Number of deaths from Covid are mounting amongst healthcare workers, yet when it comes to the question of compensation for their families, the process is slow and tedious

Akhil Kumar pauses mid sentences, describing his mother Ambika’s last 28 days, struggling and then succumbing to Covid-19. Ambika, a nurse in Delhi’s Kalra Hospital, in Kirti Nagar was one of the many healthcare workers who died from Covid during the first wave in 2020.

The Trained Nurses Association of India says a total of 107 nurses have died from Covid in India, with 11 from Delhi in both the first and second wave.

At the same time, Indian Medical Association says 513 doctors have died in India in the second wave alone, with 103 doctors who were serving in Delhi. In the first wave the total number of deaths were 748.

And while the Delhi government had decided to give ex-gratia of Rs 1 crore to health care workers, and the centre announced “Pradhan Mantri Garib Kalyan Package” essentially an insurance scheme, there are many family members who have to wait for months before seeing any compensation, if any.

Kumar tells us over a phone call from Kochi, he gave up pursuing ex-gratia compensation as it became a nightmare of bureaucratic paperwork. Ambika passed away in Delhi’s Safdarjung hospital on May 24. From June 2020 to January 3  2021, until Kumar decided to pack up and leave for Kerala, he pursued the case, “in all I submitted 36 documents. I counted it…They even wanted my 10 pass certificate. The only reason I applied for it was for my sister. She is only in class 12, I thought I’ll try for her, but (after the endless paperwork) I decided to drop it”.

All the papers are still at Delhi government’s Directorate general of health services in Karkardooma, Kumar says. The Delhi government has meanwhile, on May 14 issued an order for processing ex-gratia cases through the revenue department.

The order reads: “HCW Corona Warriors of all engaged in patient care of Covid patients and it is tragic, but inevitable, that certain cases of deaths have occurred in such HCWs. Recognizing this ultimate sacrifice, the government has approved a scheme of ex-gratia payment to be made through the Revenue Department.”

It also said “In view of the sensitivities involved, and in order of convey Government’s sense of sympathy and recognition, it is hereby instructed that all such cases shall be processed in a time bound manner so that the proposal can be submitted to the Revenue Department for further action within a period of 24 hours.”

But in Kumar’s case the hospital refused to give a certificate acknowledging his mother contracted the virus from their hospital. He believes doing so would bring to the fore the said hospitals malpractice in allowing Covid patients into their wards and not providing adequate facilities to the staff. Kalra hospital was one of the 82 hospitals which were asked to reserve  60% of ICU beds in the second wave by the Delhi government.

In the first wave when Kumar’s mother attended to ICU patients, it had not been designated Covid beds. Kumar says he is sure his mother contracted the disease which proved fatal while working in the ICU ward. Kalra hospital, where Ambika worked for the past 10 years, has refused, stating in a letter to the family, that she did not contract the disease at the hospital.

According to the health ministry order, when a positive Covid-19 patient is identified in a healthcare facility, not designated as Covid-19 isolation facility, one of the many action points is to inform the local health authorities about the case. He believes they did not inform and in order to avoid their liability.

He did his own investigation, securing phone numbers of those his mother looked after at the ICU ward, “I tried to trace everyone who was treated by my mum. Three persons who died, their kin told me were Covid positive.”

“My mother had started showing symptoms on May 14, but went to work anyway. Our financial situation at the time was very bad, so she had to work and there was pressure from the top because of a shortage of staff.”

By May 15 Ambika was too unwell to return to work, getting tested on the 17, with the result taking three days. By this point Kumar says “everything went wrong”. On the 21 she was admitted to the Safdarjung hospital, who he blames for not giving enough care to his mother. “It happened all so quickly. I was still in Kerala and my younger sister would call and tell me about the situation”.

Then on the 24, he says, “things were looking up, “she video called me from her hospital bed in the morning. She told me she was fine, she had some breathing difficulty, but was fine and would be out of there in another two days. After five hours my uncle called and said she had passed away.”

Kalra hospital has given Ambika’s gratuity and other employee benefits, which amounted to 12 lakhs. “We had so much financial commitment at the time of my mother’s death. Kalra gave 12 lakhs with gratuity and other things which we received. So, home loans and individual loans, I have been able to partly pay off.”

But Ambika’s is not the only case where the hospital refuses to say the staff died due to Covid contracted at work. This account however, is not of a large private hospital but a small private practice where the nurse Rajamma Madhusoodhanan worked for 28 years. Her daughter, Divya, tells us, no compensation was given by the clinic and running after state government ex-gratia was futile.

“They wouldn’t provide the staff with proper masks. N95 masks would be worn for days together, whereas they should be worn just for a day”.

Rajamma’s symptoms started showing around midnight of May 21 of last year. She complained of chest pain, but with no history of heart problems and a recent echocardiogram confirming the same, it was dismissed as heartburn. By the next morning she was okay, but again fell ill by afternoon, and things started worsening. “We consulted a doctor and were given medication for five days. But by 1 June, we had to get her admitted. She was first taken to Deen Dayal Hospital by my father, but they refused admission. He then took her to LNJP where she was admitted. But June 3 around 1:45 am she passed away.”

Divya, also a nurse in Delhi, says the clinic completely dismissed them, refusing to accept her mother contracted the virus while in service. “I had taken my earned leaves and was at home for a month. I couldn’t have brought the virus.”

“They didn’t give any gratuity, no Provident Fund, nothing. The doctor (owner) told me she was also in a crisis and couldn’t pay, but at the same time threatened to get legal help, accusing me of harassing her”.

Divya says she has tried to get compensation from the Delhi government but after submitting droves of paperwork was in the end rejected. “My mum used to get paid just about Rs 10,000. After all the work she put in, that’s how much she would get paid as a monthly salary. My father left his job 15 years ago, but in that small amount she could bring me up, give me a good education.”

Ajinas AM, Secretary General at Trained Nurses Association says they have “faced issues on the support from private management to give necessary documents”, for availing compensation. In this wave another nurse from Kalra hospital, Sheeba Santosh, succumbed to Covid on April 25. She was also eight months pregnant at the time. Ajinas says they have been trying to get the compensation at the earliest… the hospital now claiming “Dr Kalra is out of India, and when he comes back we will give (the documents necessary)”.

We spoke with Shibu C, a family friend of Sheeba’s who is also coordinating for all necessary documents to submit to the Delhi government and Centre schemes. While the hospital had Covid facilities, Sheeba was not working in the Covid ward. The hospital refuses to accept that Sheeba contracted the virus while at work, “they say she must have gotten it when she went to the market. She was pregnant and also has an eight year old daughter. She was being very careful and didn’t go anywhere.”

Shibu also claims that despite her complaining of feeling ill, her matron refused leave, “she was asked to work two night duties and only then was she given leave. She was subsequently admitted to the same hospital on the 20, and diagnosed with Covid on the 21, she passed away on the 25th”.

The Delhi government’s order dated June 16, 2020 says “the council of ministers Govt. of NCT has approved an ex-gratia amount of Rs 1 crore posthumously to persons attending Covid-19 patients

Since last year to the present date there have been reports citing at least four families who have received the Rs 1 crore ex-gratia. In June 2020, Delhi Chief Minister Arvind Kejriwal announced the ex-gratia for the family of a senior doctor, Aseem Gupta of the LNJP Hospital who died battling Covid-19. The 52-year-old doctor served in the front line of the war against the pandemic at the government facility, and died of the novel coronavirus infection in an ICU of a private hospital.

Then in August, the family of a sanitation worker who died due to Covid-19 received Rs 1 crore as financial assistance to them. The sanitation worker, Raju, had contracted the virus while working amid the viral outbreak, the news report says.

In May of this year the family of Sheoji Mishra, a school teacher who succumbed to Covid last year was given the ex-gratia amount posthumously. He was facilitating the screening, movements, providing food, and night shelter to migrant labourers. His son has also been assured a job by the Delhi government.

Lastly, the family of Dr Anas Mujahid, a junior resident doctor at the department of Obstetrics and Gynaecology in Delhi’s GTB hospital, was given ex-gratia after he succumbed to Covid-19 on May 9 of this year.

LNJP Hospital in fact has a total of six health workers – excluding doctors – who have died in the second wave. These include one sanitation worker, two lab technicians and three nurses according to information shared with this reporter.

And not every family receives what is promised to them on time be it a sanitation worker, a nurse of a doctor.  Dr J.A Jayalal, says the government must give the compensation “as early as possible”. “Within three months compensation should be given. In the first month (after death) the family will be in a disastrous situation, so local IMA will be there to help. But once the families are settled, the spouse may be unemployed, the children may still be studying, based on that (compensation) should be given. At least within 3 months the compensation should be given”, he reiterates.