Balbir Singh gently places the last of the wood slabs over his 27-year-old son’s unlit pyre. He observes it for a moment and then walks around to the other side and carefully replaces a loose slab. He looks around perplexed, as if wondering if someone will show him what to do next. “I have never had to set alight a pyre by myself before. He was supposed to light mine,” he says, trying to hold back the tears, as they roll into the mask hanging loosely over his nose. He is Covid-positive too.
It's 12.30pm and Balbir is at New Delhi's Seemapuri crematorium. He spent the previous night running from hospital to hospital. His son Sagar's oxygen saturation levels had fallen precipitously by early evening, dipping to 60, 25 points below normal. With no doctors answering calls, and the government helplines constantly busy, Balbir took matters into his own hands. Unable to get an ambulance, he relied on the generosity of an auto rickshaw driver in his neighbourhood. He went to six well-known hospitals in Delhi between midnight and 6am. "They wouldn't let me enter any of the hospitals. I had to watch my son die in my arms, he couldn't breathe anymore. All he needed was a little oxygen, and nobody would give it to him," he says between heart-wrenching sobs. "Such a young boy."
The crematorium caretaker, Jitender Singh Shunty, steps forward to embrace Balbir. He wears a personal protection suit complete with goggles and a face shield, despite the scorching 45-degree heat. Faced with Shunty’s kindness, Balbir breaks down completely, and his cries ring out across the crematorium. Others join in. Everyone here is witnessing a similar grief, tinged with shock at the suddenness with which they lost their loved ones. One minute they couldn’t breathe, and the next they were gone.
As a priest hurriedly performs the last rites, chanting in Sanskrit, Shunty takes a wooden slab, dips it into oil, and lights a match to it. He places the flaming torch in Balbir’s shaking hands, and helps him to set his son’s pyre alight. And then he is off to the next pyre, to console and help yet another grieving family.
The government is only counting those deaths that happen in hospitals as Covid-19 deaths. But what about those who die outside the hospitals or inside their homes?
By late afternoon, all the cremation pits have corpses burning, so Shunty starts leading those who are still awaiting their turn to the parking lot behind the crematorium. In a few hours, at least 40 pyres will burn simultaneously here.
“This is not just human beings dying, it’s more than that. Humanity is dying in Delhi right now,” Shunty says, to no one in particular. But he doesn’t have time to stand around reflecting on the crisis – another ambulance has arrived from a local hospital with six bodies.
“The government is only counting those deaths that happen in hospitals as Covid-19 deaths. But what about those who die outside the hospitals or inside their homes? I have already picked up three bodies from homes this morning, and I have five more to pick up still. They all developed a cough or a fever and were dead in a matter of days. They are Covid deaths, what else could it be?” he says as he pulls the bodies out of the ambulance and on to the stretchers.
True scale
This is at the heart of the crisis in India. Not all deaths are being accounted for, which is making it almost impossible to understand the true scale of the horror unfolding across the country at the moment. Similar scenes are taking place at crematoriums and graveyards across Delhi, and beyond in cities like Mumbai, Lucknow, Kanpur, Kolkata.
As of May 4th , India is recording more than 400,000 cases each day, the highest for any country in the world since the pandemic began. The World Health Organisation (WHO) now estimates that 50 per cent of all new infections in the world are in India, and the country accounts for 25 per cent of all coronavirus deaths currently. 3,700 people die every day. But that toll is almost certainly under-represented. Nobody has time to count the dead. They have to focus on trying to save the dying.
“The last four nights I have slept an hour here, an hour there, there is no time,” says Dr Souradipta Chandra over the phone. It took careful planning to catch him on his 10-minute break. He is a consulting physician at Helvetia Clinic in New Delhi, and a medical advisor to the European Union in India.
“I have 70-80 patients in critical care right now, and as with most doctors I am running logistics as well as medical care. There is only so much oxygen available, and everyone needs it. So, I am on the phone co-ordinating between oxygen suppliers and patients all the time. Even embassies that had prepared for this crisis have run out of oxygen. And it’s not just oxygen: we need more beds, more drugs, more doctors, more ICUs, just more, more, more...” his voice trails off.
Overwhelmed doctors echo the same words. What they are experiencing, many say, is worse than any war or a natural disaster. Their hospitals are stretched to their very limit and stocks of all essentials are perpetually running low. They simply can’t keep up. Making it even harder is the administration’s utter incompetence. Fifteen days after oxygen shortages were first reported in Delhi, they persist and worsen with each passing day. The cruel fact is that across India far too many people are dying because of a lack of oxygen. It’s not the virus that is killing them. In Delhi alone, based on local media reports, 25 patients died at Sir Gangaram hospital on April 23rd, 21 patients died at Jaipur golden hospital the next day on April 24th, and 12 at Batra hospital on May 1st. These hospitals just ran out of oxygen, nothing was left. These are just some of the reported examples. Doubtlessly, many go unreported.
In Uttar Pradesh, the government has abandoned its people, and has not offered a single word of comfort. Instead they are fighting their citizens tooth and nail
The Indian courts have begun to take notice, and with each hearing their statements become more damning. On May 4th, hearing a public interest plea about reports of people dying due to lack of oxygen, a judge at the Allahabad high court in the state of Uttar Pradesh said, such deaths are “a criminal act and not less than a genocide by those who have been entrusted the task to ensure continuous procurement and supply chain of the liquid medical oxygen”. But those who have been entrusted with this task insist that things are not as bad as they are being made to appear, particularly in Western media.
Apathy
In Uttar Pradesh, the state’s Hindu hardline chief minister Yogi Adityanath of the ruling Bharatiya Janata Party (BJP) continues to display apathy, despite mounting evidence that his state is one of the hardest hit. Days before the high court’s observations, he said there was no shortage of oxygen in his state, and those spreading rumours about the same would have their property seized under the National Security Act. Since then, at least 50 people have been arrested for spreading such “rumours”. An overworked doctor in the state capital Lucknow, who doesn’t want to be named for fear that he could be targeted, says over the phone: “It’s far worse here than in Delhi, but we have strict instructions not to talk about it. I am losing patients right in front of my eyes, who could have been saved with just a little oxygen, but I don’t know who to call in the administration. Nobody wants to listen.”
Denial is the Indian state’s de facto mode right now. “They deny even the most basic things that we can see on our television screens. What’s the point of telling people not to panic, as Yogi Adityanath keeps saying, when there clearly are enough reasons for people to panic,” says writer Vidya Krishnan over a video call from Harvard University where she is currently a Nieman fellow. She has spent two decades following the complex policies that plague India’s overburdened, underfunded healthcare system.
But this, she says, goes beyond the inherent flaws of that system. “What we are witnessing is not just the collapse of India’s healthcare system, but also the collapse of democracy in its largest playing field. In BJP-ruled states like Uttar Pradesh, the government has abandoned its people, and has not offered a single word of comfort. Instead they are fighting their citizens tooth and nail.”
“Solve the crisis, don’t deny it. Impose emergency measures and lockdown the country after making arrangements to ensure that the most vulnerable will not be penalised because of it,” says Dr K Srinath Reddy, one of India’s pre-eminent experts on public health, and the president of the Public Health Foundation of India. He has been sounding alarm bells since early February that a second, more devastating wave was coming. “But there was euphoria and erroneous declarations of total victory over the virus. There was this false assumption that somehow we were going to be unique in the world by not having a second wave. I wish I had been more blunt about certain things back then, like the Kumbh Mela, but I did warn that it could become a super-spreader event,” he says.
Pilgrimage
After the scientists started talking about a second wave, the Indian government allowed the Kumbh Mela, a massive Hindu pilgrimage, to take place on the banks of the River Ganges in the state of Uttar Pradesh in early April. The prime minister, Narendra Modi, himself welcomed the pilgrims via tweet. The virus ran rampant among the gathered millions, and the results have been devastating. One reports suggests that 90 per cent of those who came back to the state of Madhya Pradesh from the Kumbh Mela have tested positive. Dozens have died, including top seers who rejected universal masking and social distancing norms.
And it wasn’t just religious gatherings. Well into mid-April, when India was recording upwards of 200,000 cases a day, election campaigns were allowed to take place in the state of West Bengal, currently experiencing a massive surge in cases. In the state capital Kolkota, the positivity rate is said to be 50 per cent, one out of every two people now testing positive. In this state, the prime minister himself attended massive public events, often without a mask, even boasting about the size of the crowds at his rallies on April 17th. His party was the last to suspend campaigning and the election continued well until the end of April. One high court judge in Madras admonished the election commission, saying that those who had permitted such rallies should be “booked for murder”.
Dr Reddy suggests that perhaps the government could utilise the very same networks that function so effectively at election time to solve this crisis now.
“At election time, one party worker visits 20 households to campaign and distribute voter slips. Let’s activate that network and have them serve the community, do last-mile delivery for oxygen or vaccines. We can have them issue guidelines, help people understand how to recover at home. We need a strong, community-led, citizen-led response now to tackle this crisis.”
For many in India, the responsibility lies directly at the feet of the prime minister himself, even though his party and his government have tried their best to deflect the blame onto state chief ministers and opposition leaders.
Resign
Some, like the Indian intellectual and Booker prize-winning writer Arundhati Roy, are openly calling for him to resign. "Never would people like myself have imagined the day would come when we would find ourselves appealing to prime minister Narendra Modi for anything. Personally, I would rather have gone to prison than do that. But today, as we die in our homes, on the streets, in hospital car parks, in big cities, in small towns, in villages and forests and fields – I, an ordinary private citizen, am swallowing my pride to join millions of my fellow citizens in saying please sir, please, step aside," she wrote recently in an appeal to the prime minister published by Indian news portal Scroll. "We need a government. Desperately. And we don't have one. We are running out of air. We are dying," she wrote.
As the virus continues its rampant march from India’s cities into the country’s hundreds of thousands of villages, it is starting to resemble an old-fashioned plague. Social media feeds are filled with videos from the countryside of patients lying in fields, hooked on intravenous syringes hanging from trees. A local village elder, from Eastern Uttar Pradesh cannot understand it: “Is there a poison gas in the air? Why are people dying because of a simple fever? Please can you explain to me.”
