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Vol. XXX No. No. 14, November 16-30, 2020

COVID’s impact on affordable healthcare

by Our Special Correspondent

Like most public crises, the pandemic has impacted the poor and the marginalised more than the stronger sections of society. Philanthropic organisations play a key role in helping the vulnerable through these difficult times, ensuring their access to essential goods, services and care. Chennai’s not-for-profit medical institutions are doing a stellar job in this regard, even as they adapt to the ‘new normal’ where costs are on the rise, operational planning is more complex, and finances are crunched.

Akila Ganesan of the Sankara Nethralaya Eye Hospital recalled the initial challenges that the hospital faced when the pandemic struck in March. “The safety of our patients and employees was our immediate concern. We quickly defined standard operating procedures for each individual activity and department and established protocols for patient care,” she explained. Financials were also a challenge, as the salaries of employees had to be met even as patient footfalls decreased. “We’re a single specialty hospital, so many of our procedures are elective, not emergency. Consequently, revenues have taken a hit. In parallel, expenses have also gone up with increased spending on safety measures like PPE kits, masks and sanitisers,” she said. Sankara Nethralaya has received generous support from its donors, many of whom came forward to fund the procurement of equipment and safety items.

Like Sankara Nethralaya, other non-profit medical institutions have received immense support from donations in these times. Take VHS Hospital, for instance. The hospital receives a government grant but depends largely on public and corporate donations to keep going. It has quickly adapted to the new needs brought forth by the pandemic, a feat that Dr. Suresh credits to the charitable donations that continue to flow in. “Some major donors pitched in with timely help. We were able to immediately source the equipment needed to face the covid crisis, such as CPAP machines,” he said.

It’s not just capital expenditure that donors have helped with. While one-time donations help procure equipment, there’s still the cost of maintenance, which can run into lakhs for specialised machines.

Then there are operational costs to cover. Apart from the PPE kits, hospitals are facing increased labour cost in response to the risk of working at medical facilities during a pandemic. Nurses, housekeeping staff and other workers expect increased salaries as hazard pay and insurance too. “The government had already passed a minimum wage act before the pandemic struck, which had raised labour cost by more than 40 per cent,” explained Dr. Suresh. “Further increases followed the pandemic. It’s a hard act to balance – on one hand, we have to pay our employees; on the other, we have to keep the cost of care affordable for our patients.” NGOs like Bhumika have stepped forward to help patients subsidise the cost of investigation such as lab tests, allowing hospitals like VHS to continue to offer their services. In Sankara Nethralaya’s case, philanthropy has allowed them to perform 25 per cent of their surgeries free of cost even in these times.

Technology has been a huge boon as well. “Sankara Nethralaya is a pioneer in tele-ophthalmology in India,” said Akila. “We are reaching out to our patient base through tele consultation and tele counselling.” At VHS, What’s App is quite popular. “Patients can send us pictures of the pulse oxymeter reading on What’s App, and we respond immediately,” said Dr. Suresh, giving an example of how they use the app. Online consultation processes are important during a pandemic – they help hospitals treat patients who need care while ensuring that in-patient resources are utilised only for those who require in-person care. This is crucial for hospitals like VHS, which treat covid-affected patients in quarantine facilities.

Looking to the future, Akila worries about the unpredictability of the situation. “When will normalcy be restored? No one has an answer to this question. We’re continuing to strengthen protocols and shore up funds through cost-cutting measures as well as donor outreach campaigns. We’re doing our best to ensure that we can continue to service the community with free care,” she said.

Dr. Suresh had some additional points here. “Post-covid healthcare protocol is the need of the hour,” he said. “For instance, covid positive patients are reporting high blood sugar. Is it going to remain high? Post-covid care research is crucial.” The VHS Hospital’s research team has already begun work on such research and expect to publish a few papers soon.

Dr. Suresh’s positivity towards the future is driven in no small part by the philanthropic help that the hospital has received in tough times. “The amount of community support that we have received has been phenomenal,” he said. “I am happy that I am in Chennai, where there is always a helping hand when you need one. One has to just do their job sincerely and there are people to help you.”

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