Lucknow, Uttar Pradesh – For six days, 52-year-old Jai Ram Yadav has been struggling desperately to get his wife admitted to hospital. Lakshmi Yadav, 51, has tested positive for COVID but also needs twice-weekly dialysis for kidney failure resulting from severe diabetes.
For the past two weeks, she has been unable to receive dialysis – a treatment delivered by a machine that filters and purifies the blood when the kidneys are unable to do the job themselves – because the hospital cannot offer dialysis to people who have COVID. The couple, who are not well-off, were told by the hospital that they must pay 900 rupees ($12) for a COVID test before Lakshmi can receive any more dialysis as she was experiencing mild symptoms, including a cough. Once she tested positive, she was refused care because of the fear that she might contaminate the dialysis machine.
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“We are in no position to afford treatment at a private hospital,” says Jai Ram. “We have tried all the government hospitals but they have all denied admission and treatment to my wife.”
Lakshmi’s COVID symptoms have worsened since she tested positive. She is breathless and has a fever and a bad cough. She has been told that she cannot take any medicines prescribed to ease the symptoms of COVID because of the risk to her kidneys.
The family are most worried about her missed dialysis treatments – if she goes for more than 10 days without treatment, she is likely to experience symptoms such as inflammation, high blood pressure, chest pain and vomiting. So far, she has chest pain but there is no way for the family to measure her blood pressure.
“She requires dialysis twice weekly but she has already missed appointments. It may cause her severe issues if her creatinine levels increase [an indicator that the kidneys are not filtering toxins from the blood effectively]. She is already prone to more infections and is struggling to breathe,” Jai Ram explains.
Lakshmi’s family has reached out to the district magistrate, an officer with the power to compel a hospital to admit a patient if their condition is serious enough, in Lucknow for help and received assurances that Lakshmi would be admitted to a hospital but the family has yet to receive any help.
“We have tried every helpline and toll-free number provided by the government and the only reply we have been getting is: ‘We do not have beds available and we will update you when one is available,’ It has already been six days and no help has arrived yet,” Dharmesh Yadav, 25, Jai Ram’s elder son, told Al Jazeera by phone.
The family of five, all of whom have tested positive for COVID and the youngest of whom – a daughter aged 21 – has a disability and does not have the use of one of her arms, has already exhausted all financial means to pay for their mother’s dialysis in the past. One dialysis treatment in a private hospital costs 5,000 to 6,000 rupees ($67 to $80) while the injections and medicines also required by dialysis patients can cost anywhere from 20,000 to 30,000 rupees ($271 to $406) per month. It is money the family simply does not have.
The small, two-bedroom house that they live in on the outskirts of north Lucknow has been mortgaged for 150,000 rupees ($2,029) and the two elder sons, aged 25 and 27, who both work (one earns 6,000 rupees a month while the other earns 8,000 rupees) have amassed large debts to pay for their mother’s medical expenses in the past. In total, they are already struggling to repay 200,000 rupees ($2,705) of debt.
“My mother has been on regular medication since 2011 and dialysis since October 2020; our sister, too, is handicapped and we have nothing that we can sell to save our mother,” Dharmesh says, his voice laden with desperation and hopelessness.
The family is particularly frightened, Dharmesh says, because they know that COVID can put a huge strain on the kidneys, making their mother’s situation all the more dangerous.
“We are not worried about ourselves but for our mother. We might have called the coronavirus centre in Lalbagh 200 times. We visited them and pleaded to help but they are not making any bed available for us. My mother’s disease needs continuous medical care and requires a huge amount to treat. We have invested whatever we had and are left with nothing.
“We feel like there are two swords hanging over our mother’s head and, anytime, one sword will take her away from us.”
Dr Anurag Gupta, a senior nephrology consultant at Sir Ganga Ram Hospital in New Delhi, who is not treating Lakshmi, explained the dangers of missing dialysis, particularly during the COVID-19 pandemic.
“People with chronic kidney disease are at higher risk of developing a severe case of COVID-19,” explains Dr Gupta. “If a patient is on dialysis, it’s extremely important to continue scheduled treatments. Filtering blood by a dialysis machine helps keep their immune system strong… patients who are critically ill with COVID-19 and have any kidney impairment have high mortality rates.
“The situation of so many patients who require dialysis or have undergone kidney transplants and now test positive for COVID-19 is critical.”
Dr Gupta says the pandemic has caused major issues for kidney patients all over India. At his hospital in New Delhi – a large facility with many different specialist units – he says patients who have kidney disease and have also tested positive for COVID are being forced to share beds as his unit has been overrun with critical cases.
“There are no beds; we put two people on single beds to manage the crisis. On an average every day, I do 80 to 90 virtual consultations with patients who need regular guidance. We are trying to manage them at home so that they do not face any serious issue if they get infected. We are giving our best but the condition is grim.”
Uttar Pradesh is one of the most populous states in India, with a population of 200 million people, and there are more than 22,000 new cases of COVID reported each day.
India has been reporting more than 300,000 cases daily for more than a week now.
As of April 30, the total number of cases in Uttar Pradesh stood at 310,783 while 12,572 people have died. In Lucknow, total deaths have reached 1,799.