KASARAGOD: Kasaragod district -- with 688 active cases of COVID-19 and another 650 patients with symptoms in hospitals -- is fighting the battle against the virus with a woefully inadequate number of doctors and cleaning staff.
The District Health Service conducted interviews to recruit doctors on an ad hoc basis at least five times, but few turned up.
One of the main reasons is the government is paying the temp doctors a pittance, almost on a par with the cleaning staff, said health workers. "The first is there aren't enough doctors in the district looking for a job. And there is no merit in the salary to attract doctors from other districts," said a senior health official in the district.
But officials are baffled that even notifications calling for cleaning staff are not finding takers despite wages being increased to Rs 1,000 from Rs 450.
"The National Health Mission (NHM) pays only Rs 450 per day to the cleaning staff. But the local bodies have agreed to pay Rs 1,000. Yet, we are not finding enough cleaning staff," said Dr Raman Swathy Vaman, district programme manager (NHM).
Shortage of cleaning staff
The cleaning staff have to work for 14 days at a stretch and go into quarantine for 14 days. They are paid even for the quarantine period, said officials.
"We have put out the word through Kudumbashree and panchayats. But there is no response. Maybe it is because of the fear of COVID," Dr Vaman said.
Every 100 patients need six to eight cleaning staff, he said.
So in a three-shift system, at least 24 cleaning staff is required for 100 beds.
As of Tuesday, the district has 688 active COVID patients, and another 650 are hospitalised with symptoms. Just by these numbers, the district would need 167 cleaning staff. But only 15 persons responded to the job advertisements.
But the requirement is likely to increase. Kasaragod has 4,366 COVID beds ready and the district medical officer Dr A V Ramdas said it will soon have 10,000 beds, in anticipation of a spike in numbers.
Now, half of its regular 182 cleaning staffers employed at health centres and district hospitals have been redeployed to the eight First-Line Treatment Centres (FLTC) in the district.
Such redeployment affects the work of the main centres, said doctors. For instance, the Udma Family Health Centre -- which has three cleaning staffers -- collects swabs. One staff was required full time at the swab collection centre, another has been redeployed at an FLTC, leaving just one cleaning staff to manage the entire hospital. "Now we get around 300 patients every day and we have just one staff for all of them," said Dr Mohammed, the medical officer.
The situation is similar or worse across the health centres and hospitals, he said. Dr Mohammed is also the district president of the Kerala Government Medical Officers' Association.
No takers for doctor job
The situation is worse for doctor's jobs in the district. Kasaragod has 281 posts for doctors. The number of posts does not reflect the actual requirement of doctors in the district.
Of the 281 posts, 67 posts are vacant. They include 31 house surgeons, 15 casualty medical officers, 15 doctors of specialty cadre, three doctors of administrative cadre, and three dentists.
No new doctors were recruited for the COVID treatment centres.
Health officials said doctors hired on ad hoc basis are paid Rs 41,000. But after the six-day pay cut as part of the 'salary challenge' and taxes, the doctors take home Rs 35,000. "These doctors are on-call round the clock," said Dr Mohammed, explaining why the salary cannot attract doctors.