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How Many Indian Health Workers Have Lost Their Lives in the Time of COVID?

How Many Indian Health Workers Have Lost Their Lives in the Time of COVID?

Representative image. Photo: Reuters

  • The Union health ministry recently said it had settled insurance claims raised by families of 1,509 healthcare workers who had died while on duty during the pandemic.
  • However, the ministry has once again dodged the question of how many healthcare workers have died in all – and not just those whose families’ claims were settled.
  • The head of the IMA called the government’s position that it doesn’t know how many workers died overall “bogus” and that they’d shared the data with the ministry.
  • The IMA and other medical workers’ associations also said even the insurance claims numbers must be an underestimate, and the claims process is “cumbersome”.

New Delhi: Two years after the start of the COVID-19 pandemic, and after two major outbreaks of its own, the Indian government does not know how many healthcare workers have died in the line of duty.

Replying to a question in the Rajya Sabha to this effect on December 7, Bharti Pravin Pawar, the minister of state for health and family welfare, said families of 1,509 healthcare workers “who died due to COVID-19-related duties” have been paid insurance claims of Rs 50 lakh each under the ‘Pradhan Mantri Garib Kalyan Yojana’.

This is the first time after the second wave the government has shared data on insurance claims by families of deceased healthcare workers.

This said, Pawar’s reply wasn’t the definitive reply to the query, by Trinamool Congress MP and former Indian Medical Association (IMA) president Santanu Sen: “The details of doctors and other healthcare workers who succumbed to death due to COVID-19 in the 1st and 2nd wave of COVID-19”.

The fuller answer would have been to share details of all healthcare workers who lost their lives on the job – not just those whose families’ insurance claims were settled.

The Union government has consistently been cagey about this figure since the start of India’s COVID-19 epidemic.

In September last year, for example, the then minister of state for health and family welfare Ashwini Choubey said his ministry had no data about the number of healthcare workers who had died. But like Pawar, he added that 155 insurance claims had been settled.

Choubey’s response prompted the IMA to issue an angry statement saying the ministry’s choice to “feign ignorance “ on this count was “abominable”. It also published state-wise data that indicated 382 doctors – who form just one segment of healthcare workers – had died until then while caring for COVID-19 patients.

Six months later, in March 2021, Choubey refused once again to share information in Parliament about healthcare workers, saying this time that health was a state subject.

Aside from doctors, India’s phalanx of healthcare workers includes nurses, Accredited Social Health Activists (ASHAs), auxiliary nursing midwives (ANMs), paramedical staff, ambulance drivers and all others employees of medical care facilities.

According to Choubey’s response in September last year, of the 155 insurance claims that the government had settled, 64 were from families of doctors, 32 from nurses, 14 from ASHA workers and 45 pertaining to ‘others’. Pawar didn’t include such a break-up in his reply on December 7, however.

IMA national president J.A. Jayalal told The Wire Science he sensed déjà vu because the government’s estimate that 1,509 healthcare workers had died on the job seemed like an underestimate – much like the 155 figure. He added that the IMA, which only deals with doctors and not other healthcare workers, has disaggregated state-wise data for 1,594 deaths on the line of duty, and that he has made a representation to the Union health ministry to this end.

“We are cleaning up data of another 200 doctors, at least,” Jayalal added. “So the sum total of doctors itself is more than 1,700.”

He also called the government’s claim that it doesn’t have data about all the healthcare workers who have died of COVID-19 “bogus”. “We have submitted details with names, addresses and specialities. All that was left to be done was to get our details verified by the respective district collectors.”

As the IMA has kept track of doctors, Roy K. George, the president of the Trained Nurses Association of India (TNAI), said that according to a “limited exercise” the TNAI conducted, 126 nurses lost their lives through India’s two major COVID-19 outbreaks.

“Only 40% families out of these 126 have got [their] insurance claims [cleared],” George told The Wire Science.

There’s more: “A large majority of nurses who work in small towns or even otherwise are not registered,” Swati Rane, a core team member of Jan Swasthya Abhiyan, said. “There is no data as to how many of those nurses who were not registered died while treating COVID-19 patients.”

National secretary of the Centre for Indian Trade Unions, A.R. Sindhu, has been working with ASHA and anganwadi workers for more than a decade now. “We reach roughly only 1 lakh ASHA workers while there are more than 10 lakh. Even within our limited reach, we have gathered data that says at least 150 ASHA workers have died,”  she told The Wire Science.

“As many as 78 anganwadi workers have died in Uttar Pradesh, 50 in Andhra Pradesh and 19 in Karnataka,” Sindhu added. Of their families, only 21 managed to have their insurance claims settled.

The Wire Science couldn’t obtain reliable data about the number of ANMs, paramedical staff and other staff members of hospitals who had died while dispensing their duties.

Beyond numbers

This said, all association representatives The Wire Science spoke to agreed on one thing: that the family members who did seek insurance compensation have had to run from pillar to post to get them settled.

The reasons they cited were also common, for the most part. If a healthcare worker hadn’t been working in a facility directly related to COVID care at the time of their death, their family’s claims would face a lot of resistance or be rejected outright.

“There was a time when governments were appealing to all kinds of doctors and other healthcare workers – whether working in hospitals or clinics – to restart their services after they had closed during the lockdown,” Anita Panwar, president of the All India Nursing Staff Association, said.

“Now, many hospitals and clinics treated patients who had come for treatment for various diseases other than COVID, but unknowingly carried a SARS-CoV-2 infection with them, and if healthcare workers got the infection from them, it wasn’t considered … fit for compensation.”

IMA president Jayalal said the same thing.

Pawar’s reply in the Rajya Sabha on December 7 had said one of the conditions that an insurance claim will need to meet to be settled is that the worker “should have been working as frontline health workers, who may have to be in direct contact and care of COVID-19 patients and who may be at risk of being impacted by this” (sic).

However, Panwar, of the All India Nursing Staff Association, said she knew of some nurses who had served in COVID-19 wards, who were suspected of having COVID-19 themselves but whose tests came back negative. “Their claims were outrightly rejected.”

TNAI president George said he was also aware of nurses who didn’t die directly due to COVID-19 but of post-COVID complications, and that the claims of their family members weren’t accepted.

The process of submitting applications and following up has also taken a toll on family members already grieving the loss of their loved ones. Association representatives who spoke to The Wire Science called the experience “cumbersome”.

First, claimants have to submit their application at the district level, wherefrom it winds its way through multiple approvals before reaching the insurance company. The company then initiates its own vetting process – typically in the form of a barrage of questions that claimants need to answer, sometimes for the second time – even as it retains its discretion to judge each claim.

“If at one stage a bureaucratic error comes up, it would take a whole lot of effort to get it rectified and bring the process to fruition,” Jayalal said. “Some family members became so frustrated that they just gave up. Is this how martyrs ought to be treated?”

The representatives have said that instead of settling insurance claims to the tune of Rs 50 lakh each, the Indian government should consider direct compensation through verification at the district level itself.

They also said they don’t mind if the compensation amount is lower – as long as there is something meaningful at the end of it, to save family members from as much of the effort they need to put in right now as possible.

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