Helping Nepalis breathe again


On 12 May, 15 Covid-19 patients died in Rupendehi and Nepalganj after the hospitals there ran out of oxygen supply. Another 18 patients died the next day in Kathmandu’s Bir Hospital and Trauma Centre because they could not get their oxygen cylinders refilled in time. 

Private hospitals in Kathmandu Valley including Medicare, MediCiti, Om, Helping Hands, Longevity, Karuna, Voyodha, Madhyapur Thimi, and Star stopped admitting coronavirus patients, saying they had enough medical oxygen only for existing patients.

Some patients had to quickly find ambulances and move to another hospital with an empty oxygen-equipped bed after the one they were in ran out of oxygen. Those who could not move died in their beds, gasping for air.

Murari Prasad Kharel at the National Human Rights Commission (NHRC) makes a legal distinction between dying of the coronavirus, and death of a patient due to lack of medical oxygen in a hospital. One is a disease, the other is a violation of human rights, he says. 

"It was a given that there would be a new outbreak of Covid-19. Yet, many people lost their lives prematurely due to ineffective hospital management. The government completely failed in its main responsibility of protecting its citizens,” he says.

All coronavirus deaths in hospitals are lumped together under Covid-19 fatalities, however there needs to be a distinction between whether a patient died despite being given all the care necessary, or because the oxygen supply ran out. 

These are two completely different conditions and should be treated as such, says a retired chief justice of the Supreme Court. Health is a basic human need and it is the state’s responsibility to ensure it, he says, the patients did not die of Covid, but because of negligence.

A bench of Supreme Court Justice Bamkumar Shrestha on 11 May ordered the government to ‘Facilitate the supply of oxygen and medicines required for the treatment of those infected ... and immediately dispense human resources taking into account the increasing number of patients.’

Some hospitals in Kathmandu are admitting Covid patients only after families sign an undertaking that the hospital will not be held responsible if the patient dies due to the lack of oxygen. Activists call this ‘a crime against humanity’.

On 14 May Lily Thapa of the NHRC called on Deputy Prime Minister Ishwor Pokhrel who also heads the Covid-19 Crisis Management Centre (CCMC) and drew his attention to the oxygen shortage being a human rights violation. 

Hospitals in Kathmandu need 22,0000 cylinders of oxygen a day, but presently there are only 12,000 cylinders available per day—both because of the lack of cylinders being sent for refills, as well as insufficient oxygen production.

Till a month ago, Narayan Dutta Timilsina of the Nepal Oxygen Producers Association was confident that there was enough generation capacity to meet demand, but the number of serious Covid cases rose so steeply that everyone was caught unprepared. 

For example, on 25 April as the number of infections started rising, there were 252 Covid patients in ICU and 65 were on ventilator. By this week, there were nearly 1,500 patients in ICU and more than 300 needing ventilator support. 

Grande Hospital, one of Kathmandu’s biggest private centres, has 80 Covid-19 patients, and all of them need oxygen for which it needs at least 200 cylinders a day. It can only get 50.

The Lumbini Provincial Hospital in Butwal needs 700 cylinders a day for its Covid patients, and it was assured 300 a day by the local government. It is not even getting 200, and has been turning serious patients away. 

"Oxygen is not a luxury, but an essential basic need. Hospitals need to ensure adequate supply, and the government must help,” says the former director of Epidemiology and Disease Control Division Baburam Marasini. 

It may be too early to hope, but there are indications that the graphs for daily new infections is flattening, and the numbers who have recovered is also rising. 

On Tuesday, there were a total of 8,203 new cases, 2,635 of them in Kathmandu Valley. There were 196 fatalities in the last 24 hours. While the test positivity rate is still high at 39%, there were 6,891 recoveries.

In addition, 3,000 of the 20,000 empty oxygen cylinders gifted by China have been flown in. Another 2,500 cylinders have come overland through Kodari, and Nepali workers in the gulf have collected money to send at least 1,000 cylinders. 

Private groups are also stepping in to fly in oxygen concentrators and generators. On Monday, Indian Ambassador Vinay Mohan Kwatra assured that India would increase its quota of liquid oxygen for Nepal.

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