India without oxygen, travesty of incompetence

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Er P L Khushu

There’s a famous proverb ‘water, water everywhere, not a drop to drink.’ But now, it is Oxygen, Oxygen all around not a bubble to inhale. What is it? Is India a failed state? Has no governance so for since independence ever thought of making medical oxygen available in health sector, like major and district hospitals, medical institutes of repute, monstrous commercially operated private hospitals of the country, ruling the roost in collecting money in bulk, in the name of providing of super specialty medical services to the people at exorbitant costs. Did all these sources of so-called living gods, now turned demi-killers, ignored that oxygen is lifeline for an ailing one, who can be given his life back after heavy and serious hospitalization, from any disease of serious nature. We have established medical councils, other health operating forums, apart from erstwhile planning commission now Neeti Aayog. India fought three wars with Pakistan, two wars with China, along with border skirmishes and clashes as good as wars with both these countries since last about 50 years. India tested nuclear bombs of bigger magnitude with a great pomp and show. India purchased huge military hardware worth millions, like Bofors guns, Migs, Mirages, F-16s and the like to save the nation from external threats. India saw Bhopal gas tragedy and Gujrat earthquake devastation and similar like devastating situations so many times, so far. India made lot of in roads to the outer space and in fact almost succeeded in its Moon mission. Our political eras fought scores of elections both at the central level and the state levels, distributing sops like reservations for some sections of people, providing religious and non-religious concessions to garner votes and sit in fat political chairs as dynastic rulers for decades to loot the nation. But what made Indian system to ignore the fundamental requirement of providing of oxygen for its population of vast nature, at an hour of its immense need and requirement. Recent abrupt spike in the COVID pandemic in our country made people to die for the non-availability of proper oxygen. The helpless patients numbering in lacks across the country, died on the barren floors of our nude and rude hospitals, with inadequate bed facilities and zero oxygen provisions. The concerned governments of different states tried to shift their responsibilities to the central government when the central government too was also not equipped at all to attend to the demands of the proper oxygen and beds. The errant complacent central government is to be held seriously responsible for such a suicidal blunder. The other governments of the states, had never planned in advance to build oxygen manufacturing units for the production of oxygen for medical use. Nor has the Government of India paid a serious heed to this factor. What is this. Should all these be held responsible for the mass deaths of the Indians at the hands of incompetent handlers of governance. What a travesty, no beds in hospitals, no oxygen in hospitals. If the bed is there, there is no oxygen and if the oxygen is there, there is no bed. Should all such people show their faces to the masses. Certainly not. They will be mentioned in posterity as the so-called killers of humans in India. India saw a biggest brain drain after the implementation of the recommendations of the Mandal Commission. Now the next brain drain from India will follow as the educated youth of our country will now prefer to move to other developed countries for the safety of their lives, where at least oxygen is available for one’s survival with dignity. Every other country big or small are mostly equipped with the enough oxygen generation plants for the medical care of their people other than India. It has been observed that India probably is the only country which completely lacks in it when thousands of Indians died for no fault of theirs due to apathies of people in power. Relatives, friends, colleagues, and almost none has been spared from random charge of the virus. Many families have endured a double blow: Husband and wife, sister and mother, father and son, gone within days of each other. The overall loss of intellectual and cultural capital is incalculable. And it continues day after day. There’s no sense of an ending. It is the frequency and the unexpectedness of these departures that has made coping harder and more unbearable. We even log in to social media with a sense of dread. Fear and anxiety play on a loop in our heads. COVID-19 is a sadist and it has colonized our heads. For many, the management of grief and anxiety is overwhelming. How do you efface the image of a man you saw gasping for air at a hospital? How do you get over the lingering regret of not having been able to give a proper cremation to a dearly loved which is all that she ever wanted in life? How do you console a friend who’s lost his father and grandfather within hours of each other?
Earth’s atmosphere contains about 21 per cent oxygen today. Plants produce it, when humans and animals breathe it. Ancient rocks provide clues about when the oxygen in Earth’s atmosphere began to arise. Oxygen in the form of the oxygen molecule (O2), produced by plants and vital for animals, is abundant in Earth’s atmosphere and oceans. But that hasn’t always been the case. When, and in what environments, did O2 begin to build up on Earth? A new study that looked at ancient rocks in Western Australia suggests it started happening earlier than we thought. The oxygen the O2 on Earth was relatively scarce for much of our planet’s 4.6 billion-year existence. But at some point, Earth underwent what scientists call the Great Oxidation Event or GOE for short, as ocean microbes evolved to produce oxygen, O2, via photosynthesis. O2 first accumulated in Earth’s atmosphere at this time and has been present ever since. It’s been thought that this happened sometime between 2.5 and 2.3 billion years ago.
There are two types of oxygen – Industrial Oxygen and Medical Oxygen. Medical Oxygen is high purity Oxygen used for medical treatments and is developed for use in the human body. Medical Oxygen cylinders contain a high purity of Oxygen gas. No other types of gases are allowed in the cylinder to prevent contamination. There are additional requirements and rules for medical Oxygen, including requiring a person to have a prescription to order Medical Oxygen.
Industrial Oxygen is focused on uses in industrial plants, including combustion, oxidation, cutting, and chemical reactions. The Industrial Oxygen purity levels are not appropriate for human use, and there could be impurities from dirty equipment or industrial storage that could make people ill.
As of April 12, 2021, as per government sources, the Medical Oxygen consumption in the country was 3,842 MT, that is 54 per cent of the daily production capacity. The maximum consumption of Medical Oxygen in the country is by the states of Maharashtra, Gujarat, Madhya Pradesh, Uttar Pradesh, Karnataka, Tamil Nadu, Delhi, followed by Chhattisgarh, Punjab, Rajasthan.
Government sources have said that this is ‘malicious propaganda’ and that during April 2020 to February 2021, while 9,884 MT of Industrial Oxygen was exported, only 12 MT of Medical Oxygen was exported. Further, the government’s version is as follows, This, however, defies logic. Today, in order to boost the availability of Medical Oxygen, if there is a ban on all industrial use of Oxygen, then clearly, the readiness of India for the oxygen shortage cannot be seen by decoupling the Industrial and Medical Oxygen supply. Therefore, should therehave been a long-term vision of combating the COVID-19 situation, clearly such huge amount of Oxygen export, even of Industrial Oxygen, should have been done with caution.
The situation with respect to vaccination ought to have been better over 2021, yet we find that numbers vaccinated have fallen over in the first week of May. Many effective vaccines have been developed – Moderna, Pfizer, Covishield, Covaxin, Sputnik to name a few. However, only two of these are being produced domestically (Covishield and Covaxin) and that too by only two manufacturers: the Serum Institute of India and Bharat Biotech. To boost supplies quickly, we need action domestically and internationally.Countries such as UK, US, Canada and those of the European Union have reportedly got more vaccines than they need to vaccinate their entire population. Some have excess stocks. This is a moment for international solidarity whereby these countries export their excess supplies to India and others poor nations. This makes even more sense as there is a danger of vaccine-resistant mutations emerging if people across the world are not vaccinated quickly enough. Should such mutants emerge, they would render the excess stocks useless even for the countries that are holding them. In addition, these countries must support India and South Africa’s proposals for (temporary) waivers in the Trade Related Intellectual Property Rights at the World Trade Organisation for the COVID-19 vaccine, facilitate easy technology transfer and so on to ensure vaccine availability in poorer countries. India and South Africa have been making these efforts since October 2020, but are currently being blocked by the richer nations. Two days ago, the US decided to support the proposal at the World Trade Organisation, but it still needs European Union support and more time after that to get to production stage. Serious questions have also arisen about Bill Gates’ role in blocking the move towards a free Intellectual Property Rights regime for COVID. Ironically, while India has taken the right stand on vaccines internationally it is not pursuing that policy domestically. For instance, when it comes to Bharat Biotech’s Covaxin, instead of invoking compulsory licensing (under Section 92 of the Patents Act 1970) and imposing upon Bharat Biotech to share its technology with other domestic producers, the Central government allowed Bharat Biotech to maintain their monopoly over vaccine production.
One way in which they are doing this is through differential pricing. The Serum Institute initially announced three prices (the Central government will continue to get it at Rs 150, but the company initially wanted to change Rs 400 for states and Rs 600 for the private sector). Similarly, Bharat Biotech announced two prices (Rs 600 and Rs 1,200).Combined with the fact that 50 per cent of production is committed to the central government, the pricing policy means that the Serum Institute and Bharat Biotech can prioritize the more remunerative private sector orders over state governments. Faced with widespread criticism, both companies reduced the price for states marginally (the Serum Institute to Rs 300 and Bharat Biotech to Rs 400). However, that does not solve the problems created by the supply bottleneck and differential pricing (including the possibility of a black market emerging or that supplies to states will dry up as manufacturers prioritize the more profitable private sector orders).
However there does not appear now to be a bright Sun anywhere behind the dark clouds and the Indians will continue suffering, dying and longing to have sufficient and appropriate oxygen fitted beds in our hospitals and other medical facility centers, which still appears to be a long-cherished dream. ‘The King is Dead, Long Live the King’.
(The author of this article is a chartered civil engineer who loves his motherland the Union Territory of J&K).