‘Cannon fodder’: Medical students in India feel betrayed

‘Cannon fodder’: Medical students in India feel betrayed
A health worker prepares to administer a dose of the Covishield, Oxford-AstraZeneca coronavirus vaccine, at a vaccination center in Mumbai on April 1, 2021. (File/AFP)
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Updated 27 April 2021

‘Cannon fodder’: Medical students in India feel betrayed

‘Cannon fodder’: Medical students in India feel betrayed
  • India spends 1.3% of its GDP on health care, less than all major economies
  • On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, 2,771 deaths in the past 24 hours

NEW DELHI: Since the beginning of the week, Dr. Siddharth Tara, a postgraduate medical student at New Delhi’s government-run Hindu Rao Hospital, has had a fever and persistent headache. He took a COVID-19 test, but the results have been delayed as the country’s health system implodes.

His hospital, overburdened and understaffed, wants him to keep working until the testing laboratory confirms he has COVID-19.

On Tuesday, India reported 323,144 new infections for a total of more than 17.6 million cases, behind only the United States. India’s Health Ministry also reported another 2,771 deaths in the past 24 hours, with 115 Indians succumbing to the disease every hour. Experts say those figures are likely an undercount.

“I am not able to breathe. In fact, I’m more symptomatic than my patients. So how can they make me work?” asked Tara.

The challenges facing India today, as cases rise faster than anywhere else in the world, are being compounded by the fragility of its health system and its doctors.

There are 541 medical colleges in India with 36,000 post-graduate medical students, and according to doctors’ unions constitute the majority at any government hospitals — they are the bulwark of the India’s COVID-19 response.

But for over a year, they have been subjected to mammoth workloads, lack of pay, rampant exposure to the virus and complete academic neglect.

“We’re cannon fodder, that’s all,” said Tara.

In five states that are being hit hardest by the surge, postgraduate doctors have held protests against what they view as administrators’ callous attitude toward students like them, who urged authorities to prepare for a second wave but were ignored.

Jignesh Gengadiya, a 26-year-old postgraduate medical student, knew he’d be working 24 hours a day, seven days a week when he signed up for a residency at the Government Medical College in the city of Surat in Gujarat state. What he didn’t expect was to be the only doctor taking care of 60 patients in normal circumstances, and 20 patients on duty in the intensive care unit.

“ICU patients require constant attention. If more than one patient starts collapsing, who do I attend to?” asked Gengadiya.

Hindu Rao Hospital, where Tara works, provides a snapshot of the country’s dire situation. It has increased beds for virus patients, but hasn’t hired any additional doctors, quadrupling the workload, Tara said. To make matters worse, senior doctors are refusing to treat virus patients.

“I get that senior doctors are older and more susceptible to the virus. But as we have seen in this wave, the virus affects old and young alike,” said Tara, who suffers from asthma but has been doing regular COVID-19 duty.

The hospital has gone from zero to 200 beds for virus patients amid the surge. Two doctors used to take care of 15 beds – now they’re handling 60.

Staff numbers are also falling, as students test positive at an alarming rate. Nearly 75% of postgraduate medical students in the surgery department tested positive for the virus in the last month, said a student from the department who spoke anonymously out of fear of retribution.

Tara, who’s part of the postgraduate doctors association at Hindu Rao, said students receive each month’s wages two months late. Last year, students were given four months’ pending wages only after going on hunger strike in the midst of the pandemic.

Dr. Rakesh Dogra, senior specialist at Hindu Rao, said the brunt of coronavirus care inevitably falls on postgraduate students. But he stressed they have different roles, with postgraduate students treating patients and senior doctors supervising.

Although Hindu Rao hasn’t hired any additional doctors during the second wave, Dogra said doctors from nearby municipal hospitals were temporarily posted there to help with the increased workload

India — which spends 1.3% of its GDP on health care, less than all major economies — was initially seen as a success story in weathering the pandemic. However, in the succeeding months, few arrangements were made.

A year later, Dr. Subarna Sarkar says she feels betrayed by how her hospital in the city of Pune was caught completely off guard.

“Why weren’t more people hired? Why wasn’t infrastructure ramped up? It’s like we learnt nothing from the first wave,” she said.

Belatedly, the administration at Sassoon Hospital said last Wednesday it would hire 66 doctors to bolster capacity, and this month increased COVID-19 beds from 525 to 700.

But only 11 new doctors have been hired so far, according to Dr. Murlidhar Tambe, the hospital’s dean.

“We’re just not getting more doctors,” Tambe said, adding that they’re struggling to find new technicians and nurses too.

In response to last year’s surge, the hospital hired 200 nurses on a contractual basis but fired them in October after cases receded. Tambe said the contract allowed the hospital to terminate their services as it saw fit.

“Our primary responsibility is toward patients, not staff,” the dean said.

Cases in Pune city have nearly doubled in the last month, from 5,741 to 10,193. To deal with the surge, authorities are promising more beds.

Sarkar, the medical student at Sassoon Hospital, says that’s not enough.

“Increased beds without manpower are just beds. It’s a smokescreen,” she said.

To handle the deluge, students at Sassoon said authorities had weakened rules meant to keep them and patients safe. For instance, students work with COVID-19 patients one week and then go straight to working with patients in the general ward.

This increases the risk of spreading infections, said Dr. T. Sundararaman of the University of Pennsylvania’s National Health Systems Resource Center.

Students want hospital administration to institute a mandatory quarantine period between duty in the COVID-19 and general wards.

Over the last month, 80 of the hospital’s 450 postgraduate students have tested positive, but they only get a maximum of seven days of convalescence leave.

“COVID ruins your immunity, so there are people who are testing positive two, three times because their immunity is just so shot, and they’re not being allowed to recover,” said Sarkar.

And after a year of processing COVID-19 tests, she says she knows everything there is to know about the virus, but little else. Nationwide, diverting postgraduate students to take care of COVID-19 patients has come at a cost.

At a government medical college in the city of Surat, students said they haven’t had a single academic lecture. The hospital has been admitting virus patients since March of last year, and postgraduate medical students spend almost all their time taking care of them. The city is now reporting more than 2,000 cases and 22 deaths a day.

Having to focus so heavily on the pandemic has left many medical students anxious about their future.

Students studying to be surgeons don’t know how to remove an appendix, lung specialists haven’t learned the first thing about lung cancer and biochemists are spending all their time doing PCR tests.

“What kind of doctors is this one year going to produce?” said Dr. Shraddha Subramanian, a resident doctor in the department of surgery at Sassoon Hospital.


Uncertainty looms over successor as head of ‘world’s largest family’ dies in India

Uncertainty looms over successor as head of ‘world’s largest family’ dies in India
Updated 16 June 2021

Uncertainty looms over successor as head of ‘world’s largest family’ dies in India

Uncertainty looms over successor as head of ‘world’s largest family’ dies in India
  • Chana, aged 76, is survived by 38 wives, 89 children, 36 grandchildren

NEW DELHI: A question mark was on Tuesday hanging over who would become the new head of reportedly the world’s largest family, two days after the death of 76-year-old Ziona Chana.

Chana, patriarch of a Christian religious sect of 2,000 people that practiced polygamy, died in Aizawl, capital of India’s Mizoram state, on Sunday, without naming a successor.

The cult leader, who was believed to have suffered from diabetes and hypertension, is survived by 38 wives, 89 children, and 36 grandchildren.

His eldest son, 60-year-old Para Nunparliana, told Arab News: “The successor will be decided by the church. First, the burial will take place, and then the church will decide.” He has two wives and 11 children and is widely tipped to be the next in line to head the 163-member family.

Meanwhile, Chana’s daughter Thartei Chhuanthar, 50, told Arab News: “A special burial chamber is being prepared for our father, and he will be laid to rest in the next two to three days.”

Mother-of-four Chhuanthar is Chana’s fifth child but does not know how many siblings she has. “It’s difficult to say,” she said.

She grew up in the remote village of Baktawng, more than 50 kilometers from her present home in Aizawl and spent a major part of her life with the extended family.

“My father was shy and a man of few words. He did not speak much, but he did love everyone equally. There was no favoritism. He was gifted, and he wrote songs for the children to learn on every Sunday school,” she added.

The Chana family lives in a four-storey building with 100 rooms in Baktawng, and a separate school and playground has been allotted to it in the village.

The family runs the Chana Pawl sect with most of its followers residing around Chana’s house in Baktawng.

Chhuanthar said that while the family was Christian, its members did “not follow normal practices of the church. Chhuanthar kohhran means church of the new generation. They believe that they are the selected ones, going through the great road toward heaven. And will reach their destination in the flesh.”

Claims that Chana headed the world’s largest family have been disputed, with media reports suggesting that Winston Blackmore, leader of a polygamous Mormon sect in Canada, has around 150 children from 27 wives, making a total family membership of 178 people.

However, in a condolence message to the Chana family, Mizoram Chief Minister Zoramthanga described it as “the world’s largest family,” and it has featured twice on TV show “Ripley’s Believe It or Not!”

During the 1990s, Baktawng village became something of a global tourist attraction on the back of the family’s notoriety.

Founded by Pu Khuangtuaha in 1942, the polygamous sect was taken over by his brother, Pu Chana, after Khuangtuaha’s death and later by his son, Ziona Chana.

“I expect that after our father’s death, my elder brother Para will take over too,” Chhuanthar said.

Chana first married at the age of 17, with his last wedding taking place in his 50s. During a 2007 interview with Arab News, Chana said: “I want to expand the family as much as possible.”


Afghan translators of departing foreign forces face a mortal danger: Taliban retaliation

Afghan translators of departing foreign forces face a mortal danger: Taliban retaliation
Updated 16 June 2021

Afghan translators of departing foreign forces face a mortal danger: Taliban retaliation

Afghan translators of departing foreign forces face a mortal danger: Taliban retaliation
  • Planned withdrawal by US and NATO troops will leave thousands of interpreters and other assistants exposed
  • Process of resettlement in Western countries complicated by need for recommendation letters and other documents

KABUL: Back in the spring of 2013, Tajik Mohammed was enjoying his leave in the small garden of his family home in the lush village of Kapisa when he learnt that the Taliban had put him on a blacklist. His crime? He was working as a translator for the US military.

Under cover of night, the high-school graduate was forced to flee 110 kilometers south to Kabul, the Afghan capital, where he has remained ever since. His family followed after the Taliban “threw a hand grenade one day” at their house, thinking he was there.

Mohammed, 32, worked for American troops in restive Ghazni province, which lies on the main highway leading to the Taliban’s bastion of support in the south.

He subsequently lost his job for failing to return to duty on time because he could not travel by air from Kapisa to Ghazni. He pointed out that if he had taken the trip by road, the Taliban would have killed him.

He and thousands like him are living in fear. In April, US President Joe Biden announced that he would be withdrawing the estimated 3,500 American troops stationed in Afghanistan by September, 20 years after the Al-Qaeda attacks on New York City and Washington, D.C.

Officials at the US embassy said they could not provide data on the percentage of applicants who had been turned down for special immigration visas or the number of former translators and employees who had been killed over the years. (AFP)

The withdrawals started on May 1. Departing with the American forces are their NATO allies and thousands of foreign military contractors. They leave behind those Afghans who have worked as translators, cooks, cleaners, and guards. Many are fearful that the militants will seek retaliation.

US-led efforts to reconcile the Taliban with the government of Afghan President Ashraf Ghani in Kabul have not borne fruit since talks began in Qatar last year.

Last week the Taliban, a grouping of mainly Pashtun militants who harbored Osama bin Laden and ruled Afghanistan for five years until 2001, said that they no longer considered the former employees of foreign forces as “foes.” But the militants noted that the workers needed to show “remorse” and should not use “danger” as an excuse to bolster their push for a “fake asylum case.”

In the past, the Taliban openly preached that Afghan translators should be killed. “You are a legitimate target for the Taliban even if you have served for one day for the foreign forces. I have no faith in the Taliban’s promise,” Mohammed told Arab News.

“Who killed so many journalists and civil society activists? Of course, (it was) the Taliban. But they did not take responsibility for them. We risked our lives while working for the foreign forces and now that they are leaving, there is no guarantee at all for our future and we face risk again,” he said.

Mohammed is a member of the Afghans Left Behind Association (ALBA), a union of 2,000 former translators and workers. The group was recently formed with the purpose of highlighting the voices and concerns of those who say they will be targeted once NATO forces leave.

Last week, ALBA held its first large-scale gathering under tight security in Kabul. A number of the former translators wore masks to protect their identities. No One Left Behind, an American non-profit organization that advocates for the relocation of Afghan interpreters to the US, said that according to US media reports more than 300 translators or their relatives had been killed since 2014.

Omid Mahmoodi, an ALBA press officer, said the Taliban killed at least one member of the union, named as Sohail Pardis, as he was driving in Khost province in southeastern Afghanistan, near the border with Pakistan.

In April, US President Joe Biden announced that he would be withdrawing the estimated 3,500 American troops stationed in Afghanistan by September. (AFP)

Another translator said he had moved to Kabul from his native Nangarhar province after receiving a threatening telephone call, naming him as an “apostate” who “deserved to be killed.”

Thousands have submitted applications for special immigration visas (SIVs) which allow them to emigrate to the US. Successful applicants need to prove that they served with US forces for at least two years and demonstrate that they provided “faithful and valuable service.”

This is usually attested by US military officers in the form of a letter of recommendation. Successful applicants typically also need to show that they have received evidence that they had been threatened. Those who are unsuccessful often lack documentation or are the subject of “derogatory information.”

The translators have been the eyes and ears for American troops and accompanied them during military campaigns against the Taliban and other militants. They have helped with the arrests of insurgents as well as the controversial searching of homes.

They have also acted as cultural advisers in what is a highly conservative society, helping foreign troops understand tribal, ethnic, and religious sensitivities, while in addition coordinating with Afghan forces.

Mohammed has recently applied for an SIV at the American embassy in Kabul. Thousands of translators from Afghanistan and Iraq have relocated to America using this mechanism as a reward for helping the US troops. “The answer I got through an embassy email asked me why I was terminated, where my recommendation letters were, etc,” he said.

“But the people we worked with in the US military have gone home, changed their addresses and even their profession, so it is tough for us to get hold of them, get the answers and pass them to the embassy here.”

Officials at the US embassy said they could not provide data on the percentage of applicants who had been turned down for an SIV or the number of former translators and employees who had been killed over the years.

Feraidoon, a 28-year-old former translator in Ghazni, told Arab News that he had had his SIV rejected in 2015 but had recently applied again. “The embassy says I do not have sufficient recommendation letters. We have no trust in the Taliban and see no commitment in them because they consider us as traitors, sell-outs and spies,” he said.

Mohammed Basir, 46, who worked for five years with French troops in Kapisa until 2013, said he had appeared in press conferences while translating on TV and had become a “known face” and feared reprisal. “The Taliban will spare no time to behead us if they capture people like me,” he added.

The Taliban said those who worked with foreign forces needed to show “remorse” and should not use “danger” as an excuse to bolster their push for a “fake asylum case.” (AN photo/Sayed Salahuddin)

A number of former translators whose cases were denied in the past have fled Afghanistan, according to ALBA. Akhtar Mohammed Shirzai escaped to India in 2013 with his family. He has been living there since in the hope that he will be able settle in a coalition country because he served with NATO’s media branch.

He applied for an SIV from India in 2016 but was rejected because he did not have a letter of recommendation from his superiors in Kabul. He applied again in May and is now waiting anxiously.

On the Taliban’s offer of an amnesty, Shrizai said: “I heard about it, but I personally do not believe in that because the Taliban are not monolithic. There are different groups with different ideologies and thinking among them.”

In Kabul, Ayazuddin Hilal, who worked for American forces in a number of regions, said the former translators “could not attend wedding ceremonies or funerals back in their villages and even in secure areas where they live. Residents of the area do not treat them well because of their service for the foreign forces.”

He noted that a friend and colleague had also wanted to move to Kabul because of security threats in Nangarhar but was killed by a bomb blast. “I hope the politicians in the US and other capitals take a wise decision on our fate,” he added.

Twitter: @sayedsalahuddin


Italian island in plea for help after 600 migrants arrive in 24 hours

Italian island in plea for help after 600 migrants arrive in 24 hours
Updated 15 June 2021

Italian island in plea for help after 600 migrants arrive in 24 hours

Italian island in plea for help after 600 migrants arrive in 24 hours
  • Eight boats carrying 634 people, including a five-month-old baby, have arrived at Lampedusa, south of Sicily, since early Tuesday
  • Lampedusa’s mayor, Salvatore Martello, said that almost 1,370 people are now staying at the Imbriacola migrant reception center, a facility designed for 250 occupants

ROME: The Italian island of Lampedusa is struggling to cope after more than 600 migrants landed on its shores in less than 24 hours.

Eight boats carrying 634 people, including a five-month-old baby, from North Africa have arrived at the Mediterranean island, south of Sicily, since early Tuesday, overwhelming migrant facilities and leaving services on the brink of collapse.

More than 380 migrants of various nationalities were crowded onto one fishing boat alone.

“We intercepted a boat at dawn with 85 people on board. A small boat carrying 13 Tunisians landed later, followed by another with 12 men from Morocco and Sudan,” Admiral Roberto Isidori, commander of the Sicilian Coast Guard, told Arab News.

“All those on board were in very bad condition.”

Four other boats carrying at least 100 people reached the island — viewed as a gateway to Europe by migrants — in quick succession.

These groups were in addition to the 442 people who landed on Monday.

Mayor of Lampedusa Salvatore Martello. (AFP)

Lampedusa’s mayor, Salvatore Martello, told Arab News that almost 1,370 people are now staying at the Imbriacola migrant reception center, a facility designed for 250 occupants.

“The conditions facing migrants are very hard as we are experiencing a heatwave,” he added.

Agrigento authorities have arranged for 100 migrants who have been identified and tested negative for COVID-19 to be transferred by ferry to Porto Empedocle, an industrial port in the south of Sicily.

“From there we will try to send them to other reception centers, although all the facilities in Sicily and Calabria are already full beyond capacity,” Isidori said.

Other migrants could also be transferred on quarantine ships and patrol boats.

“In Lampedusa, the situation is unsustainable, both for the migrants and the local population, which is showing generosity to those people who endured a long, dangerous trip reach the island,” Urania Papatheu, a Forza Italia senator, told Arab News.

“What is happening is intolerable and unacceptable. It’s time for the EU to take action and hear to the calls for help from the Italian government. Enough with words from the EU. The time has come for facts and solidarity — Italy cannot be left alone.”

About 40 migrants from Algeria who landed on the southern coast of Sardinia also have been transferred to the migrant reception center in Monastir where they will be kept in quarantine.


Ryanair CEO says diverted flight had to land in Belarus

Ryanair CEO says diverted flight had to land in Belarus
Updated 15 June 2021

Ryanair CEO says diverted flight had to land in Belarus

Ryanair CEO says diverted flight had to land in Belarus
  • Ryanair’s CEO Michael O’Leary appeared before a British Parliament committee to give evidence on the May 23 diversion
  • The pilot was put under “considerable pressure” to land in Belarus

LONDON: The pilot of a Ryanair flight that was diverted to Belarus last month, leading to the arrest of a dissident Belarusian journalist, had no alternative but to land in Minsk, the airline’s head said Tuesday.
Ryanair CEO Michael O’Leary appeared before a British Parliament committee to give evidence on the May 23 diversion. The scheduled flight from Greece to Lithuania changed course and landed in Belarus’ capital.
Opposition journalist Raman Pratasevich, who had been a passenger on the plane, was arrested.
O’Leary told British lawmakers that Minsk air traffic control warned the flight crew of a “credible threat” that if the plane entered Lithuanian airspace, “a bomb on board would be detonated.”
The captain repeatedly asked to communicate with Ryanair’s operations control center, but Minsk air traffic officials told him — falsely — that “Ryanair weren’t answering the phone,” O’Leary said.
“This was clearly a premeditated breach of all the international aviation rules, regulations, safety,” he said.
O’Leary said the pilot was put under “considerable pressure” to land in Belarus instead of the more standard options of Poland or other Baltic countries.
“He wasn’t instructed to do so, but he wasn’t left with any great alternatives,” he told members of the Parliament committee.
After the plane was on the ground, several “unidentified persons” boarded the aircraft with video cameras, according to O’Leary.
They “repeatedly attempted to get the crew to confirm on video that they had voluntarily diverted to Minsk,” the Ryanair executive said. The crew refused to provide such confirmation, he said.
Western countries have called the forced diversion a brazen “hijacking” by Belarus. Outraged European Union leaders swiftly slapped sanctions on the country, including banning Belarusian airlines from using the airspace and airports of the 27-nation bloc and telling European airlines to skirt Belarus. UK authorities took similar actions.
O’Leary said he did not support continuing such flight bans in the long term.
“We cannot have a situation whereby airlines, air travel, our customers and our citizens run the risk of being hijacked and diverted under false pretenses,” he said. “But equally, far more UK citizens will be disrupted as a result of long-haul flights between the UK and Asia, for example, now having to fly around Belarus or avoiding Belarusian airspace.”


Vaccines key in preventing hospitalization for COVID-19 Delta variant: Study 

Vaccines key in preventing hospitalization for COVID-19 Delta variant: Study 
Updated 15 June 2021

Vaccines key in preventing hospitalization for COVID-19 Delta variant: Study 

Vaccines key in preventing hospitalization for COVID-19 Delta variant: Study 
  • Single Pfizer dose offers 94% protection against hospitalization
  • England’s chief medical officer hails study as ‘very encouraging indeed’

LONDON: Coronavirus vaccines are about as effective at preventing hospitalization in cases of the Delta variant of COVID-19 as they are for the earlier Alpha strain, a UK study has found.

The Public Health England (PHE) report found that a single dose of Pfizer’s vaccine results in 94 percent protection against people being admitted to hospital after becoming infected with the Delta variant.

It compares with the 85 percent protection that the same jab offers against the Alpha variant — results that bode well for worldwide vaccination efforts aimed at ending the pandemic. 

Other vaccines delivered similar results. A single dose of the Oxford-AstraZeneca vaccine provides 71 percent protection against the Delta variant, compared to 76 percent against the Alpha strain, according to the 14,000-case analysis conducted by PHE. 

Following the delivery of a second dose, protection against the Delta variant offered by the Pfizer and AstraZeneca jabs climbs to 96 percent and 92 percent, respectively.

PHE concluded in its report that vaccination efforts could result in a sharp drop in hospitalization rates, including both Alpha and Delta variant cases.

Prof. Chris Whitty, chief medical officer for England, hailed the study as “very encouraging indeed.”

An earlier Scottish study found that people who had caught the Delta variant, which is thought to be about 60 percent more transmissible than the Alpha strain, were about 85 percent more likely to be admitted to hospital than those who become infected with the earlier variant.