COVID-19: Streching healthcare systems to breaking point; mothers, children most vulnerable

The second wave is killing more people in South Asia. Resources and services are being diverted from non-COVID medical facilities. More children and mothers are dying due to COVID and other ailments

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Gyan Pathak

The deadly new surge in COVID-19 in South Asia, especially India, has strained the healthcare systems to a breaking point in the whole region. India has become the worst affected country, not only in the region but also in the world with 4.13 lakh new daily infection and about 4,000 daily death. The worsening situation compelled diversion of medical services and resources away from other diseases to the COVID-19 management. Due to this, the region lost 228,000 children and 11,000 mothers even during the first wave in 2020, who died of non-COVID-19 complications, as against only about 186,000 deaths by COVID-19 by mid-March 2021.

“The scenes we are witnessing in South Asia are unlike anything our region has seen before. Family members of patients are pleading for help as the region reels under an acute shortage of medical-grade oxygen. Exhausted health workers are being pushed to the brink of collapse. We are faced with a real possibility that our health systems will be strained to a breaking point - leading to even more loss of life,” said UNICEF’s regional director urging an “urgent action” to stop the catastrophe. “The deadly new surge in South Asia threatens us all” and can reverse global gains.

The second wave is obviously killing more people in the region, resources and services are being diverted more than ever before away from other non-COVID-19 medical facilities. Obviously, more children and mothers are losing their lives not only to COVID-19, but also to non-COVID-19 complications. The situation is fast worsening for other patients also but the children and mothers are the most vulnerable group along with the adolescents. According to an assessment, an additional about 6,000 adolescents in the region died during the first wave of the pandemic who were suffering from tuberculosis, malaria, typhoid, and HIV/Aids. They could not get medical help in time.

“As we work to respond to the public health emergency, we cannot forget the profound impacts of the pandemic on children. Children are being directly affected by the disease in higher numbers than ever before. They are losing parents and caregivers, becoming witnesses to the scenes no child should ever see, and being cut off from their schools and vital support networks,” UNICEF has said.

Countries across the region are witnessing rise in infections, with India accounting for over 90 per cent of both cases and deaths in the region, according to the World Health Organization (WHO). India also accounted for 46 per cent of global cases and 25 per cent of global deaths reported in the past week.

Caseload in neighbouring Nepal, Pakistan, Sri Lanka, and Maldives are also increasing fast. The situation in Nepal is particularly alarming, where cases recorded a 137 per cent rise this week, reaching the highest levels since the outbreak of the pandemic last year. It has severely strained its already fragile health system resulting in shortage of hospital beds, intensive care and critical medical supplies, including personal protective equipments and oxygen.


Pakistan is also experiencing a major surge in infection. The number of cases increased rapidly in recent weeks. UN Office for the coordination of Humanitarian Affairs has said that the healthcare system in the country has been impacted in Punjab and Khyber Pakhtunkhwa, with hospitals reporting shortages of available beds, oxygen, and other essential supplies.

The UN report titled “Direct and Indirect Effects of COVID-19 Pandemic and Response in South Asia” released in mid-March 2021 had examined the issue and said that the deaths of mothers and children under five were due to disruption in crucial services ranging from nutrition benefits to immunization being halted. It said that the number of children being treated for severe malnutrition fell by more than 80 per cent in Bangladesh and Nepal, and immunisation among children dropped by 35 per cent and 65 per cent in India and Pakistan respectively.

The report also said that child mortality rose the highest in India in 2020 - up by 15.4 per cent - followed by Bangladesh at 13 per cent. Sri Lanka saw the sharpest increase in maternal deaths - 21.5 per cent followed by Pakistan's 21.3 per cent. It also had estimated that there were some 3.5 million additional unwanted pregnancies, including 400,000 among teenagers, due to poor or no access to contraception.

The state of the World’s Midwifery 2021 has reported that there was already a great shortfall of midwives, and the COVID-19 pandemic has worsened it further. Even before the pandemic the number of midwives available could cater to only 75 per cent of the needs due to shortage of 900,000 midwives. In low income countries only 41 per cent of the needs could be catered. It may be mentioned that South Asia houses only low and middle income countries. In South Asia, inadequate education and training significantly jeopardized the professional identity, competence and confidence of midwives.

Given the high level of population density in the region, which included the world’s second biggest populated country like India, South Asia needs to urgently take appropriate steps to save the region’s mothers and children also from non-COVID-19 complications while struggling with the containment measures in the fight against the second wave of COVID-19. It must be done through balancing the healthcare facilities for both communicable and incommunicable diseases. We cannot afford to let non-COVID-19 patients die without medical help.

(IPA Service)

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