Maharashtra government hospitals run out of life-saving basic drugs as non-Covid attendance rises again

ON MARCH 25, Kaliprasad Ramlakhan, 36, was rushed to JJ Hospital in Mumbai, the largest public hospital in Maharashtra, after being bitten by a dog. Since he didn’t even have basic medications like TT injections and antibiotics like amoxicillin, his brother had to queue at a nearby private pharmacy.

“There were no drugs in the hospital. He even refused to give me an anti-rabies injection from his stocks, although he agreed when I begged,” said Ramlakhan, who had a high fever and had to wait outside the building. ‘hospital. It’s another matter that JJ Hospital receives over 30 dog bite cases a day for treatment.

Ramlakhan’s case is not isolated. With the outbreak of the Covid-19 pandemic in early 2020, patient attendance at OPD wards and emergency departments in public hospitals in Maharashtra dropped by almost 70%, according to the public health department. of State. Now, with the flattening of the pandemic curve, these hospitals are inundated with non-Covid patients. For example, the number of patients visiting JJ Hospital daily has nearly doubled to 1,100 since February this year, from 600 in 2020-21. A senior doctor at the hospital said: “Most patients have refrained from visiting hospitals during the pandemic. Now patients with more serious complications are rushing to hospitals. To meet demand, we have also added beds.

Maharashtra’s official nodal body for centralized drug procurement, Haffkine Bio-Pharma Corporation, Mumbai, however failed to foresee the sudden increase in drug requirements and delayed the annual procurement of more than 2,500 types of non-Covid medicines, which has resulted in the 18 state public hospitals affiliated with government medical colleges (GMCs) now running out of even basic life-saving medicines.

Therefore, hospitals refuse to treat even patients with diabetes and hypertension. A 57-year-old unemployed man from Dogri, Hasan Mehdi, who is a chronic diabetic patient, was forced to pay Rs 2,000 per month for medicine. “I have to ask my relatives to support me financially for my medication,” he said.

The Maharashtra Association of Resident Physicians unit of the Yavatmal Government Medical College has already submitted to Dean of Shri Vasantrao Naik GMC on March 22 a list of 34 life-saving drugs that have disappeared from the shelves. Pointing to shortages of “emergency and essential” drugs for months, resident doctors said they “encountered many difficulties when treating patients” at the hospital.

The plight of patients in rural districts like Latur, Amravati, Dhule, who depended on free treatment and medicine from public hospitals, is more distressing. A 39-year-old worker from Dhule, Amir Ali Siddiqui, recently suffered severe burns to his hand while making roti. All he could get at Shri BhausahebHire Government Medical College (SBHGMC), Dhule was paracetamol. “I had to spend 650 rupees to buy medicine (amoxicillin, pantoprazole and polyvitamin tablets) outside,” he said.

Due to limited drug supplies, hospitals have asked their doctors to “rationalize” the use of drugs, placing them in a moral dilemma. “For us, all patients are equal. It is ethically wrong on our part to rationalize the use of drugs when a patient needs them. But due to the situation, we are forced to provide the limited drugs only to emergency patients and ask others to purchase them from outside,” said a resident doctor at Yavatmal GMC.

When The Indian Express visited the OPD ward at JJ Hospital, several patients and their relatives were seen pleading in front of hospital staff at the drug counters. “We were given targets for daily drug allocation. We cannot surpass him to help patients because we are responsible,” a hospital staff member said.

Dr Pallavi Saple, Dean of JJ Hospital, said: “Currently we are procuring the drugs locally to deal with the shortage. We gave Haffkine the list of medications needed. We hope to get the drugs within the next 15 days. In addition, she asked the hospital’s pharmacy department to make her needs known a month in advance.

The issue of drug shortages at JJ Hospital has also reached the Assembly. When contacted, Minister of Medical Education Deshmukh blamed Deans and Superintendents of medical schools for the delay in passing their request for the drugs which led to the crisis. “They have to submit their request for the purchase of drugs to the government in advance… They have to be more efficient so that there is no lag in the procedures. It is about reforming the whole structure,” he said.

Many hospital deans have refuted these accusations and singled out Haffkine for “their failure to meet the bulk drug purchase requirement resulting in the shortfall”.

When contacted, Dr Madhavi Khode Chaware, Medical Director of Haffkine Bio-Pharma, said technical issues were to blame for the delay. “In some cases, despite issuing a call for tenders, we were unable to place the order because the consignment list was with DMER. Without this list, I didn’t know the college requirements for placing orders. To address this issue, the state has for the first time linked drug supply to the centralized E-Aushadhi portal. “With the start of the portal, we will get real-time updates on requirements and supplies, resolving intermediate issues. We have cleared all tenders from last year. Also, we will start our inspection from Monday, starting with Yavatmal GMC,” she said.

A Haffkine officer, who did not wish to be named, said that during the pandemic they have mainly focused on procuring drugs for the treatment of Covid patients. “We have almost 40% vacancies in the department, including in the purchasing cell. We are therefore overwhelmed with purchases of Covid and non-Covid drugs. Many of our existing employees have contracted Covid which has further delayed our procurement process,” the officer said.

In addition to this, the pandemic has also disrupted the supply of essential materials needed for the production of drugs from China, Japan and other countries, due to which manufacturers, according to the officer, were struggling to meet the demand for non-Covid medicines. “There were nearly 30% fewer responses from bidders,” the officer said.

Drug vendors, however, said they had ‘boycotted’ the tender process due to their pending dues worth nearly Rs 220 crore for the supply of drugs and drugs. non-surgical equipment to 18 public hospitals. All Food And Drug License Holder’s Foundation (AFDLHF) Chairman Abhay Pandey said the vendors have yet to receive their 2019-20 dues of Rs 90 crore and 2020-21 of Rs 30 crore from Haffkine. The Directorate of Medical Education and Research (DMER) also owed around Rs 100 crore to the suppliers. “We’re still compiling pending dues for the current fiscal year,” Pandey said.

This is despite the fact that the state government has made a provision of Rs 2,077 crore for the procurement of drugs in 2021-2022. Asked about this, Minister Deshmukh said it was up to the authorities to look into the discrepancies in drug supply. “It takes a while to clear the (procurement) records. After due diligence, vendor dues will also be settled,” he said.

Deshmukh said the department has also issued rules allowing deans to procure drugs from District Planning Committee (DPC) funds.

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