“I was a proud father and now I have become a beggar”

As coronavirus cases ravaged India this spring, Anil Sharma visited his 24-year-old son Saurav every day at a private hospital in northwest New Delhi for more than two months.

In May, as new cases of Covid-19 in India broke world records to reach 400,000 per day, Saurav was put on a ventilator.

The sight of the tube entering Saurav’s throat is etched in Sharma’s mind.

“I had to stay strong when I was with him, but immediately afterwards I would collapse as soon as I left the room,” he said.

Saurav is home now, still weak and recovering. But the family’s joy is tempered by a mountain of debt that accumulated while he was ill.

Life has temporarily returned to normal in India as coronavirus cases have declined. But millions of people are now facing a huge mountain of medical bills, leaving them in debt as most Indians do not have health insurance.

Sharma used up her savings paying for an ambulance, tests, medicine and an intensive care bed. Then he took out bank loans.

As costs increased, he borrowed from friends and relatives. Then he turned to strangers, asking for help online at Ketto, an Indian crowdfunding website.

Overall, Sharma says he paid over $ 50,000 in medical bills.

Although he received $ 28,000 through the crowdfunding platform, he still has to repay $ 26,000 to his lenders.

“He was fighting for his life and we were fighting to give him an opportunity to survive,” he said, his voice charged with emotion.

“I was a proud father – and now I have become a beggar.”

Poor public health system

The pandemic has devastated the Indian economy, bringing financial calamity to millions of people at the mercy of its chronically underfunded and fragmented healthcare system. Experts say such costs can only hinder economic recovery.

“What we have is a patchwork of incomplete public insurance and a poor public health system. The pandemic has shown how creaky and unsustainable these two things are, ”said Vivek Dehejia, an economist who has studied public policy in India.

Even before the pandemic, access to healthcare in India was a problem.

Indians pay about 63 percent of their medical expenses out of pocket. This is typical of many poor countries with inadequate government services.

Data on the global personal medical costs of the pandemic are hard to come by, but in India and many other countries, treating COVID-19 is a huge additional burden at a time when hundreds of millions of jobs have been lost .

In India, many jobs have returned as cities opened after a severe lockdown in March 2020, but economists are worried about the loss of some 12 million salaried positions.

Sharma’s job as a marketer was one of them.

When he asked his son’s friends to set up the campaign on Ketto to raise funds, Sharma had not seen a paycheck for 18 months.

Between April and June this year, 40% of the 4,500 COVID-19 campaigns at the site were for hospital costs, the company said.

32 million Indians outside the middle class: study

The pandemic has driven out 32 million middle-class Indians, defined as those who earn $ 10 to $ 20 a day, according to a Pew Research Center study published in March.

He estimated that the crisis has increased the number of poor people in India by 75 million – those with an income of $ 2 or less a day.

“If you look at what drives people into debt or poverty, the two main sources are often direct health care costs and catastrophic treatment costs,” said K Srinath Reddy, president of the Public Health Foundation of India.

In the northeastern town of Imphal, 2,400 kilometers (1,490 miles) away, Diana Khumanthem lost her mother and sister to the virus in May.

The costs of treatment wiped out the family’s savings, and when the private hospital where her sister died did not return her body for the last rites until a bill of around $ 5,000 was paid, she pledged the family’s gold jewelry to pawn shops.

When that wasn’t enough, sought help from friends, family, and colleagues from her sister. She still owes some $ 1,000.

A health insurance scheme launched by Prime Minister Narendra Modi in 2018 was intended to cover around 500 million of India’s 1.3 billion people and was an important step towards reducing medical costs.

But it does not cover primary care and outpatient care which constitute most of the personal expenses. Thus, it has not “effectively improved access to care and protection against financial risks,” according to a working paper written by researchers at Duke University.

The program has also been hampered by disparities in how different states have implemented it, said Shawin Vitsupakorn, one of the authors of the article.

Another article, from the Duke Global Health Institute and the Public Health Foundation of India, found that ICU hospital costs for COVID-19 are equivalent to almost 16 months of work for a typical Indian day laborer or seven to 10 months for an employee or a self-employed person. salaried workers.

The meager financing of health care, at just 1.6% of India’s gross domestic product (GDP), is proportionately less than what Laos or Ethiopia spends.

At the height of the epidemic in May, hospitals were overrun, but public facilities lacked the resources to handle the influx of patients.

“The result is a suffering public health system, where the delivery of care is often poor, prompting a lot of people to flock to private hospitals,” Dehejia said.

A public hospital treated Khumanthem’s mother, but her sister Ranjita was admitted to a private hospital which cost $ 1,300 a day.

Ranjita was the sole breadwinner after Khumanthem quit her job as a nurse last year to return home during the first wave of the virus. She is now looking for work while looking after her father and her sister’s three-year-old son.

At home in Imphal, Khumanthem mourned her mother as she remembered her favorite food – “chagem pomba”, a kind of porridge made from vegetables, rice and soy. Every few minutes, she looked towards the front gate.

“This is usually when Ranjita came home from work,” she said. “I still think she could walk through the door anytime now.”

Back in New Delhi, Sharma sighed in relief when an ambulance brought her son back from hospital last week.

Saurav needs physiotherapy to strengthen his weakened muscles, a daily nurse, and a long list of medications. It may be weeks before he can fend for himself and months before the ambitious lawyer who was one of the best students in his class can appear in court again.

The charges will continue.

“Our first priority was to save him,” Sharma said. “Now we’ll have to find the rest. “