR Shah. The court also took umbrage to the state government’s decision to issue an executive notification that hospitals will not be required to adhere to fire safety norms till 2022.

The Bench slammed the state government, reportedly saying, “Once a mandamus is there, it cannot be overridden by an executive notification like this! You now give a carte blanche and say hospitals don't have to adhere till 2022 and people will continue dying and be burnt...”

The Court has hearing a suo moto case concerning fire tragedies at Covid Hospitals after two cases in Rajkot and Ahmedabad. SabrangIndia had previously reported on the fire that broke out in the Intensive Care Unit (ICU) of Ahmedabad’s Shrey Hospital leading to the deaths of eight Covid-19 patients on August 6, 2020. Advocate Suhel Tirmizi, whose wife Ayesha was one of the victims, had filed a PIL demanding accountability be fixed on various state and hospital authorities. Then in November 2020, another inferno, this time at a Rajkot Covid care hospital claimed five lives.

Two significant orders by the Gujarat HC

Following this, the Gujarat High Court had passed two significant orders. On December 15, 2020, while passing orders in a batch of Public Interest Litigations (PIL) in connection with the Shrey Hospital fire case, the Gujarat High Court had made a series of pertinent observations and passed orders that are bound to have a far-reaching impact.

The court ordered the State of Gujarat “to enact a consolidated Code/Act/Guidelines for fire safety requirement for clinical establishments/hospitals of all kinds setting out minimum standards of fire safety standards to be maintained by clinical establishments/ hospitals such as across the State of Gujarat.” It also directed the state government “to frame rules and guidelines for fire safety in ICU wards of the hospitals.”

It further ordered all respondent authorities “to comply with the provisions of Gujarat Fire Prevention and Life Safety Measures Act, 2013 strictly in clinical establishments such as Hospital/Nursing Homes/ School buildings of the city of Ahmedabad.”

Significantly, it also directed respondent authorities “to make mandatory installation of sprinkles and a fire extinguisher in every room/ward of every Hospital/Nursing Home irrespective of its height with a view to protect lives of innocent and infirm patients who are not capable of escaping any disaster in case of emergency situations.”

Then on February 26, 2021, the court ordered that all Municipal Corporations mentioned in the PIL be served notice. It further ordered, “We direct all the Municipal Corporations to place on C/WPPIL/118/2020 ORDER record by way of an affidavit, a list of all the high rise buildings

-15 metres and 18 metres in height, special buildings, schools, hospitals, industries and factories within the jurisdictional limits of all the Municipal Corporations :

a. Which have a valid and subsisting No Objection Certificate with regard to the Fire Prevention and Protection Systems in the State of Gujarat ;

AND b. Which do not have a valid and subsisting No Objection Certificate with regard to the Fire Prevention and Protection Systems in the State of Gujarat”

The Court had ordered, “Ahmedabad Municipal Corporation is directed to place on record by way of an affidavit, the details of all the private hospitals which have not complied with the directions issued in Paragraph No. 23(14) of our earlier Order dated 15.12.2020” and that it was “directed to place on record the photocopies of the No Objection Certificates issued to all the hospitals located within the jurisdictional limits of Ahmedabad Municipal Corporation signed and certified by the Competent Authority within a period of 10 days from the date of the receipt of this order. One set of such photocopies shall also be furnished to the party-in-person.”

Specifically, when it came to reopening the Shrey Hospital, the court had on February 26, 2021 ordered, “The Ahmedabad Municipal Corporation is directed not to remove or open the seals applied at the premises of the Shrey Hospital without the permission of this Court and shall not permit the Management to once again start with the functioning of the Hospital without the permission of this Court.”

The case in the Supreme Court

Following the Rajkot fire at the Uday Shivananda Hospital the SC took suo moto cognizance, and in the case titled, In Re: Proper Treatment of COVID-19 Patients and Dignified Handling of Dead Bodies in the Hospitals, etc., asked the government via an order passed on December 9, 2020, to submit a report comprising data from all states on fire safety audits carried out in hospitals.

Meanwhile, little changed on the ground as yet another fire broke out in the ICU of the Bharuch Welfare Hospital in May this year, killing 18 people. Meanwhile, the Gujarat government issued an executive notification that gave a virtual carte blanche to hospitals by allowing them to function without adhering to fire safety norms till June 2022, and that no action will be taken against them till then. Given the number of lives lost and the direct involvement of the highest court in the country, this notification showcased the Gujarat government’s impunity.

Bar&Bench quoted Justice Shah as saying, “40 hospitals in Gujarat were held liable and they came to High Court. Later, government order was that no action should be taken against hospitals for violation of fire safety. Such an order is a contempt of this court.”

The case has been adjourned for two weeks.

To be updated with order copy.

Related:

Guj HC slams state gov’t for lax attitude to fire safety
Gujarat: 18 Covid patients killed in Bharuch hospital fire!
Shrey Hospital Fire: Guj HC bats for greater accountability
SC takes suo moto cognisance of Rajkot Covid Hospital fire
Shrey Hospital Fire: Four months on, no evidence yet!
8 killed in Ahmedabad Covid-19 Hospital Fire
Another fatal inferno in Gujarat Covid hospital!

Guj gov’t faces heat for submitting report on fire safety in hospitals to SC in sealed cover

Pressure has been mounting to ensure higher safety standards since the tragic Shrey Hospital fire of August 2020

Fire safetyImage Courtesy:deccanherald.com

The Supreme Court has come down heavily on the Gujarat government for a series of decisions regarding fire safety that appear to be contempt of court. The court also appeared flummoxed at the state government’s decision to submit its report in a sealed cover.

“What is this report in sealed cover? It is not a nuclear secret,” Justice DY Chandrachud was quoted as saying by Bar&Bench. Justice Chandrachud was hearing the case along with Justice MR Shah. The court also took umbrage to the state government’s decision to issue an executive notification that hospitals will not be required to adhere to fire safety norms till 2022.

The Bench slammed the state government, reportedly saying, “Once a mandamus is there, it cannot be overridden by an executive notification like this! You now give a carte blanche and say hospitals don't have to adhere till 2022 and people will continue dying and be burnt...”

The Court has hearing a suo moto case concerning fire tragedies at Covid Hospitals after two cases in Rajkot and Ahmedabad. SabrangIndia had previously reported on the fire that broke out in the Intensive Care Unit (ICU) of Ahmedabad’s Shrey Hospital leading to the deaths of eight Covid-19 patients on August 6, 2020. Advocate Suhel Tirmizi, whose wife Ayesha was one of the victims, had filed a PIL demanding accountability be fixed on various state and hospital authorities. Then in November 2020, another inferno, this time at a Rajkot Covid care hospital claimed five lives.

Two significant orders by the Gujarat HC

Following this, the Gujarat High Court had passed two significant orders. On December 15, 2020, while passing orders in a batch of Public Interest Litigations (PIL) in connection with the Shrey Hospital fire case, the Gujarat High Court had made a series of pertinent observations and passed orders that are bound to have a far-reaching impact.

The court ordered the State of Gujarat “to enact a consolidated Code/Act/Guidelines for fire safety requirement for clinical establishments/hospitals of all kinds setting out minimum standards of fire safety standards to be maintained by clinical establishments/ hospitals such as across the State of Gujarat.” It also directed the state government “to frame rules and guidelines for fire safety in ICU wards of the hospitals.”

It further ordered all respondent authorities “to comply with the provisions of Gujarat Fire Prevention and Life Safety Measures Act, 2013 strictly in clinical establishments such as Hospital/Nursing Homes/ School buildings of the city of Ahmedabad.”

Significantly, it also directed respondent authorities “to make mandatory installation of sprinkles and a fire extinguisher in every room/ward of every Hospital/Nursing Home irrespective of its height with a view to protect lives of innocent and infirm patients who are not capable of escaping any disaster in case of emergency situations.”

Then on February 26, 2021, the court ordered that all Municipal Corporations mentioned in the PIL be served notice. It further ordered, “We direct all the Municipal Corporations to place on C/WPPIL/118/2020 ORDER record by way of an affidavit, a list of all the high rise buildings

-15 metres and 18 metres in height, special buildings, schools, hospitals, industries and factories within the jurisdictional limits of all the Municipal Corporations :

a. Which have a valid and subsisting No Objection Certificate with regard to the Fire Prevention and Protection Systems in the State of Gujarat ;

AND b. Which do not have a valid and subsisting No Objection Certificate with regard to the Fire Prevention and Protection Systems in the State of Gujarat”

The Court had ordered, “Ahmedabad Municipal Corporation is directed to place on record by way of an affidavit, the details of all the private hospitals which have not complied with the directions issued in Paragraph No. 23(14) of our earlier Order dated 15.12.2020” and that it was “directed to place on record the photocopies of the No Objection Certificates issued to all the hospitals located within the jurisdictional limits of Ahmedabad Municipal Corporation signed and certified by the Competent Authority within a period of 10 days from the date of the receipt of this order. One set of such photocopies shall also be furnished to the party-in-person.”

Specifically, when it came to reopening the Shrey Hospital, the court had on February 26, 2021 ordered, “The Ahmedabad Municipal Corporation is directed not to remove or open the seals applied at the premises of the Shrey Hospital without the permission of this Court and shall not permit the Management to once again start with the functioning of the Hospital without the permission of this Court.”

The case in the Supreme Court

Following the Rajkot fire at the Uday Shivananda Hospital the SC took suo moto cognizance, and in the case titled, In Re: Proper Treatment of COVID-19 Patients and Dignified Handling of Dead Bodies in the Hospitals, etc., asked the government via an order passed on December 9, 2020, to submit a report comprising data from all states on fire safety audits carried out in hospitals.

Meanwhile, little changed on the ground as yet another fire broke out in the ICU of the Bharuch Welfare Hospital in May this year, killing 18 people. Meanwhile, the Gujarat government issued an executive notification that gave a virtual carte blanche to hospitals by allowing them to function without adhering to fire safety norms till June 2022, and that no action will be taken against them till then. Given the number of lives lost and the direct involvement of the highest court in the country, this notification showcased the Gujarat government’s impunity.

Bar&Bench quoted Justice Shah as saying, “40 hospitals in Gujarat were held liable and they came to High Court. Later, government order was that no action should be taken against hospitals for violation of fire safety. Such an order is a contempt of this court.”

The case has been adjourned for two weeks.

To be updated with order copy.

Related:

Guj HC slams state gov’t for lax attitude to fire safety
Gujarat: 18 Covid patients killed in Bharuch hospital fire!
Shrey Hospital Fire: Guj HC bats for greater accountability
SC takes suo moto cognisance of Rajkot Covid Hospital fire
Shrey Hospital Fire: Four months on, no evidence yet!
8 killed in Ahmedabad Covid-19 Hospital Fire
Another fatal inferno in Gujarat Covid hospital!

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Why are Indians denied ex gratia compensation for Covid-19?

The Supreme Court considered this issue while dealing with two petitions seeking ex gratia compensation for families of those who succumbed to Covid-19 and other related relief

15 Jul 2021

Covid 19Image Courtesy:livelaw.in

The Union government had made a submission before the Supreme Court that it would not paying ex-gratia compensation to families of persons deceased due to Covid-19. The court then passed a judgement that the Central authority under Disaster Management Act (DMA) has to issue guidelines on payment of compensation to these families.

The initial stand taken by the Union government was that it was not financially feasible for it and for the states to give such compensation and that it had to invest in long term infrastructure for health. However, on the day of the final hearing, on June 30 the Centre took a different stand and stated that the issue was of priority and making optimal use of the financial resources in the face of an on-going and unprecedented disaster, and not just financial ability.

While the arguments made by the Centre seem logically sound, do they stand the test of closer scrutiny of both constitutional and statutory mandate? Does the Supreme Court’s judgement make up for the lacunae in policy and will the people in need who have lost family members to Covid-19 have their rights safeguarded? We explore whether the Supreme Court’s judgement has actually brought some or any relief and whether the Centre can shirk off its liability after declaring Covid-19 as a notified disaster.

The two PILs filed by Reepak Kansal and Gaurav Bansal inter alia, seek ex gratia monetary compensation of Rs. 4 lakhs each to families of deceased who succumbed to Covid-19 under section 12 of the DMA.

Other reliefs included issuing directions for the issuance official document to families of deceased stating cause of death as Covid-19 and also a mandamus against the Union government to provide social security and rehabilitation to these families.

Why is it the Centre’s responsibility?

A question often raised is, why does the Centre have to do everything? States are managing the pandemic at the state level and public health is also a state subject; why then expect the Union government to compensate the aggrieved families. The answer lies not just in law but also in policy. The Union government’s policy from day one of the outbreak, has been to assume full control/responsibility and to centralise things. It was the central government that decided to impose a nation-wide lockdown without consultations with the state -- forming an Inter-State Council-- or even giving an advance time-frame or warning to the states or citizens. The lockdown thereafter kept getting extended for months until states were given (or left in) charge to manage on their own. It was the Union Home Ministry that declared Covid-19 as a “notified disaster” under the DMA so that assistance could be provided to states under the State Disaster Response Fund (SDRF).

The liability also lies in law as the Union Home Ministry had on April 8, 2015 issued a communication that stated that for any death which is caused due to disaster, an amount of Rs. 4 lakhs has to be paid to the victim’s family, in addition to other reliefs. Section 12 of DMA mandatorily provides for the National Authority defined under Section 3 of the said Act to recommend guidelines for the minimum standards of relief to be provided to persons affected by the disaster and it shall include, inter alia, ex gratia assistance on account of loss of life.

The arguments made during the hearing sum up correctly why this compensation is impending and a writ of mandamus upon the central authority is a valid ask. The counsel for the petitioner submitted that the word “shall” occurring twice in Section 12 of the Act puts a constitutional and statutory obligation on the part of the Central/State Government to recommend guidelines for providing ex gratia assistance which is in the nature of sustenance assistance. It was also stressed upon that this is also a constitutional obligation under Article 21 of the Indian Constitution as right to life stands affected in the given scenario.

Section 12 of the DMA states as follows:

The National Authority shall recommend guidelines for the minimum standards of relief to be provided to persons affected by disaster, which shall include:

(i) the minimum requirements to be provided in the relief camps in relation to shelter, food, drinking water, medical cover and sanitation;

(ii) the special provisions to be made for widows and orphans;

(iii) ex gratia assistance on account of loss of life as also assistance on account of damage to houses and for restoration of means of livelihood;

(iv) such other relief as may be necessary.

One other submission made by the petitioners rightly points to the purpose of DMA which is to provide social security & social insurance to the persons and families affected by disasters. Thus, denying the ex-gratia payment to the families of Covid-19 deceased shall not only hit on the foundation stone on which DMA 2005 is standing, but shall also defeat the whole purpose of DMA 2005. Giving compensation to these families who in many cases have lost the sole breadwinner of to the disease, would serve the letter and spirt of DMA and would also give them a sense of social security.

Did the Centre shirk off its responsibility?

During one of the hearings, Centre had assured the court that it will attend to the concerns as the issues are genuine. However, on the hearing held on June 20, the Central government filed an affidavit stating that it will not be giving ex-gratia compensation in Covid death cases where the number of deceased has crossed the figure of 4 lakhs and counting. The Centre reasoned that the finances of both the Union and state governments are under severe strain due to reduced tax revenues and increased expenditure on health infrastructure and looking at the scale of deaths, it would not be wise to spend such scare financial resources on compensation.

Furthermore, the Centre also cautioned courts from intervening in policy matters. “It is well settled through numerous judgments of the Supreme Court that this is a matter which should be performed by the authority (National Disaster Management Authority), to whom it has been entrusted and not one where the Court will substitute its own judgment for the decision to be taken by the Executive. Any attempt to second guess may create unintended and unfortunate Constitutional and administrative ramifications,” the affidavit read.

The Centre also washed its hands off the liability by pushing the same on states while reasoning that health is a state subject and burden would be on SDRF to pay such compensation. For all states combined, the total budget allocated to SDRF this year comes to ₹22,184 crore. “If the entire SDRF funds get consumed on ex-gratia for Covid-19 victims, the States may not have sufficient funds for organizing Covid-19 response, for provision of various essential medical and other supplies, or to take care of other disasters like cyclones, floods, etc,” the Centre submitted.

The Centre also justified declaring Covid-19 as “notified disaster” under DMA stating that it was done as a special one-time dispensation in order to supplement efforts of state governments. The Centre also contended that there was no precedent for granting ex gratia compensation for an on-going disease extending for months or years and stated that if compensation is provided for this disease, denying compensation in other diseases would be unfair.

The Centre also took a stand that the term “shall” used in section 12 of DMA will have to be read as “may”. The submissions made by the petitioners counter this stand, and stated that the use of the word “shall” has been made twice in the section 12 which clearly indicates the intention of the Parliament that the National Disaster Management Authority (NDMA) is not only bound to recommend guidelines for the minimum standards of relief but such reliefs must contain the provisions of ex gratia assistance on account of loss of life.

During the hearing on June 30, Solicitor General Tushar Mehta on behalf of Union government submitted that the issue is not of fiscal affordability but of the most rational, judicious and optimum usage of fiscal and all other resources of the nation. He submitted that question is of priorities and it should not be misconstrued that government is contending facing financial constraint. He stated that in an ongoing disaster like Covid-19 views on “Minimum Standards of Relief”, under Section 12 will differ and the government will have to broaden its vision providing for a multi-pronged approach and putting life, health and safety of the citizens at the topmost priority, for which expenditure is needed on a daily basis. He submitted that it was advisable not to formulate a strait jacket guideline and a cast in stone formula on “Minimum Standards of Relief" with respect to Covid-19.

Can a govt claim fiscal strain against liability?

The answer lies in precedents of the Supreme Court. In Municipal Council, Ratlam vs Vardichan And Ors (1980) 4 SCC 162, the court had observed that the plea that “notwithstanding the public nuisance financial inability validly exonerates it from statutory liability has no juridical basis”. Justice Krishna Iyer had stated in the judgement, “the law will relentlessly be enforced and the plea of poor finance will be poor alibi when people in misery cry for justice”.



Also, while the Centre contended that the compensation would strain state governments, there are states like Bihar, Karnataka and Delhi which are paying one time compensation in the form of ex gratia to those families whose members have died due to Covid-19.

In Charan Lal Sahu v. Union of India, (1990) 1 SCC 613 (popularly known as “Bhopal Gas Leak Disaster case”) the court had held that the Government has the sovereign power of guardianship over the persons under disability and it is its duty to protect them.

Was the Supreme Court convinced?

On June 30, the bench of Justices MR Shah and Ashok Bhushan was in agreement with the submissions made by petitioners that the use of the word “shall” in section 12 of DMA makes the provision unambiguous and statutory enactments must ordinarily be construed according to its plain meaning and the beneficial provision of the legislation must be literally construed so as to fulfil the statutory purpose and not to frustrate it.

The court observed that the NDMA has not yet issued any guidelines for ex gratia assistance on account of loss of life due to Covid-19 and deemed it to be a failure on its part to perform its statutory duty cast upon by section 12 of DMA.

The court, however, also agreed that Covid-19 is a peculiar kind of “disaster” and there is a need to focus simultaneously on prevention, preparedness, mitigation and recovery, which calls for a different order of mobilisation of both financial and technical resources. The court thus observed that there is no justification to mandate the government to provide ex gratia compensation of Rs. 4 lakhs to affected families as the impact of Covid-19 is different from other disasters. It said,

“The Courts would be very slow to interfere with priorities fixed by the government in providing reliefs, unless it is patently arbitrary and/or not in the larger public interest at all. The Government should be free to take policy decisions/decide priorities (of course to achieve the ultimate goal of DMA 2005, government should be free to take its own decisions/priorities while providing minimum standards of relief and even towards preparedness, mitigation, prevention and recovery), subject to the availability of the resources/funds and the amount to be spent towards other reliefs on the aid and advice of the experts and looking to the circumstances from time to time. Therefore, no relief can be granted to direct the National Authority/Central Government/State Governments to pay a particular amount towards ex gratia assistance on account of loss of life to the family members of the persons who have died due to Covid-19.”

The court observed that it should be left to the wisdom of National Authority while considering the guidelines/recommendations of the Finance Commission in its XVth Finance Commission Report and the funds required for other reliefs/priorities but it has to consider issuing/recommend guidelines on ex gratia assistance on account of loss of life.

What amount to be paid by way of ex gratia assistance to the family members of the persons who died due to Covid-19 pandemic should be left to the National Authority/Central Government, the court held.

The court, however, skirted around the issue of whether receiving compensation was a matter of statutory right or even a constitutional right. It did not delve deep into the matter of rights of the affected families and deferred from declaring the right to receive compensation under DMA in the face of disasters as defined under the Act.

Is it fair to pressure the government to give compensation?

The defense of fiscal strain has already been raised by the government and it has submitted that giving compensation to such a large and growing number of deceased persons succumbing to Covid-19 would be a drain on the exchequer. While that is a valid point, it is not a legally viable defense to be put up by a democratically elected government working ‘for the people’. The fundamental rights of citizens in a democracy are sacrosanct and the right to life under Article 21 is indefeasible under any circumstance. Thus, the government’s defense even if it sounds logical, does not have a legal sanction. There is no law the government can harp on while making such claims and neither has any Supreme Court precedent supported the same in the past. Thus, making the government’s argument baseless and unfounded. Additionally, it is not just the fundamental rights that are being enforced here but the provisions of the DMA as well. When the Centre has, on its own accord declared Covid-19 to be a “notified disaster” it cannot cherry pick provisions that is suitable to its financial ability. If the government has given compensation in disasters like floods or earthquakes, the same principle, if not applied for Covid-19 would be unfair and an unreasonable classification which is not even provided for in the law. The law makes no exceptions and neither can the government.

The Supreme Court judgement may be read here:

Related:

Right to health: Obligations of the State
COVID awareness and Medical Relief for Purvanchal continues
An Indian’s right to vaccination amidst a global pandemic

Why are Indians denied ex gratia compensation for Covid-19?

The Supreme Court considered this issue while dealing with two petitions seeking ex gratia compensation for families of those who succumbed to Covid-19 and other related relief

Covid 19Image Courtesy:livelaw.in

The Union government had made a submission before the Supreme Court that it would not paying ex-gratia compensation to families of persons deceased due to Covid-19. The court then passed a judgement that the Central authority under Disaster Management Act (DMA) has to issue guidelines on payment of compensation to these families.

The initial stand taken by the Union government was that it was not financially feasible for it and for the states to give such compensation and that it had to invest in long term infrastructure for health. However, on the day of the final hearing, on June 30 the Centre took a different stand and stated that the issue was of priority and making optimal use of the financial resources in the face of an on-going and unprecedented disaster, and not just financial ability.

While the arguments made by the Centre seem logically sound, do they stand the test of closer scrutiny of both constitutional and statutory mandate? Does the Supreme Court’s judgement make up for the lacunae in policy and will the people in need who have lost family members to Covid-19 have their rights safeguarded? We explore whether the Supreme Court’s judgement has actually brought some or any relief and whether the Centre can shirk off its liability after declaring Covid-19 as a notified disaster.

The two PILs filed by Reepak Kansal and Gaurav Bansal inter alia, seek ex gratia monetary compensation of Rs. 4 lakhs each to families of deceased who succumbed to Covid-19 under section 12 of the DMA.

Other reliefs included issuing directions for the issuance official document to families of deceased stating cause of death as Covid-19 and also a mandamus against the Union government to provide social security and rehabilitation to these families.

Why is it the Centre’s responsibility?

A question often raised is, why does the Centre have to do everything? States are managing the pandemic at the state level and public health is also a state subject; why then expect the Union government to compensate the aggrieved families. The answer lies not just in law but also in policy. The Union government’s policy from day one of the outbreak, has been to assume full control/responsibility and to centralise things. It was the central government that decided to impose a nation-wide lockdown without consultations with the state -- forming an Inter-State Council-- or even giving an advance time-frame or warning to the states or citizens. The lockdown thereafter kept getting extended for months until states were given (or left in) charge to manage on their own. It was the Union Home Ministry that declared Covid-19 as a “notified disaster” under the DMA so that assistance could be provided to states under the State Disaster Response Fund (SDRF).

The liability also lies in law as the Union Home Ministry had on April 8, 2015 issued a communication that stated that for any death which is caused due to disaster, an amount of Rs. 4 lakhs has to be paid to the victim’s family, in addition to other reliefs. Section 12 of DMA mandatorily provides for the National Authority defined under Section 3 of the said Act to recommend guidelines for the minimum standards of relief to be provided to persons affected by the disaster and it shall include, inter alia, ex gratia assistance on account of loss of life.

The arguments made during the hearing sum up correctly why this compensation is impending and a writ of mandamus upon the central authority is a valid ask. The counsel for the petitioner submitted that the word “shall” occurring twice in Section 12 of the Act puts a constitutional and statutory obligation on the part of the Central/State Government to recommend guidelines for providing ex gratia assistance which is in the nature of sustenance assistance. It was also stressed upon that this is also a constitutional obligation under Article 21 of the Indian Constitution as right to life stands affected in the given scenario.

Section 12 of the DMA states as follows:

The National Authority shall recommend guidelines for the minimum standards of relief to be provided to persons affected by disaster, which shall include:

(i) the minimum requirements to be provided in the relief camps in relation to shelter, food, drinking water, medical cover and sanitation;

(ii) the special provisions to be made for widows and orphans;

(iii) ex gratia assistance on account of loss of life as also assistance on account of damage to houses and for restoration of means of livelihood;

(iv) such other relief as may be necessary.

One other submission made by the petitioners rightly points to the purpose of DMA which is to provide social security & social insurance to the persons and families affected by disasters. Thus, denying the ex-gratia payment to the families of Covid-19 deceased shall not only hit on the foundation stone on which DMA 2005 is standing, but shall also defeat the whole purpose of DMA 2005. Giving compensation to these families who in many cases have lost the sole breadwinner of to the disease, would serve the letter and spirt of DMA and would also give them a sense of social security.

Did the Centre shirk off its responsibility?

During one of the hearings, Centre had assured the court that it will attend to the concerns as the issues are genuine. However, on the hearing held on June 20, the Central government filed an affidavit stating that it will not be giving ex-gratia compensation in Covid death cases where the number of deceased has crossed the figure of 4 lakhs and counting. The Centre reasoned that the finances of both the Union and state governments are under severe strain due to reduced tax revenues and increased expenditure on health infrastructure and looking at the scale of deaths, it would not be wise to spend such scare financial resources on compensation.

Furthermore, the Centre also cautioned courts from intervening in policy matters. “It is well settled through numerous judgments of the Supreme Court that this is a matter which should be performed by the authority (National Disaster Management Authority), to whom it has been entrusted and not one where the Court will substitute its own judgment for the decision to be taken by the Executive. Any attempt to second guess may create unintended and unfortunate Constitutional and administrative ramifications,” the affidavit read.

The Centre also washed its hands off the liability by pushing the same on states while reasoning that health is a state subject and burden would be on SDRF to pay such compensation. For all states combined, the total budget allocated to SDRF this year comes to ₹22,184 crore. “If the entire SDRF funds get consumed on ex-gratia for Covid-19 victims, the States may not have sufficient funds for organizing Covid-19 response, for provision of various essential medical and other supplies, or to take care of other disasters like cyclones, floods, etc,” the Centre submitted.

The Centre also justified declaring Covid-19 as “notified disaster” under DMA stating that it was done as a special one-time dispensation in order to supplement efforts of state governments. The Centre also contended that there was no precedent for granting ex gratia compensation for an on-going disease extending for months or years and stated that if compensation is provided for this disease, denying compensation in other diseases would be unfair.

The Centre also took a stand that the term “shall” used in section 12 of DMA will have to be read as “may”. The submissions made by the petitioners counter this stand, and stated that the use of the word “shall” has been made twice in the section 12 which clearly indicates the intention of the Parliament that the National Disaster Management Authority (NDMA) is not only bound to recommend guidelines for the minimum standards of relief but such reliefs must contain the provisions of ex gratia assistance on account of loss of life.

During the hearing on June 30, Solicitor General Tushar Mehta on behalf of Union government submitted that the issue is not of fiscal affordability but of the most rational, judicious and optimum usage of fiscal and all other resources of the nation. He submitted that question is of priorities and it should not be misconstrued that government is contending facing financial constraint. He stated that in an ongoing disaster like Covid-19 views on “Minimum Standards of Relief”, under Section 12 will differ and the government will have to broaden its vision providing for a multi-pronged approach and putting life, health and safety of the citizens at the topmost priority, for which expenditure is needed on a daily basis. He submitted that it was advisable not to formulate a strait jacket guideline and a cast in stone formula on “Minimum Standards of Relief" with respect to Covid-19.

Can a govt claim fiscal strain against liability?

The answer lies in precedents of the Supreme Court. In Municipal Council, Ratlam vs Vardichan And Ors (1980) 4 SCC 162, the court had observed that the plea that “notwithstanding the public nuisance financial inability validly exonerates it from statutory liability has no juridical basis”. Justice Krishna Iyer had stated in the judgement, “the law will relentlessly be enforced and the plea of poor finance will be poor alibi when people in misery cry for justice”.



Also, while the Centre contended that the compensation would strain state governments, there are states like Bihar, Karnataka and Delhi which are paying one time compensation in the form of ex gratia to those families whose members have died due to Covid-19.

In Charan Lal Sahu v. Union of India, (1990) 1 SCC 613 (popularly known as “Bhopal Gas Leak Disaster case”) the court had held that the Government has the sovereign power of guardianship over the persons under disability and it is its duty to protect them.

Was the Supreme Court convinced?

On June 30, the bench of Justices MR Shah and Ashok Bhushan was in agreement with the submissions made by petitioners that the use of the word “shall” in section 12 of DMA makes the provision unambiguous and statutory enactments must ordinarily be construed according to its plain meaning and the beneficial provision of the legislation must be literally construed so as to fulfil the statutory purpose and not to frustrate it.

The court observed that the NDMA has not yet issued any guidelines for ex gratia assistance on account of loss of life due to Covid-19 and deemed it to be a failure on its part to perform its statutory duty cast upon by section 12 of DMA.

The court, however, also agreed that Covid-19 is a peculiar kind of “disaster” and there is a need to focus simultaneously on prevention, preparedness, mitigation and recovery, which calls for a different order of mobilisation of both financial and technical resources. The court thus observed that there is no justification to mandate the government to provide ex gratia compensation of Rs. 4 lakhs to affected families as the impact of Covid-19 is different from other disasters. It said,

“The Courts would be very slow to interfere with priorities fixed by the government in providing reliefs, unless it is patently arbitrary and/or not in the larger public interest at all. The Government should be free to take policy decisions/decide priorities (of course to achieve the ultimate goal of DMA 2005, government should be free to take its own decisions/priorities while providing minimum standards of relief and even towards preparedness, mitigation, prevention and recovery), subject to the availability of the resources/funds and the amount to be spent towards other reliefs on the aid and advice of the experts and looking to the circumstances from time to time. Therefore, no relief can be granted to direct the National Authority/Central Government/State Governments to pay a particular amount towards ex gratia assistance on account of loss of life to the family members of the persons who have died due to Covid-19.”

The court observed that it should be left to the wisdom of National Authority while considering the guidelines/recommendations of the Finance Commission in its XVth Finance Commission Report and the funds required for other reliefs/priorities but it has to consider issuing/recommend guidelines on ex gratia assistance on account of loss of life.

What amount to be paid by way of ex gratia assistance to the family members of the persons who died due to Covid-19 pandemic should be left to the National Authority/Central Government, the court held.

The court, however, skirted around the issue of whether receiving compensation was a matter of statutory right or even a constitutional right. It did not delve deep into the matter of rights of the affected families and deferred from declaring the right to receive compensation under DMA in the face of disasters as defined under the Act.

Is it fair to pressure the government to give compensation?

The defense of fiscal strain has already been raised by the government and it has submitted that giving compensation to such a large and growing number of deceased persons succumbing to Covid-19 would be a drain on the exchequer. While that is a valid point, it is not a legally viable defense to be put up by a democratically elected government working ‘for the people’. The fundamental rights of citizens in a democracy are sacrosanct and the right to life under Article 21 is indefeasible under any circumstance. Thus, the government’s defense even if it sounds logical, does not have a legal sanction. There is no law the government can harp on while making such claims and neither has any Supreme Court precedent supported the same in the past. Thus, making the government’s argument baseless and unfounded. Additionally, it is not just the fundamental rights that are being enforced here but the provisions of the DMA as well. When the Centre has, on its own accord declared Covid-19 to be a “notified disaster” it cannot cherry pick provisions that is suitable to its financial ability. If the government has given compensation in disasters like floods or earthquakes, the same principle, if not applied for Covid-19 would be unfair and an unreasonable classification which is not even provided for in the law. The law makes no exceptions and neither can the government.

The Supreme Court judgement may be read here:

Related:

Right to health: Obligations of the State
COVID awareness and Medical Relief for Purvanchal continues
An Indian’s right to vaccination amidst a global pandemic

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Beyond Pride Month: Where is the commitment to Equal Rights?

LGBTQIA+ community in India suffers even more in wake of Covid-19, and doesn’t have any real support system to protect the vulnerable

10 Jul 2021

Image Courtesy:bsr.org

After the Pride Month celebrations concluded at the end of June, and public relations driven glitzy corporate campaigns came to an abrupt end, the Lesbian Gay Bisexual Transgender Queer Intersex Asexual + (LGBTQIA+) community in India was pushed back into its dark reality. The community’s plight was exacerbated by the Covid-19 induced lockdown. In this piece, we try to highlight certain issues that remain inadequately addressed and in urgent need of a sustainable solution.

LGBTQIA+ persons in India

Multinational research firm Ipsos released report on LGBT+ Pride 2021 Global Survey conducted between April 23 and May 7, 2021. The survey was conducted as a 27-market survey conducted through interview on a sample of 500 individuals in India. The report shows that 3% of the Indian Population identify as homosexual (Including Gay and Lesbian), 9% identify as bisexual, 1% identify as pansexual and 2% identify as asexual. Totally, 17% identify as not heterosexual (excluding 'do not know', and 'prefer not to answer')[1]. It is however noteworthy that the people were interviewed online, and therefore the respondents are likely to be educated, and having at least a certain amount of financial power. Therefore, it is difficult to gauge the responses of people in the hinterland, those who lack internet access or the unlettered.

Connection with community cut off

Over time, members of LGBTQIA+ individuals have built spaces for themselves outside of their natal homes due to prejudice and abuse by family members. For some members of the queer community venturing outside of home and interacting as a collective is important for accessing safe space and even livelihood. However, the very nature of the Covid-19 lockdown restricts this access. The government’s negligible attempts at aiding the queer community have amplified the difficulties and abuse that they have had to face due to the pandemic.

Forced return to abusive biological families

Several individuals who are queer form a chosen family or a community space for themselves outside of home, be it in college, professional spaces or through support networks. A number of queer individuals who have been forced to return to their biological families have faced unprecedented abuse or discomfort due to the need to behave in a hetero-normative fashion in their homes.

At home, many individuals are unable to express their identity, use their preferred pronouns, prohibited from dressing according to their choice. The very existence of their identities is denied and even suppressed due to the prejudices of the natal families, this can cause dysphoria and grave mental distress. While there have been government initiated helplines for mental health during lockdown, no such helplines were formed to address the suffering of queer individuals. There are also queer individuals who have been unable to return to home because their home situations are extremely volatile or have been disowned by their families for being queer.

Impact on livelihood, and ability to access justice

For queer individuals who live on their own and have entered the workforce in India, there have been various difficulties. Several members of the transgender community in India rely on alms or professions such as sex work, which require social interaction. Moreover, as activist, professor and transman Bittu, points out, “Several transmen who work in itinerant forms of labour such as in roadside dhabas, trucking, driving cabs have also lost their sources of livelihood as these professions have been shut down during the lockdown.”

There is also disparity within the queer community. For instance in Lucknow there is a system of badhai which is earned by members of the Hijra community from public spaces. This system itself is unequal as 80% of their earnings have to go to the gurus of their gharana. “When individuals ventured out to earn badhai they were brutally beaten up by the police or asked for sexual favours,” Ritu a transwoman from Lucknow shared. She also pointed out that the distress caused by the pandemic has led to an increase in violence within the community itself. However, reporting any violence between members of the queer community to the police is difficult due to their prejudice. Ritu shared an instance when she went to the police in Balaganj thana in Lucknow with a queer friend to report abuse and the police officer derogatorily said, “The current times are so dismal that now we have to address cases of ‘these’ people.”

There have been various cases where the police have denied fair investigation into the violence against transgender individuals. For queer partners, reporting cases to the police, has always been a difficulty as their relationship and identity is denied at every level by their families, the society and even the officials.

Exclusion of transgender persons

A transwoman activist from Telangana, Rachana, highlighted, “The violence within the community and against the community is a result of the systematic exclusion and discrimination of transgender people, mainly that of welfare.” When the loss of welfare was emphasised by the pandemic, there was little questioning of the lack of access to welfare schemes such as ration cards, housing, pension, healthcare, monetary schemes that prevails within the trans community.

A major obstacle in accessing such schemes comes from the poor documentation of trasngender individuals in the population census. Even schemes rolled out by the government were quite discriminatory, and did not recognise the right to self identification. Rachana further added that the national portal that was introduced by the government to allow transgender individuals to register themsevles in order to avail schemes focused on the binary identification of male-female and required doctor’s certification for identification.

These attempts by the government have been quite poor and at best superficial. In the first year of the lockdown, the government announced that they would provide a one time cash transfer of INR 1,500 and ration supplies. A trans woman activist, Meera Sangamitra said that according to their calculations “only 1% of the community received this transfer.” Although the estimated population of trangender community in India is 4.8 million, only 5,711 received cash transfer and and a mere 1,229 received ration supplies[2]. The idea of a direct cash transfer also makes little sense as a majority of the members of the community do not have bank accounts due to lack of documentation. This policy not only failed in implementation, but the fundamental thought behind the idea never took into account the situation of the transgender community in India in the first place.

Restricted access to healthcare

Access to adequate healthcare has always been difficult for LGBTQIA individuals, the advent of Covid-19 lockdown enhanced the problems. Loss of livelihood on one hand has limited options of nutritious sustenance hampering immunity of individuals during a pandemic. In hospitals transgender individuals often face discrimination which can create a mentally traumatic experience.

Rachana shared, “Several transgender individuals were turned away from hospitals on the claim that there was no space for them. Their symptoms were often dismissed as mild cough and fever.” She added, “While accessing healthcare several trans individuals are questioned about their chosen identity by doctors and medical professionals.” Ritu shared an experience of a transwoman friend who was told by a pharmacist in Lucknow, “There is already a shortage of medicine, let the common person survive, why do you need to live?”

Government apathy

The Central government has not taken any firm steps to lend support to the transgender community, although very few states such as West Bengal[3] have undertaken some policies, though even these are less than adequate. Additionally, the breakdown of the health infrastructure in the country has also made it difficult for some members of the transgender community to access their monthly hormone treatments[4]. These treatments are often important for individuals to deal with dysphoria which can cause grave mental stress, and regular access to doctors during their treatment is important for their health. Owing to the mental stress caused by the society, personal dysphoria and government’s insistence for surgery for identification several transgender individuals have gone to quack doctors to undergo surgery, Rachana added. Although this has been a prevalent practise in the Hijra community, it increased during Covid-19 when scheduled surgeries could not take place. These surgeries are then conducted in unhygienic conditions often leading to problems such as Urinary Tract Infection (UTI). Rushing for these surgeries is a direct result of social prejudice which forces individuals to fit into a binary to prove their existence.

These policies by the government, or lack thereof, are indicative of their own prejudice and how they seek to deny the very existence of a significantly marginalised community. Queer individuals are penalised for being queer. The dismissal of queer identities only increased during the lockdown. This has led to abuse, mental distress and even loss of life. The systemic denial of existence of queer identities can also be seen in the larger field of medical research, where there has been a marked absence of data[5] on how individuals undergoing hormone treatment will be affected by the vaccination.

It is easy to paint a pride flag onto an organisation’s logo, but addressing the difficulties of the community which were magnified during Covid-19 will require a larger structural change, including one of consciousness. A thorough understanding of the pre-existing situation is imperative. Simply painting rainbow flags in advertisements and superficial governmental policies do not save lives.

 


[1] https://www.ipsos.com/sites/default/files/ct/news/documents/2021-06/LGBT%20Pride%202021%20Global%20Survey%20Report_3.pdf

[2] https://www.indiaspend.com/gendercheck/denied-visibility-in-official-data-millions-of-transgender-indians-cant-access-benefits-services-754436

[3] https://timesofindia.indiatimes.com/city/kolkata/west-bengal-transgender-covid-ward-comes-to-rescue-as-activist-gets-infected/articleshow/79147210.cms

[4] https://www.thehindu.com/news/cities/mumbai/covid-19-lockdown-transgender-community-pushed-further-to-the-margin/article31265535.ece

[5] https://www.downtoearth.org.in/news/health/this-pride-month-the-lgbtqia-community-wants-to-talk-about-hea

Beyond Pride Month: Where is the commitment to Equal Rights?

LGBTQIA+ community in India suffers even more in wake of Covid-19, and doesn’t have any real support system to protect the vulnerable

Image Courtesy:bsr.org

After the Pride Month celebrations concluded at the end of June, and public relations driven glitzy corporate campaigns came to an abrupt end, the Lesbian Gay Bisexual Transgender Queer Intersex Asexual + (LGBTQIA+) community in India was pushed back into its dark reality. The community’s plight was exacerbated by the Covid-19 induced lockdown. In this piece, we try to highlight certain issues that remain inadequately addressed and in urgent need of a sustainable solution.

LGBTQIA+ persons in India

Multinational research firm Ipsos released report on LGBT+ Pride 2021 Global Survey conducted between April 23 and May 7, 2021. The survey was conducted as a 27-market survey conducted through interview on a sample of 500 individuals in India. The report shows that 3% of the Indian Population identify as homosexual (Including Gay and Lesbian), 9% identify as bisexual, 1% identify as pansexual and 2% identify as asexual. Totally, 17% identify as not heterosexual (excluding 'do not know', and 'prefer not to answer')[1]. It is however noteworthy that the people were interviewed online, and therefore the respondents are likely to be educated, and having at least a certain amount of financial power. Therefore, it is difficult to gauge the responses of people in the hinterland, those who lack internet access or the unlettered.

Connection with community cut off

Over time, members of LGBTQIA+ individuals have built spaces for themselves outside of their natal homes due to prejudice and abuse by family members. For some members of the queer community venturing outside of home and interacting as a collective is important for accessing safe space and even livelihood. However, the very nature of the Covid-19 lockdown restricts this access. The government’s negligible attempts at aiding the queer community have amplified the difficulties and abuse that they have had to face due to the pandemic.

Forced return to abusive biological families

Several individuals who are queer form a chosen family or a community space for themselves outside of home, be it in college, professional spaces or through support networks. A number of queer individuals who have been forced to return to their biological families have faced unprecedented abuse or discomfort due to the need to behave in a hetero-normative fashion in their homes.

At home, many individuals are unable to express their identity, use their preferred pronouns, prohibited from dressing according to their choice. The very existence of their identities is denied and even suppressed due to the prejudices of the natal families, this can cause dysphoria and grave mental distress. While there have been government initiated helplines for mental health during lockdown, no such helplines were formed to address the suffering of queer individuals. There are also queer individuals who have been unable to return to home because their home situations are extremely volatile or have been disowned by their families for being queer.

Impact on livelihood, and ability to access justice

For queer individuals who live on their own and have entered the workforce in India, there have been various difficulties. Several members of the transgender community in India rely on alms or professions such as sex work, which require social interaction. Moreover, as activist, professor and transman Bittu, points out, “Several transmen who work in itinerant forms of labour such as in roadside dhabas, trucking, driving cabs have also lost their sources of livelihood as these professions have been shut down during the lockdown.”

There is also disparity within the queer community. For instance in Lucknow there is a system of badhai which is earned by members of the Hijra community from public spaces. This system itself is unequal as 80% of their earnings have to go to the gurus of their gharana. “When individuals ventured out to earn badhai they were brutally beaten up by the police or asked for sexual favours,” Ritu a transwoman from Lucknow shared. She also pointed out that the distress caused by the pandemic has led to an increase in violence within the community itself. However, reporting any violence between members of the queer community to the police is difficult due to their prejudice. Ritu shared an instance when she went to the police in Balaganj thana in Lucknow with a queer friend to report abuse and the police officer derogatorily said, “The current times are so dismal that now we have to address cases of ‘these’ people.”

There have been various cases where the police have denied fair investigation into the violence against transgender individuals. For queer partners, reporting cases to the police, has always been a difficulty as their relationship and identity is denied at every level by their families, the society and even the officials.

Exclusion of transgender persons

A transwoman activist from Telangana, Rachana, highlighted, “The violence within the community and against the community is a result of the systematic exclusion and discrimination of transgender people, mainly that of welfare.” When the loss of welfare was emphasised by the pandemic, there was little questioning of the lack of access to welfare schemes such as ration cards, housing, pension, healthcare, monetary schemes that prevails within the trans community.

A major obstacle in accessing such schemes comes from the poor documentation of trasngender individuals in the population census. Even schemes rolled out by the government were quite discriminatory, and did not recognise the right to self identification. Rachana further added that the national portal that was introduced by the government to allow transgender individuals to register themsevles in order to avail schemes focused on the binary identification of male-female and required doctor’s certification for identification.

These attempts by the government have been quite poor and at best superficial. In the first year of the lockdown, the government announced that they would provide a one time cash transfer of INR 1,500 and ration supplies. A trans woman activist, Meera Sangamitra said that according to their calculations “only 1% of the community received this transfer.” Although the estimated population of trangender community in India is 4.8 million, only 5,711 received cash transfer and and a mere 1,229 received ration supplies[2]. The idea of a direct cash transfer also makes little sense as a majority of the members of the community do not have bank accounts due to lack of documentation. This policy not only failed in implementation, but the fundamental thought behind the idea never took into account the situation of the transgender community in India in the first place.

Restricted access to healthcare

Access to adequate healthcare has always been difficult for LGBTQIA individuals, the advent of Covid-19 lockdown enhanced the problems. Loss of livelihood on one hand has limited options of nutritious sustenance hampering immunity of individuals during a pandemic. In hospitals transgender individuals often face discrimination which can create a mentally traumatic experience.

Rachana shared, “Several transgender individuals were turned away from hospitals on the claim that there was no space for them. Their symptoms were often dismissed as mild cough and fever.” She added, “While accessing healthcare several trans individuals are questioned about their chosen identity by doctors and medical professionals.” Ritu shared an experience of a transwoman friend who was told by a pharmacist in Lucknow, “There is already a shortage of medicine, let the common person survive, why do you need to live?”

Government apathy

The Central government has not taken any firm steps to lend support to the transgender community, although very few states such as West Bengal[3] have undertaken some policies, though even these are less than adequate. Additionally, the breakdown of the health infrastructure in the country has also made it difficult for some members of the transgender community to access their monthly hormone treatments[4]. These treatments are often important for individuals to deal with dysphoria which can cause grave mental stress, and regular access to doctors during their treatment is important for their health. Owing to the mental stress caused by the society, personal dysphoria and government’s insistence for surgery for identification several transgender individuals have gone to quack doctors to undergo surgery, Rachana added. Although this has been a prevalent practise in the Hijra community, it increased during Covid-19 when scheduled surgeries could not take place. These surgeries are then conducted in unhygienic conditions often leading to problems such as Urinary Tract Infection (UTI). Rushing for these surgeries is a direct result of social prejudice which forces individuals to fit into a binary to prove their existence.

These policies by the government, or lack thereof, are indicative of their own prejudice and how they seek to deny the very existence of a significantly marginalised community. Queer individuals are penalised for being queer. The dismissal of queer identities only increased during the lockdown. This has led to abuse, mental distress and even loss of life. The systemic denial of existence of queer identities can also be seen in the larger field of medical research, where there has been a marked absence of data[5] on how individuals undergoing hormone treatment will be affected by the vaccination.

It is easy to paint a pride flag onto an organisation’s logo, but addressing the difficulties of the community which were magnified during Covid-19 will require a larger structural change, including one of consciousness. A thorough understanding of the pre-existing situation is imperative. Simply painting rainbow flags in advertisements and superficial governmental policies do not save lives.

 


[1] https://www.ipsos.com/sites/default/files/ct/news/documents/2021-06/LGBT%20Pride%202021%20Global%20Survey%20Report_3.pdf

[2] https://www.indiaspend.com/gendercheck/denied-visibility-in-official-data-millions-of-transgender-indians-cant-access-benefits-services-754436

[3] https://timesofindia.indiatimes.com/city/kolkata/west-bengal-transgender-covid-ward-comes-to-rescue-as-activist-gets-infected/articleshow/79147210.cms

[4] https://www.thehindu.com/news/cities/mumbai/covid-19-lockdown-transgender-community-pushed-further-to-the-margin/article31265535.ece

[5] https://www.downtoearth.org.in/news/health/this-pride-month-the-lgbtqia-community-wants-to-talk-about-hea

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Do Baba Ramdev’s statements attract criminal liability?

The Yoga Guru has been infamously in the news for dissing modern science and anti-Covid vaccines

10 Jul 2021

coronilImage Courtesy:brandequity.economictimes.indiatimes.com

By claiming that his herbal concoction ‘Coronil’ is a cure for Covid-19, interestingly without any scientific data to corroborate his claim, Baba Ramdev has managed to upset many scientists and medical experts over the past few months.

Additionally, in a video circulated on social media, the Yogi allegedly criticised allopathy treatment and contentiously said, “Allopathy ek stupid aur diwaliya science hai, pehle chloroquine fail hogayi, phir remdesivir, phir anti-biotics fail hogaye, phir steroids inke fail hogaye, kal plasma therapy pe ban lag gaya aur fabiflu bhi fail hai..yeh kya tamasha ho raha hai? Laakhon logo ki maut allopathy ki davaiyaan khaane se hui hai”. (Allopathy is a stupid and bankrupt science, first chloroquine failed, then Remdesivir, then anti-biotics, steroids, plasma therapy was banned yesterday, and fabiflu failed too. Lakhs of people have died because of consuming allopathic medicines).

This statement by Ramdev did not go down well with the Indian Medical Association (IMA) that served a defamation notice on Ramdev for his disparaging remarks against allopathy and allopathic doctors, demanding an apology from him, failing which it said it will demand a compensation of Rs 1,000 crore. After a nudge from the Union Health Minister Dr. Harshvardhan, Ramdev was forced to retract his statement against allopathy and modern science, and also tendered an apology. However, he went on to tweet an open letter of “25 questions to IMA” on lines of treatment on not just Covid-19 but also diabetes, hypertension, spondylitis, etc. One question posed to the IMA was about whether allopathy can find a cure for rudeness and violent behaviour!

Ramdev has also been solely responsible for triggering people for his insensitive remarks against Covid-19 patients, mocking them for complaining about oxygen shortage. During one of his live yoga sessions in the beginning of May, The Quint reported him saying, “People are looking for cylinders outside while God has given you two cylinders right here inside you (referring to one’s lungs). Use them, fool! Two cylinders are here (pointing to his lungs), the two doctors are your legs, and two nurses are right here (pointing to his hands). Have some courage, they are just dying. There are no beds, no hospitals, not enough doctors, not enough medicines, no cremation grounds…a negative environment has been created everywhere.”

Ramkrishna Yadav alias Baba Ramdev, has also made objectional statements against vaccines saying that he did not feel the need to get inoculated since he had been practicing yoga-Ayurveda for decades, reported the Scroll.in. In another video from May, Ramdev claimed that 1,000 doctors died even after getting two doses of the vaccine. But in June, he decided against his own preaching and said that he will take the vaccine.

Yoga guru’s legal troubles

Ramdev’s statements are not only unverified and misleading, but attracts criminal liability. Multiple FIRs have been filed against him and Patanjali’s CEO Acharya Balkrishna, in the states of Bihar and Chhattisgarh, alleging that his comments are likely to cause prejudice to Covid-19 control, and dissuade patients to take allopathic treatment.

In Uttarakhand, the High Court is seized with the matter filed against Patanjali Ayurveda for making claims about Coronil vis-à-vis treatment of the deadly Covid-19 virus, in the absence of requisite permission from the Government. According to LiveLaw, the court has already issued a notice to the to the Central Government. On June 23, 2020, Patanjali had reportedly launched “Coronil and Swasari”, what it claims is the Ayurvedic cure for treating Covid, which they said has shown “100 per cent favourable results” during clinical trials on some affected patients.

But the Ministry of AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy), jumped in on the subject refraining Patanjali Ayurveda Limited to advertise/publicise such claims till the issue is duly examined. The Ministry had also clarified those facts of the claim and details of the stated scientific study are not known to it, and are uncorroborated. The company was also asked by the Ayush Ministry to provide at the earliest, details of the name and composition of the medicines being claimed for Covid treatment; site(s)/hospital(s), where the research study was conducted; protocol, sample size, Institutional Ethics Committee clearance, and results data of the studies

In June this year, Ramdev has approached the Supreme Court seeking clubbing of the multiple FIRs against him and praying for interim relief. He has been booked under various provisions of the Indian Penal Code and Disaster Management Act, 2005 for spreading misinformation. The Supreme Court has listed this matter (Swami Ramdev vs Union of India W.P Crl. No. 265 of 2021), on July 5 and has directed him “to file additional documents in the matter”. Chief Justice NV Ramana, Justices AS Bopanna and Hrishikesh Roy asked the yoga guru to produce video and transcripts of his statements on Allopathy cure for Covid, as per a LiveLaw report.

Is an apology enough?

The saffron robe clad Ramdev has amassed a lot of support and fan following including within the government over the years. As one of the most prominent faces of alternate medicines in India, his jibe at modern science and doctors has yet not gotten him into any trouble. Coronil, a traditional Indian medicine manufactured by Patanjali and launched in the presence of the Union Health Minister last year in June, was alleged to have been a cure for Covid-19.

Since it failed to scientifically substantiate its claim about Covid-19, the Central Government intervened to stop its marketing as an anti-Covid drug but allowed it to be sold as an “immunity booster”. As per a BBC report, on February 19 this year, Patanjali held another event in the presence of the health minister, at which claims were repeated that it could prevent and treat Covid-19.

Balkrishna told BBC, “It has treated and cured people”, while referring to the scientific trials, the results of which it says have been published in several peer-reviewed journals. It received AYUSH Ministry’s certification as ‘supporting measure’ for Covid-19 treatment in February. Patanjali’s statement read, “Coronil has received the Certificate of Pharmaceutical Product (CoPP) from the Ayush section of Central Drugs Standard Control Organisation as per the WHO certification scheme.” With some emerging rumours about WHO certification, the international body was forced to issue a statement clarifying their stand against approving any traditional medicine for Covid-19.

Despite the barrage of misinformation and unsolicited claims, Dr. Harshvardhan, who was the Union Health Minister at that time, thought its most appropriate to write him a letter asking him to withdraw all objectionable statements instead of prosecuting him. Is Ramdev above the law? Doesn’t law apply to everyone equally? An apology does not absolve an individual of legal liability, nor does it make the offence less punishable. Even as the medical community is fighting tooth and nail to contain the pandemic and misinformation, health authorities are not proactively taking a stand against the yoga guru.

According to an Indian Express report, the Maharashtra cyber police has arrested 342 people since the beginning of the pandemic last year for circulating misinformation, including in the form of social media posts, creating panic or peddling fake cures related to Covid-19. Self-proclaimed god man Ahmad Siddiqui who also called himself ‘Corona wale baba’ had put up a board outside his shop in Daliganj area, UP, claiming that he had a cure for the deadly virus. He was arrested by the Police in March, 2020 as per media sources. But Ramdev continues to enjoy immunity from arrests despite his scandalous and incorrect claims.

Brazen violations of the law

Some provisions under the Epidemics Act, Disaster Management Act, Indian Penal Code can be (and have been before some courts) easily invoked against Baba Ramdev. When last year, as discussed above, Patanjali had claimed that they have developed 100% cure for the Covid-19 through “Coronil and Swasari” medicines, the Ministry of Ayush had to refrain them for publicising the efficiency of this product. But why did it do so?

The answer lies in the April 21, 2020 directive, in which Ayush had imposed several conditions on the research for Covid-19 treatment using traditional means. As per these conditions, it was mandatory for the institution to apprise the Ministry of Ayush, the government of India about the research developments. An Ayush registered practioneer was also supposed to be a part of the research, but going by Patanjali’s declaration of finding a cure and Ayush’s intervention, it seems like Ramdev’s company missed a couple of steps.

Under the Disaster Management Act, 2005 (DMA), section 52 (Punishment for false claim) lays down that whoever knowingly makes a claim which he knows or has reason to believe to be false for obtaining any relief, assistance, repair, reconstruction or other benefits consequent to disaster from any officer of the Central Government, the State Government, the National Authority, the State Authority or the District Authority, shall, on conviction be punishable with imprisonment for a term which may extend to two years, and also with fine; 

Section 54: Punishment for false warning states: “Whoever makes or circulates a false alarm or warning as to disaster or its severity or magnitude, leading to panic, shall on conviction, be punishable with imprisonment which may extend to one year or with fine;

And section 60 states (Cognizance of offences), No court shall take cognizance of an offence under this Act except on a complaint made by— 

(a) the National Authority, the State Authority, the Central Government, the State Government, the District Authority or any other authority or officer authorised in this behalf by that Authority or Government, as the case may be; or 

(b) any person who has given notice of not less than thirty days in the manner prescribed, of the alleged offence and his intention to make a complaint to the National Authority, the State Authority, the Central Government, the State Government, the District Authority or any other authority or officer authorised as aforesaid. 

In addition to these, section 3 of the Epidemic Disease Act, 1897, states that any person disobeying any regulation or order made under this Act shall be deemed to have committed an offence punishable under section 188 of the Indian Penal Code. Section 188 of the IPC covers ‘Disobedience to order duly promulgated by public servant.’

All these provisions require prior sanction by the concerned public officer, state, centre, district or any other appropriate authority, making it the legal and moral responsibility of the State to initiate actions against Ramdev. He cannot take the defense under Article 19 (freedom of speech and expression), to push his anti-science agenda that can trigger a new level of public disorder. This is not an Ayurveda versus allopathy debate. It is about how the State decides to tackle false claims of thousands of doctors dying despite vaccine shots, or how allopathy has killed people!

Section 505(1) (b) of the Indian Penal Code, penalises people who make, publish or circulate any statement, rumour or report, with intent to cause, or which is likely to cause, fear or alarm to the public. Arguably Baba’s statements do fall under this section, making him liable for a criminal offence. The Supreme Court has accepted the higher moral responsibility of people with influence, who are supposed to be careful with the information they disseminate. In Amish Devgan vs Union of India (W.P Crl. No. 160 of 2020), the court said:

“Persons of influence, keeping in view their reach, impact and authority they yield on general public or the specific class to which they belong, owe a duty and have to be more responsible. They are expected to know and perceive the meaning conveyed by the words spoken or written, including the possible meaning that is likely to be conveyed. With experience and knowledge, they are expected to have a higher level of communication skills. It is reasonable to hold that they would be careful in using the words that convey their intent.”

Ramdev, a business tycoon

An upstart, so to speak, Ramdev helped launch Patanjali Ayurveda to initially sell herbal medicines, that eventually expanded as a huge business empire selling soaps, noodles, biscuits, diapers, vegetable oil, candles and even cow urine.

Prabir Purkayastha (engineer, science activist and President of Free Software Movement) explains his rise as someone who is not the first to have built an empire out of ‘babagiri’. “Many others have made religion a business, from Puttaparthi Saibaba to Sri Sri Ravi Shankar. Compare Sri Sri’s Rs. 50 crore annual revenue from his business to Ramdev’s Rs. 25,000 crore turnover from Patanjali Ayurveda, and we begin to see that the primary business of Ramdev is neither religion nor Yoga. It is leveraging his image as a ‘Yoga guru’ to become India’s latest billionaire”, he wrote for NewsClick.

Some people might even argue that Ramdev was one of the most televised Indian characters from hosting live yoga sessions with celebrities to being invited to the pro wrestling leagues and defeating Olympic medallists with his core strength. But Ramdev and Balkrishna preached much more than yoga and medicines. With Ramdev becoming an instant hit amongst the masses, his brand name helped Patanjali’s products to reach almost every household in the country. His rise as a yoga guru has been even more prominent after Prime Minister Narendra Modi’s win in 2014. According to an investigative report done by Reuters, Baba Ramdev used to allegedly send his followers/supporters into the streets to campaign which ultimately helped propel Modi’s win.

Besides his exponential rise, this is about Ramdev’s slanderous attitude that is worthy of reiteration. This does not only demoralise the spirits of all health professionals, but also disrespects and degrades the efforts of all frontline workers who have been facing extraordinary circumstances since early last year.

Related:

What do Ramdev and Adityanath have in common?
Indian Medical Association seeks FIR against Ramdev
Covid-19: IMA slaps Rs 1,000 crore notice on Patanjali boss Ramdev

Do Baba Ramdev’s statements attract criminal liability?

The Yoga Guru has been infamously in the news for dissing modern science and anti-Covid vaccines

coronilImage Courtesy:brandequity.economictimes.indiatimes.com

By claiming that his herbal concoction ‘Coronil’ is a cure for Covid-19, interestingly without any scientific data to corroborate his claim, Baba Ramdev has managed to upset many scientists and medical experts over the past few months.

Additionally, in a video circulated on social media, the Yogi allegedly criticised allopathy treatment and contentiously said, “Allopathy ek stupid aur diwaliya science hai, pehle chloroquine fail hogayi, phir remdesivir, phir anti-biotics fail hogaye, phir steroids inke fail hogaye, kal plasma therapy pe ban lag gaya aur fabiflu bhi fail hai..yeh kya tamasha ho raha hai? Laakhon logo ki maut allopathy ki davaiyaan khaane se hui hai”. (Allopathy is a stupid and bankrupt science, first chloroquine failed, then Remdesivir, then anti-biotics, steroids, plasma therapy was banned yesterday, and fabiflu failed too. Lakhs of people have died because of consuming allopathic medicines).

This statement by Ramdev did not go down well with the Indian Medical Association (IMA) that served a defamation notice on Ramdev for his disparaging remarks against allopathy and allopathic doctors, demanding an apology from him, failing which it said it will demand a compensation of Rs 1,000 crore. After a nudge from the Union Health Minister Dr. Harshvardhan, Ramdev was forced to retract his statement against allopathy and modern science, and also tendered an apology. However, he went on to tweet an open letter of “25 questions to IMA” on lines of treatment on not just Covid-19 but also diabetes, hypertension, spondylitis, etc. One question posed to the IMA was about whether allopathy can find a cure for rudeness and violent behaviour!

Ramdev has also been solely responsible for triggering people for his insensitive remarks against Covid-19 patients, mocking them for complaining about oxygen shortage. During one of his live yoga sessions in the beginning of May, The Quint reported him saying, “People are looking for cylinders outside while God has given you two cylinders right here inside you (referring to one’s lungs). Use them, fool! Two cylinders are here (pointing to his lungs), the two doctors are your legs, and two nurses are right here (pointing to his hands). Have some courage, they are just dying. There are no beds, no hospitals, not enough doctors, not enough medicines, no cremation grounds…a negative environment has been created everywhere.”

Ramkrishna Yadav alias Baba Ramdev, has also made objectional statements against vaccines saying that he did not feel the need to get inoculated since he had been practicing yoga-Ayurveda for decades, reported the Scroll.in. In another video from May, Ramdev claimed that 1,000 doctors died even after getting two doses of the vaccine. But in June, he decided against his own preaching and said that he will take the vaccine.

Yoga guru’s legal troubles

Ramdev’s statements are not only unverified and misleading, but attracts criminal liability. Multiple FIRs have been filed against him and Patanjali’s CEO Acharya Balkrishna, in the states of Bihar and Chhattisgarh, alleging that his comments are likely to cause prejudice to Covid-19 control, and dissuade patients to take allopathic treatment.

In Uttarakhand, the High Court is seized with the matter filed against Patanjali Ayurveda for making claims about Coronil vis-à-vis treatment of the deadly Covid-19 virus, in the absence of requisite permission from the Government. According to LiveLaw, the court has already issued a notice to the to the Central Government. On June 23, 2020, Patanjali had reportedly launched “Coronil and Swasari”, what it claims is the Ayurvedic cure for treating Covid, which they said has shown “100 per cent favourable results” during clinical trials on some affected patients.

But the Ministry of AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy), jumped in on the subject refraining Patanjali Ayurveda Limited to advertise/publicise such claims till the issue is duly examined. The Ministry had also clarified those facts of the claim and details of the stated scientific study are not known to it, and are uncorroborated. The company was also asked by the Ayush Ministry to provide at the earliest, details of the name and composition of the medicines being claimed for Covid treatment; site(s)/hospital(s), where the research study was conducted; protocol, sample size, Institutional Ethics Committee clearance, and results data of the studies

In June this year, Ramdev has approached the Supreme Court seeking clubbing of the multiple FIRs against him and praying for interim relief. He has been booked under various provisions of the Indian Penal Code and Disaster Management Act, 2005 for spreading misinformation. The Supreme Court has listed this matter (Swami Ramdev vs Union of India W.P Crl. No. 265 of 2021), on July 5 and has directed him “to file additional documents in the matter”. Chief Justice NV Ramana, Justices AS Bopanna and Hrishikesh Roy asked the yoga guru to produce video and transcripts of his statements on Allopathy cure for Covid, as per a LiveLaw report.

Is an apology enough?

The saffron robe clad Ramdev has amassed a lot of support and fan following including within the government over the years. As one of the most prominent faces of alternate medicines in India, his jibe at modern science and doctors has yet not gotten him into any trouble. Coronil, a traditional Indian medicine manufactured by Patanjali and launched in the presence of the Union Health Minister last year in June, was alleged to have been a cure for Covid-19.

Since it failed to scientifically substantiate its claim about Covid-19, the Central Government intervened to stop its marketing as an anti-Covid drug but allowed it to be sold as an “immunity booster”. As per a BBC report, on February 19 this year, Patanjali held another event in the presence of the health minister, at which claims were repeated that it could prevent and treat Covid-19.

Balkrishna told BBC, “It has treated and cured people”, while referring to the scientific trials, the results of which it says have been published in several peer-reviewed journals. It received AYUSH Ministry’s certification as ‘supporting measure’ for Covid-19 treatment in February. Patanjali’s statement read, “Coronil has received the Certificate of Pharmaceutical Product (CoPP) from the Ayush section of Central Drugs Standard Control Organisation as per the WHO certification scheme.” With some emerging rumours about WHO certification, the international body was forced to issue a statement clarifying their stand against approving any traditional medicine for Covid-19.

Despite the barrage of misinformation and unsolicited claims, Dr. Harshvardhan, who was the Union Health Minister at that time, thought its most appropriate to write him a letter asking him to withdraw all objectionable statements instead of prosecuting him. Is Ramdev above the law? Doesn’t law apply to everyone equally? An apology does not absolve an individual of legal liability, nor does it make the offence less punishable. Even as the medical community is fighting tooth and nail to contain the pandemic and misinformation, health authorities are not proactively taking a stand against the yoga guru.

According to an Indian Express report, the Maharashtra cyber police has arrested 342 people since the beginning of the pandemic last year for circulating misinformation, including in the form of social media posts, creating panic or peddling fake cures related to Covid-19. Self-proclaimed god man Ahmad Siddiqui who also called himself ‘Corona wale baba’ had put up a board outside his shop in Daliganj area, UP, claiming that he had a cure for the deadly virus. He was arrested by the Police in March, 2020 as per media sources. But Ramdev continues to enjoy immunity from arrests despite his scandalous and incorrect claims.

Brazen violations of the law

Some provisions under the Epidemics Act, Disaster Management Act, Indian Penal Code can be (and have been before some courts) easily invoked against Baba Ramdev. When last year, as discussed above, Patanjali had claimed that they have developed 100% cure for the Covid-19 through “Coronil and Swasari” medicines, the Ministry of Ayush had to refrain them for publicising the efficiency of this product. But why did it do so?

The answer lies in the April 21, 2020 directive, in which Ayush had imposed several conditions on the research for Covid-19 treatment using traditional means. As per these conditions, it was mandatory for the institution to apprise the Ministry of Ayush, the government of India about the research developments. An Ayush registered practioneer was also supposed to be a part of the research, but going by Patanjali’s declaration of finding a cure and Ayush’s intervention, it seems like Ramdev’s company missed a couple of steps.

Under the Disaster Management Act, 2005 (DMA), section 52 (Punishment for false claim) lays down that whoever knowingly makes a claim which he knows or has reason to believe to be false for obtaining any relief, assistance, repair, reconstruction or other benefits consequent to disaster from any officer of the Central Government, the State Government, the National Authority, the State Authority or the District Authority, shall, on conviction be punishable with imprisonment for a term which may extend to two years, and also with fine; 

Section 54: Punishment for false warning states: “Whoever makes or circulates a false alarm or warning as to disaster or its severity or magnitude, leading to panic, shall on conviction, be punishable with imprisonment which may extend to one year or with fine;

And section 60 states (Cognizance of offences), No court shall take cognizance of an offence under this Act except on a complaint made by— 

(a) the National Authority, the State Authority, the Central Government, the State Government, the District Authority or any other authority or officer authorised in this behalf by that Authority or Government, as the case may be; or 

(b) any person who has given notice of not less than thirty days in the manner prescribed, of the alleged offence and his intention to make a complaint to the National Authority, the State Authority, the Central Government, the State Government, the District Authority or any other authority or officer authorised as aforesaid. 

In addition to these, section 3 of the Epidemic Disease Act, 1897, states that any person disobeying any regulation or order made under this Act shall be deemed to have committed an offence punishable under section 188 of the Indian Penal Code. Section 188 of the IPC covers ‘Disobedience to order duly promulgated by public servant.’

All these provisions require prior sanction by the concerned public officer, state, centre, district or any other appropriate authority, making it the legal and moral responsibility of the State to initiate actions against Ramdev. He cannot take the defense under Article 19 (freedom of speech and expression), to push his anti-science agenda that can trigger a new level of public disorder. This is not an Ayurveda versus allopathy debate. It is about how the State decides to tackle false claims of thousands of doctors dying despite vaccine shots, or how allopathy has killed people!

Section 505(1) (b) of the Indian Penal Code, penalises people who make, publish or circulate any statement, rumour or report, with intent to cause, or which is likely to cause, fear or alarm to the public. Arguably Baba’s statements do fall under this section, making him liable for a criminal offence. The Supreme Court has accepted the higher moral responsibility of people with influence, who are supposed to be careful with the information they disseminate. In Amish Devgan vs Union of India (W.P Crl. No. 160 of 2020), the court said:

“Persons of influence, keeping in view their reach, impact and authority they yield on general public or the specific class to which they belong, owe a duty and have to be more responsible. They are expected to know and perceive the meaning conveyed by the words spoken or written, including the possible meaning that is likely to be conveyed. With experience and knowledge, they are expected to have a higher level of communication skills. It is reasonable to hold that they would be careful in using the words that convey their intent.”

Ramdev, a business tycoon

An upstart, so to speak, Ramdev helped launch Patanjali Ayurveda to initially sell herbal medicines, that eventually expanded as a huge business empire selling soaps, noodles, biscuits, diapers, vegetable oil, candles and even cow urine.

Prabir Purkayastha (engineer, science activist and President of Free Software Movement) explains his rise as someone who is not the first to have built an empire out of ‘babagiri’. “Many others have made religion a business, from Puttaparthi Saibaba to Sri Sri Ravi Shankar. Compare Sri Sri’s Rs. 50 crore annual revenue from his business to Ramdev’s Rs. 25,000 crore turnover from Patanjali Ayurveda, and we begin to see that the primary business of Ramdev is neither religion nor Yoga. It is leveraging his image as a ‘Yoga guru’ to become India’s latest billionaire”, he wrote for NewsClick.

Some people might even argue that Ramdev was one of the most televised Indian characters from hosting live yoga sessions with celebrities to being invited to the pro wrestling leagues and defeating Olympic medallists with his core strength. But Ramdev and Balkrishna preached much more than yoga and medicines. With Ramdev becoming an instant hit amongst the masses, his brand name helped Patanjali’s products to reach almost every household in the country. His rise as a yoga guru has been even more prominent after Prime Minister Narendra Modi’s win in 2014. According to an investigative report done by Reuters, Baba Ramdev used to allegedly send his followers/supporters into the streets to campaign which ultimately helped propel Modi’s win.

Besides his exponential rise, this is about Ramdev’s slanderous attitude that is worthy of reiteration. This does not only demoralise the spirits of all health professionals, but also disrespects and degrades the efforts of all frontline workers who have been facing extraordinary circumstances since early last year.

Related:

What do Ramdev and Adityanath have in common?
Indian Medical Association seeks FIR against Ramdev
Covid-19: IMA slaps Rs 1,000 crore notice on Patanjali boss Ramdev

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