On Monday, the District Hospital in Rukum (East) installed a tent and admitted a coronavirus patient to its Covid-19 ward, taking the number of Covid-19 patients receiving treatment at the hospital to seven.

Six of the patients are receiving treatment at an under-construction building of the District Hospital. All of the patients are on oxygen support, health workers of the District Hospital in Rukum (East) say.

Until a few days ago, the hospital had only five beds for Covid-19 patients. It added one bed a few days ago but does not have space to put additional beds.

Doctors at the hospital visit the Covid-19 patients thrice a day but haven’t been able to treat the infected for a lack of essential medicines.

“We are somehow managing medical oxygen for the patients but we don’t have enough medicines to go around,” Purna Bahadur Pun, a doctor at the hospital, told the Post. “We are rationing our limited supply of medicines. Essential medicines used in the treatment of Covid-19 patients are in short supply in the market.”

According to him, the hospital is not only facing a shortage of essential medicines but also of other necessary medical supplies such as face masks, Personal Protective Equipment and hand sanitisers, among others.

“We have only a few face masks, a couple of bottles of sanitisers and PPE sets left at the hospital,” said Shovna Singh, a staff nurse at the hospital. “It’s been challenging to take care of Covid-19 patients without the necessary equipment.”

According to her, out of six staff nurses at the hospital, three are deployed in the general ward and three have been mobilised for the treatment of Covid-19 patients.

Since mid-April, 111 individuals have tested positive for Covid-19 in Rukum (East), according to the data of the District Health Office. Among them, four died and seven individuals are undergoing treatment at the District Hospital.

Around a 100 individuals are in home isolation, the data of the District Health Office showed.

Similarly, the District Hospital in Rolpa, which is a designated Covid-19 treatment centre in the district, is running from a dilapidated hospital building.

The Covid-19 patients in the district are undergoing treatment at the old hospital building which was built five decades ago. The District Hospital in Rolpa admits around a dozen Covid-19 patients on a daily basis amid a shortage of physical infrastructure and human resources.

“Since we are also running the Out Patient Department for non-Covid-19 patients, the hospital is stretched thin,” said Dr Prativa Subedi, a medical officer at the hospital.

The hospital hasn’t been able to run Covid-19 tests on suspects since it does not have enough antigen kits. “We do not have a PCR machine here. It takes at least a week to obtain PCR reports from the laboratories in Dang, Banke, Kapilvastu or Rupandehi. This has led to problems in the identification of Covid-19 patients. We are providing treatment based on their symptoms,” said Subedi.

The District Hospital in Rolpa says it may have to refer Covid-19 patients to hospitals outside the district in the next few days, as it has only a few cylinders of medical oxygen left.

“We have only a few oxygen cylinders left. The provincial and federal governments should address this issue immediately,” said Dr Prakash Bahadur Budha, acting medical superintendent at the hospital.

According to Budha, the hospital has no other option but to refer critical Covid-19 patients to Dang, Banke, Kapilvastu or Rupandehi-based health facilities due to a lack of oxygen and testing kits.

The data of the District Health Office in Rolpa shows there are around 400 active Covid-19 cases in the district at present. Most of the infected are in home isolation while the remaining are admitted to various isolation centres, officials at the health office say.

In Arghakhanchi, the health workers at the district hospital also say they are under immense pressure due to the lack of medical equipment and poor physical infrastructure.

Auxiliary Health Worker Ashok Chauhan at the hospital says the absence of ICU beds is the biggest challenge plaguing the health facility. The hospital does not have an ICU.

“We have lost some critical Covid-19 patients for want of treatment,” he said.

According to the hospital chief Dr Kapil Gautam, the hospital is also reeling under a shortage of medicines, health equipment and most importantly, oxygen. “It’s getting difficult to save Covid-19 patients amidst all the shortages,” he said.

There are 10 HDU beds and six general beds in the Covid-19 ward of the Arghakhanchi hospital.

Currently, 29 Covid-19 patients are receiving treatment at the hospital. “The number of patients seeking treatment at the hospital is increasing every day. We are compelled to find donors to refill empty oxygen cylinders,” said Gautam.

Gulmi, another hill district of Lumbini Province, is facing a similar ordeal.

“We have to provide treatment to all patients—Covid and non-Covid—while facing a shortage of oxygen, medicines, PPE and other health equipment,” said Dr Uttam Pachya, chief at the district hospital in Gulmi.

Various hospitals in the rural areas of Lumbini have been hit hard by the second wave of the pandemic, as they are not equipped, in terms of medical infrastructure and human resources, to deal with the health crisis.

“One doctor has to take care of 35-40 patients per day. We don’t have enough staff nor sufficient resources,” said Dr Tilchan Pandeya, a general physician at Palpa-based Lumbini Medical College. “The hospital has an old oxygen plant that does not produce enough oxygen. We have had to turn away both Covid and non-Covid patients since we have been stretched to the limit.”