The poor, the rich: In a sick India, all are on their own

When the pandemic exploded in India in early April, with the government left unprepared and medical system quickly on the verge of collapse, millions of families found themselves faced with a new reality: They would have to keep their relatives alive

Virus Outbreak India On Their Own (Copyright 2021 The Associated Press. All rights reserved.)

For the family of the retired diplomat, the terror struck as they tried desperately to get him past the entrance doors of a private hospital. For the New Delhi family, it came when they had to create a hospital room in their ground-floor apartment. For the son of an illiterate woman who raised her three children by scavenging human hair, it came as his mother waited days for an ICU bed, insisting she’d be fine.

Three families in a nation of 1.3 billion. Seven cases of COVID-19 in a country facing an unparalleled surge, with more than 300,000 people testing positive every day.

When the pandemic exploded here in early April, each of these families found themselves struggling to keep relatives alive as the medical system neared collapse and the government was left unprepared.

Across India families scour cities for coronavirus tests, medicine, ambulances, oxygen and hospital beds. When none of that works, some have to deal with loved ones zippered into body bags.

The desperation comes in waves. New Delhi was hit at the start of April, with the the worst coming near the end of the month. The southern city of Bengaluru was hit about two weeks later. The surge is at its peak now in many small towns and villages, and just reaching others.

But when a pandemic wave hits, everyone is on their own. The poor. The rich. The well-connected bureaucrats who hold immense sway here, and the people who clean the sewers. Wealthy businessmen fight for hospital beds, and powerful government officials send tweets begging for oxygen. Middle-class families scrounge wood for funeral pyres, and in places where there’s no wood to be found, hundreds of families have been forced to dump their relatives’ bodies into the Ganges River.

The rich and well-connected, of course, still have money and contacts to smooth the search for ICU beds and oxygen tanks. But rich and poor alike have been left gasping for breath outside overflowing hospitals.

“This has now become normal,” said Abhimanyu Chakravorty, 34, whose extended New Delhi family frantically tried to arrange his father’s medical care at home. “Everyone is running helter-skelter, doing whatever they can to save their loved ones.”

But every day, thousands more people die.

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The Chakravorty family, New Delhi

COVID-19 tests. That’s all the family wanted after a niggling cough had spread from relative to relative. But in a city where the virus had descended like a whirlwind, even that had become difficult.

First they called the city’s top diagnostic labs. Then the smaller ones. They called for days.

The ground-floor apartment, in an affluent neighborhood with a tiny, well-tended garden and a spreading hibiscus tree in bloom, has been home to the Chakravorty family for more than 40 years. There’s 73-year-old Prabir, the family patriarch and widower, a construction executive who has long ignored his family’s pleas to stop working, and his two sons, Prateek and Abhimanyu. Prateek, who runs an air-conditioning company, shares a room with his wife, Shweta, and their seven-year-old son Agastya. Rounding out the clan is Prabir’s sister, Taposhi, and her adult son, Protim.

They tried to isolate as best they could, seven of them retreating to various corners of the three-bedroom apartment, and kept calling testing centers.

It wasn’t supposed to be like this.

In January, Prime Minister Narendra Modi declared victory over COVID-19. In March, the health minister claimed the country was in the pandemic’s “endgame.”

By then, medical experts had been warning for weeks of an approaching viral wave. The government ignored the warnings, allowing the immense Kumbh Mela religious festival to go forward, with millions of Hindu devotees gathering shoulder-to-shoulder along the Ganges River. Hundreds of thousands also turned out for state election rallies.

The Chakravorty family, like most Indians hadn’t expected things to grow so bad. Certainly not in the capital, which has much better medical care than most of the country, and where those with money have access to private hospitals.

Finally, Shweta found a lab to administer tests. A man arrived in head-to-toe in protective clothing to swab everyone. It seemed, he told them wearily, as if everyone in this city of 29 million people needed coronavirus tests.

The family had their first scare the next day, when a weakened Prabir nearly fell and his sons had to carry him to bed. Stomach problems and a raging fever kept him there.

“He was visibly shaking,” said Abhimanyu, a 34-year-old news editor.

They got the results three days later. Four members of the family tested positive, with a few losing their senses of taste and smell. But it was far worse for Prabir.

Prateek struggled to find a doctor for his father. One wouldn’t answer the phone, another had his own emergency. Finally, a relative in Thailand contacted a friend, a New Delhi doctor, who said the 73-year-old needed a chest CT scan.

Prateek ventured out on April 28 to find a lab in a scarred city, with roads empty except for ambulances and oxygen tankers. The scan confirmed their fears: Prabir had pneumonia. Doctors warned the family to be very watchful.

Their worries deepened every night, when Prabir coughed relentlessly and his blood oxygen levels dropped dangerously.

“It was an alarm bell,” said Abhimanyu.

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Padmavathi’s Family Bengaluru

In a small community of homemade huts, a short walk from one of Bengaluru’s wealthiest neighborhoods, one woman’s sore throat was turning into breathing problems.

The people here are at the bottom of India’s caste ladder, “rag pickers” who support themselves by collecting the city’s waste and selling it to recyclers.

Shunned by most Indians, they are an informal - but pivotal - part of the urban infrastructure. India is among the world’s largest waste producers, and a city like Bengaluru, the Silicon Valley of India, would drown in its own trash if not for them. Yet when vaccines began to be distributed, with essential workers at the front of the line, they were left off that list.

Some people collect newspapers in the little community. Some pick through dumps. Some specialize in metal. Padmavathi, who uses one name, collected hair, taking it from women’s combs and hairbrushes to later be used for wigs. She earned about $50 a month.

It’s a life along the fringes, but Padmavathi, who never went to school and whose name translates from Sanskrit as “She who emerged from the lotus,” made it work.

“She was very pushy about our education,” said her son, Gangaiah, a community health worker for a non-profit group.

But her oldest daughter had to drop out in sixth grade, when Padmavathi ran out of money. Gangaiah only made it to seventh. She succeeded with her youngest, a seventh-grade daughter who earned a scholarship and now lives in a private school dormitory across town.

Padmavathi shares a one-room hut made from bamboo and plastic sheeting with Gangaiah, his wife and their two children.

Gangaiah’s work meant he could quickly get Padmavathi tested when her symptoms started May 1. It meant he had access to an oximeter to test his mother’s blood oxygen level.

But when those levels began to drop, he couldn’t get her into a hospital. Working with colleagues in the non-profit, he began calling. Again and again he was told every bed was taken.

By the fifth day, with Padmavathi’s oxygen levels dangerously low and her breathing sometimes coming in gasps, Gangaiah’s colleagues finally found a bed.

She left the neighborhood unworried.

“I’ll be back soon. Don’t worry,” she told her neighbors.

The hospital had oxygen, but everyone said she needed to be in an ICU on a ventilator. That was impossible.

“It was sheer helplessness,” said Gangaiah.

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The Amrohi Family, Gurgaon

Ashok Amrohi thought it was just a cold when he began coughing on April 21. After all, the retired diplomat and his wife had both been fully vaccinated against coronavirus.

A medical doctor before joining the diplomatic corps, Ashok had traveled the world. He’d been ambassador to Algeria, Mozambique and Brunei, and had retired to Gurgaon, a city just outside the capital, and a life of golf and piano lessons. He was a respected, highly educated member of the upper-middle class.

He was someone who, in normal times, could easily get a bed in the best hospitals.

His fever soon disappeared. But his breathing became labored and his oxygen levels dropped. It appeared to be COVID-19. His wife, Yamini, reached out for help. A sister who lived nearby found an oxygen cylinder.

The situation seemed manageable at first, and they treated Ashok at home.

“I was always with him,” said Yamini.

But his oxygen levels kept dropping.

If things worsened even a little more, his family would have no idea how to respond.

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The Chakravorty Family, New Delhi

Reluctantly, as Prabir’s condition also worsened, the Chakravorty family decided he needed to be hospitalized.

First, they tried a government-run mobile app showing the city’s available beds. It wasn’t functioning. So Prateek went searching.

The first three hospitals he visited -- private, costly hospitals, built for India’s growing population of new money -- were full.

Then he went to the massive 1,200-bed public field hospital built last June in a leafy New Delhi neighborhood. The hospital had been closed in February when cases fell in north India, and frantically reopened in late April as cases surged.

Outside the hospital entrance, Prateek found dozens of people begging staff to admit sick family members. Some were openly offering bribes to cut the line, others slumped on the floor breathing from oxygen bottles.

Worried families were waiting under a nearby canopy for news - any news - about loved ones inside. Some hadn’t seen their relatives in weeks.

“You know nothing,” one person told him.

The army doctors running the facility, who were refusing the bribes, were working frantically. They had little time for patient comfort, let alone worried relatives.

Prateek was stunned at the scene: “My body trembled.”

Beneath the canopy, he met a sobbing young man whose father had died and been taken away for cremation. But in the chaos, ID numbers attached to some corpses had been mixed up, and the wrong body was carted off for cremation.

His father’s body was now lost inside the complex, where death had become mundane.

At that moment, Prateek decided: “We will do what we can at home, this wasn’t an option.”

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Padmavathi’s Family, Bengaluru

Late on the night of May 5, an ICU bed finally opened up for Padmavathi, whose condition was clearly deteriorating.

“She kept telling other people that she’d soon be fine,” said Gangaih.

Padmavathi was a fighter, and knew how hard India could be on the least fortunate. She’d grown up in a family so poor they often didn’t have enough food, and was a traveling laborer by the time she was seven. She married at 14, and raised three children alone after her husband abandoned her.

“She was a sad person, but she would hide her melancholy from us,” said Gangaiah. She buried her sadness in more work: “She sacrificed everything she had for us. Her struggle to feed us and raise us consumed all her time.”

Joy only came when her oldest daughter and Gangaiah had children.

“She was so happy. Perhaps the only time we saw her happy in a real sense,” he said.

She was also a force in the neighborhood, helping other women with their troubles, and fighting to ban the cheap and sometimes poisonous home-made liquor that kills hundreds of India’s poor every year.

But in the hospital that night, none of that mattered.

A few hours after being transferred to the ICU, amid the noise of medical machinery, Padmavathi died. She was 48 years old.

Gangaiah was waiting outside when it happened.

“I cried bitterly,” he said. “I had hardly seen my father’s love and care. She was both my parents.”

He is furious.

“We also knew from experience that the government is for rich people and the upper castes. But we always nurtured this belief that at least hospitals will cater to us in our time of need,” he said. “It turned out to be an utterly fake belief, a lie.”

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The Amrohi Family, Gurgaon

At the Amrohi apartment, the former ambassador’s family was calling his medical school classmates for help. One eventually arranged a bed at a nearby hospital.

It was April 26. The brutal north Indian summer was coming on. Temperatures that day reached nearly 105 degrees Fahrenheit (40 degrees Celsius).

His wife, Yamini, and their adult son Anupam put him into the family’s compact SUV.

They arrived about 7:30 p.m. and parked in front of the main doors, thinking Ashok would be rushed inside. They were wrong. Admission paperwork had to be completed first, and the staff was swamped.

So they waited.

Anupam stood in line while Yamini stayed in the car with Ashok, who was breathing bottled oxygen. She blasted the air-conditioning, trying to keep him cool.

An hour passed. Two hours. Someone came to swab Ashok for a coronavirus test. It came back positive. His breathing had grown difficult.

“I went thrice to the hospital reception for help. I begged, pleaded and shouted at the officials,” she said. “But nobody budged.”

At one point, their daughter called from London, where she lives with her family. With everyone on a video call, their four-year-old grandson asked to talk to Ashok.

“I love you, Poppy,” he said.

Ashok pulled off his oxygen mask: “Hello. Poppy loves you too.”

Three hours.

Four hours.

Anupam returned regularly to the car to check on his father.

“It’s almost done,” he would tell him each time. “Everything is going to be alright. Please stay with us!”

Five hours.

A little after midnight, Ashok grew agitated, pulling off the oxygen mask and gasping. His chest heaved. Then he went still.

“In a second he was no more,” Yamini said. “He was dead in my arms.”

Yamini went to the reception desk: “You are murderers,” she told them.

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The Chakravorty Family, New Delhi

Prateek Chakravorty returned from the field hospital and told his family about the nightmare there. All agreed Prabir would be treated at home.

The brothers grew up in this pink three-story building. It’s where they returned to after evenings playing soccer. It’s where they spent India’s harsh, months-long lockdown last year, glad to be together.

Now it was where they had to help their father breathe.

For rich countries, oxygen is a basic medical need, like running water. Last year, Indian authorities ordered most of the country’s industrial oxygen production to switch to medical oxygen.

But it was nowhere near enough for the surge’s ferocity. Hospitals went on social media, begging the federal government for more oxygen. The government responded to social media criticism by ordering Twitter to take down dozens of tweets.

The Chakravorty family decided their best bet was an oxygen concentrator. Unaffordable to most Indians, with prices reaching $5,500, concentrators remove nitrogen from the air and deliver a stream of concentrated oxygen.

They reached out to friends, relatives, business colleagues - anyone they could think of - trying to find one.

It’s how things work now in India. With the formal medical system barely functioning, tight networks of family, friends and colleagues, and sometimes the generosity of complete strangers, would save many. Informal volunteer networks have germinated to reuse medical equipment and look for hospital beds. The black market thrives, charging astronomical prices.

A friend responded to their SOS. Sougata Roy knew someone in Chandigarh, a city in the Himalayan foothills about a five-hour drive away, who had a machine and wasn’t using it. He offered to get it.

Roy arrived April 27 with the machine and instructions.

On April 29, the family found someone to care for their father. He wasn’t a trained nurse, but had experience treating COVID-19 patients at home.

Prabir’s signs of improvement were slow, but the family grasped at them, overjoyed when he could eat a little boiled chicken. They celebrated quietly each time his oxygen levels were good, knowing they were lucky to have the resources to treat him at home.

“It was hell,” said Prateek, remembering the worst two weeks. Slowly, though, their optimism grew.

May 7 was Prateek’s birthday. Prabir looked brighter, and the relieved family decided to celebrate. They ordered chocolate cake from a nearby bakery.

Prabir didn’t want any. But for the first time in weeks, he was craving something sweet.

He settled for a cookie.

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The Amrohi Family, Gurgaon

The horror didn’t end with the ambassador’s death.

Ashok’s body, sealed in a plastic bag, was taken by ambulance the next morning to an outdoor cremation ground.

Cremations are deeply important in Hinduism, a way to free a person’s soul so it can be reborn elsewhere. A priest normally oversees the rites. Family and friends gather. The eldest son traditionally lights the funeral pyre.

But when the Amrohis got to the cremation ground, a long line of ambulances was in front of them. Beyond the gate, nine funeral pyres were blazing.

Finally, Anupam was called to light his father’s pyre.

Normally, families wait as the fire burns down, paying their respects and waiting for the ashes. But immense fires burned around the Amrohi family. The heat was crushing. Ashes filled the air.

“I have never seen a scene like that,” said Yamini. “We couldn’t stand it.”

They returned to their car, waited until they were told the body had been cremated, and drove away.

Anupam returned the next morning to collect his father’s ashes.