Kashinath Baburao Kale died waiting for a bed! When Kashinath felt unwell on the 4th of July his family was worried and rushed him to the hospital right away. With his history of Asthma, they did not wait for it to become worse. At the hospital he tested positive for Covid 19 and the family was informed that they should look for an ICU bed given his comorbidities. Not aware that the hospital should have arranged for this transfer themselves, his family ran from pillar to post trying to arrange a bed that had ICU facilities and were stonewalled at every turn.
Kashinath did not die because he lacked health insurance. He did not die because his family could not raise funds. He did not die because he was diagnosed too late. Nor did he die because of insufficient health history. He had insurance, his family had already deposited Rs.20,000/ that they hastily raised from whatever source possible. His concerned family brought him to the health care system well in time and all his medical history was shared with the treatment teams to enable optimal care.
Kashinath was gainfully employed, and he had paid all the dues the formal employment system demands and that urban poor often lose out from the lack of. He was a security guard and a legitimate contract worker of the PCMC. His contractor deducted Provident Fund and ESIC dues, but the family has no clue if the money was indeed deposited in those accounts. The contractor did not provide any of the documents to Kashinath. Enrollment in the ESIC is meant precisely for such eventualities, but again his family was never made aware of this. Incidentally, he was also eligible for Maharashtra’s recently universalized Mahatma Phule Jan Arogya Yojana and the Centre’s flagship scheme, the Pradhan Mantri Jan Arogya Yojana. We can safely estimate that his total insurance cover was more than 5 lakhs. He did not die because he had insufficient insurance cover.
Kashinath had co-morbidities – he had a history of Tubercolosis from 20 years ago, he was asthmatic, and was on medication for hypertension as well but having won that struggle and at just 44 with a young family, he deserved a fighting chance. What makes it more distressing is that Pune-Pimpri-Chinchwad is well endowed with the best medical facilities. What is incontrovertible is that he was done in by the denial of a fighting chance to beat the virus – an oxygenated ICU bed and a ventilator, because of who he was, poor, powerless and voiceless. He went quietly. He did not record his fears that could go viral or make a video demanding that there be better coordination between public and private hospitals and the implementing agencies of the medical schemes.
As the bed seemed elusive, several agencies and activists desperately made telephone calls to hospitals, officials; constantly monitored the much publicized websites like the Covid Care Software of the Pune division, messaged municipal officials, tweeted the highest officials of the Mahatma Phule Jan Arogya Yojana and even the concerned Hon. Minister. The bed never materialized despite the website proudly proclaiming the availability of beds with oxygen and ventilators in some hospitals on the day before and after his death. No ICU bed for 8 days in a metro region that prides itself as a medical tourism destination or sheer apathy; either way it cost Kashinath his life.
He is survived by his wife, 38 year old Sangita who is a waste picker and their three sons. They are battling Covid themselves and the hospital is yet to share details of the Rs. 20,000/ deposited in the hope of getting an ICU bed.
He needs a voice and we are hoping others will raise the voice that he could not when they know of his story. Kashinath was betrayed by the system that was supposed to protect him. Like many others he gave up a part of his earnings for health insurance which never materialized when it was actually needed. No one heeded his condition and all pleas to those who are expected to listen and help – from doctors to local bureaucrats and politicians fell on deaf ears. Government insurance cover has little value for private medical establishments that resent the regulation of hospital rates. Just because you are legal and pay your dues to systems like ESIC does not mean it works. The several sites and reports of availability of beds does not hold true for everyone, especially for the voiceless and powerless. The story of hundreds of others, who try to negotiate an unfriendly medical system in times of COVID!