The 1500-bed Telangana Institute of Medical Sciences and Research Institute (TIMS) in Gachibowli, Hyderabad is being developed into a state-of-the-art facility for treating Covid-19 patients. The sprawling hospital has all essential facilities and the Finance Department has accorded permission to engage clinical and non-clinical staff in various categories.
Already Gandhi Hospital, Government Chest and General Hospital and Fever Hospital have been designated as Covid-19 specific hospitals. There are 17 ICMR-approved private testing labs and hospitals in Hyderabad. Those approaching Basti Dawakhanas or Urban Primary Health Centres with corona symptoms are being referred to Sarojini Devi Eye Hospital, King Koti Hospital, or any other higher centre. Further, the Telangana government has identified seven district hospitals as Covid-19 testing sites, which will facilitate testing for 21 districts.
Medical and Health officials have made it clear that government hospitals in the state have the capacity, facilities and equipment to treat Coronavirus patients, regardless of the caseload. Gandhi Hospital has facilities to treat 2,150 patients and there are 1,000 beds with oxygen supporting facility. Telangana is better equipped to face any situation, whether in terms of availability of PPE or N95 masks or any other requirement for treating a patient. In all the designated government hospitals, 3,600 beds are ready with oxygen supporting facility, according to medical officials.
Chief Minister K Chandrasekhar Rao has been reassuring people time and again that the government is ready to offer treatment to Coronavirus positive patients, whatever may be their number. Adequate test kits, PPE kits, ventilators, ICU beds, beds and masks are available. Keeping in view the spread of coronavirus, the government has augmented medical and health facilities by involving non-government as well as private medical and health facilities.
However, it seems that there is still need for an increase in Covid-19 testing centres as well as hospitals. In Hyderabad, for serving people living in slums as well as outside the slums either an existing Aanganwadi Centre or a place which has been used as a polling booth with minimum facilities may be designated as a Corona Testing Centre exclusively for those with symptoms and in exceptional cases for asymptomatic persons. Anganwadi worker and ASHA worker may be made as a team, headed by a doctor, to attend to the testing work there in shifts with full protection, after imparting adequate training to collect samples.
At the rate of say 2,500 persons (all are not required to be tested) per centre, for the whole of Hyderabad the requirement would be around 4,000 centres. One doctor can serve two centres to work on average for about 8-10 hours. A maximum of 2,000 doctors are required to cover all the centres. These doctors can be drawn from out of the in-service house surgeons in addition to a few doctors hired temporarily for this purpose.
On an average, every year about 3000+ admissions are registered in both government and private medical colleges. Even if two-thirds pass out every year, the number of house surgeons available for corona testing centres would be around 2,000. Their job is to do a clinical general check-up and organize testing. This is in a way the primary health care referral centre. These centres may, to begin with, be concentrated in slums, where there is nearly 40 lakh population, and later they can be scaled up.
The number of urban health centres in Hyderabad may be increased substantially, with a qualified doctor, to serve as first referral centre. Corona testing centres may be attached to each urban health centre for an integrated approach. PG medical students of various private and government medical colleges should take care of urban health centres, which are supposed to provide secondary health care and counselling to the virus-affected. On an average, in both private and government hospitals put together, there would be around 1,000 PG students in Telangana. Later, after the state is free from coronavirus, these could be converted as a first referral health care centre.
Both in the primary and secondary stages, that is in the corona testing centres and urban health centres, required sample collections may be taken up and in the tertiary care centres further diagnostic tests as to whether the patient suffers from any other medical and health problems like heart, kidney, lungs, sugar etc. may be done. Tertiary care could be provided either in the government-designated hospitals like TIMS, Gandhi, Chest, Fever etc. or in the 17 ICMR-approved private hospitals. There has to be an integrated approach to enlist NGO-run hospitals like Andhra Mahila Sabha, Mahavir and Saint Theresa and similar centres as well as large number of private nursing homes, RTC, Railways, even Military hospitals.
Coming to rural areas, the present structure is beginning with sub-centres. We have Primary Health Centres, Community Health Centres, Area Hospitals and then the District Hospitals. There are also teaching hospitals. We also have Ayurveda, Homeo, Unani and Naturopathy hospitals in the state. These may be integrated for the time being to effectively and efficiently contain the virus.
The services of all government doctors should be utilised optimally. The total bed strength and the total Anganwadi centres are to be optimally utilized all over the state. In every district with medical colleges, the services of house surgeons and PG students could be effectively utilized at primary care, secondary and tertiary care that is CHC/PHC, Area/district and teaching hospitals, wherever they are.
For the population living in villages, access to qualified primary health care is possible only either through Tele-Medicine or through FDHS (Fixed Date Health Services) scheme. So, FDHS Mobile Health Units can be strengthened. #KhabarLive #hydnews
