The second wave of COVID-19 in Gujrat state has exposed this Gujrat model. According to senior government officials, there is a severe shortage of doctors and medical personnel besides oxygen, beds and other life-saving equipment in the state’s 18,000 villages spread over 33 districts.
Many districts in Gujarat have a single community or healthcare centre for eight-ten neighbouring villages. Some of these centres do not even have facilities for rapid antigen tests. People’s reluctance to follow COVID-19 guidelines and social distancing norms as well as ‘vaccine hesitancy’ is making the situation worse.
Manish Doshi, the state Congress spokesperson claimed in a letter to Chief Minister Vijay Rupani that COVID-19 was present in all 18,000 villages of Gujarat. Posts for doctors, nurses and Para-medical staff were vacant as the state government had not yet filled them, Doshi wrote. If proper steps were not taken to curb the contagion’s spread in rural areas, the situation would become extremely grave, he said. The health facilities are under immense pressure.
Gujarat had a population of 60 million according to the 2011 Census of India. Some 0.53 million people have been infected with COVID-19 so far in the state. The district of Mahesana in north Gujarat has the highest caseload among the rural districts of Gujarat. It is the home district of Gujarat’s health minister, Nitin Patel.
Why Gujrat is facing a health crisis of this magnitude? Because Gujrat spend lowest amount on health sector compare to other rich states. No wonder then that when it comes to diseases like swine flu dengue, heart diseases, diabetes and chronic obstructive pulmonary disorder, Gujarat’s numbers are among the highest.
According to the National Health Profile (NHP) report brought out this year, Gujarat spends Rs 1,189 on every citizen in a budget year, and it spends just 0.72% of its GSDP on health.
Gujarat has a legacy of a bad public healthcare system. The four terms of Narendra Modi as chief minister of the state played an important role in creating this legacy.
Modi became the prime minister while flaunting the Gujrat Model of Development in 2014. He had been the chief minister (CM) of Gujarat for almost 13 years from 2001 to 2014. Modi’s achievements as chief minister of Gujarat in the field of public healthcare may reflect on his healthcare policy at the Centre, and help us understand his response to the coronavirus pandemic.
Currently, Gujrat has 0.33 hospital beds per 1,000 populations. There is only one state that has smaller ration – Bihar. The national average is 0.55 beds per 1,000 populations. This disparity between Gujarat and the national average needs to be understood. According to the World Health organisation, India had 0.70 hospital beds per 1,000 of population in 2011.
Gujarat was ranked 17 among the 18 largest states in India by the Reserve Banks of India in terms of social sector spending. Gujarat was spending only 31.2% of its total budgetary expenditure on the social sector.
In terms of per capita health expenditure, Gujarat’s rank slipped from fourth in 1999-2000 to 11th position in 2009-10. During the same period, Assam improved from the 12th to the third position and Uttar Pradesh from the 15th to ninth position. In 1999-2000, Gujarat was spending 4.39% of its total state expenditure on health, but by 2009-10 this came down to 0.77%.
In terms of health expenditures as a share of NSDP, Gujarat went down from 0.87% to 0.73% between 1999-00 and 2009-10, while the average of major states increased from 0.95% to 1.04% during the same period.
Tamil Nadu and Assam almost doubled their expenditures during the same period. This indicates the increasing disinterest of the Gujarat government in public health services.
Gujrat has one of the highest fatality rate from COVId-19 pandemic. The high fatality rate in Gujarat perhaps reflects the alarming conditions of the public health system in the state. There is a need to understand this, particularly since Gujarat has been projected as the model state in the past for India to follow.
The right wing Hindu nationalist Indian Prime Minister Narendra Modi with the help of corporate media builds his image of a chief minister who transformed the state of Gujrat. His image was built as a clean, effective and efficient administrator who economically lifted the state of Gujrat.
Gujrat was presented as a ‘model state.’ New highways, flyovers, industries and other infrastructure development was showcased to build his image of a strong leader capable to brought unprecedented economic development and growth to India that India never experienced before.
He mixed economic growth with Hindutva agenda to reach out to wider electorate. His tarnished image being a butcher of Gujrat was transformed into a leader who could take India to new heights. The image of Modi was promoted that bring multinational corporations to Gujrat. Gujrat was a shining example of Modi’s leadership qualities.
But he deliberately ignored the social development including public health. The COVID-19 pandemic has exposed the Gujrat Model as far as social progress and development is concern. Gujrat has slipped in all the social indicators in last 20 years.
Reports from villages say this is already the state of affairs. Chandrakant Parmar from the prosperous Kherva village in Mehsana district told the media that more than 80 people had died there during March and April.
The village that lies on the state highway between the cities of Gandhinagar and Mehsana has a population of 15,000. It is said to be witnessing three-four deaths daily. Infection numbers surged rapidly in April.
The village has a primary health care centre with 25-30 staff including a doctor, 10-15 nurses and paramedical staff. But intensive care units, CT-Scans, sonography and oxygen cylinders are not available in the village hospital.
The village sarpanch did arrange for a 200-bed quarantine centre. However, a lot of people are still quarantined at their homes. The village also receives patients from 15-16 odd neighbouring villages. Kherva has about 500 COVID-189 patients according to the sarpanch.
The situation at Kherva’s health centre is becoming increasingly difficult to manage due to increasing caseload and shortages of medical personnel and equipment.
This is not just the situation of just one village and primary health care centre in rural Gujrat. Many villages and primary health care centres are facing the similar situation. BJP is ruling the state of Gujrat for last 26 years.
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