Covid in India: 'The black market saved my family. If it'd been left to the public health system, they would have died'

By ITV News Journalist Sanjay Jha in Darbhanga, IndiaApril 14 seemed like any other bright, hot morning in India as I began what looked like another busy day covering the Covid pandemic.

But for my family, it was to become a date none of can ever forget, the beginning of a nightmare that will scar us foreverWhen my sister Sarita woke up that morning, her head was spinning so badly she was unable to balance and had developed a fever.

A 36-year-old mother, she was visiting our family’s home in Darbhanga, a city in North Bihar some 750-miles east of the capital New Delhi, for a long-planned gathering. I joined them that evening. Our father, Lalit Jha, 65 and mother, Shanti Devi, 62, thought it might be the seasonal flu that strikes every year at this time.

The next morning Sarita was worse – she was coughing violently and regularly, she was breathless and the intensity of fever had increased. She was exhausted and I could hear the congestion in her lungs as she struggled to breathe despite partial relief provided by a nebuliser.

Alarmed, Sarita’s husband, Pankaj Priyardarshi, 39, who works in Bangalore, India’s 'Silicon Valley', began explaining the symptoms to doctors on the phone. The answer he received was the one I was already dreading: suspected Covid.

Months earlier I had suffered from coronavirus and having spent months covering the deadly pandemic for ITV News, I knew the symptoms – and the possible implications.

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We were told we needed a chest scan and the PCR test to confirm it was Covid.  As so many have found out in the past year, this was easier said than done.

Darbhanga has a population of some four million but is appallingly served with hospitals and medical facilities. While there is a network of small privately run hospitals and medical centres, there is only one private diagnostic facility offering the PCR test. There is a shortfall of healthcare facilities, hospitals and specialist doctors in smaller towns in India. In Bihar, one doctor serves a population of around 50,000; WHO advise one doctor to 1,000 people.

Inevitably, these facilities are shamefully overstretched and people often queue before sunrise, with little social distancing or face coverings, for the tests costing £8 a time.  Families wait patiently - many are so weak they are propped up by family and friends.  The telltale rasping coughs and sweating bodies suggested the majority would soon find they were had Covid. Significantly, many visiting the centres are young, a clear indication this virus was attacking all ages.On the day we went, we were more fortunate and able to wait, protected from the sun by a roof covering the small reception area.  Still, it was suffocating and we waited shoulder to shoulder, suspicious of every cough. If Covid was to pick a breeding ground, it would be here.Sadly, the number of test kits available is limited and not everyone can be tested. Some have to return again the next day. We were lucky, we got our test.

The next challenge was to find an available diagnostic centre for the CT scan. We headed to an area called Alalpatti, which is known as the medical centre of the city with several clinics. As we were to find out, staff at these centres can be poorly trained, low paid, rude and unprofessional.

The scan cost the equivalent of £80 (Bihar is India’s poorest province with an average daily wage of as little as £3) and showed a large infection on Sarita’s lungs. If she was to survive, we were told, she needed to be admitted to hospital and to be placed on a ventilator.

The state-run hospital was already at breaking point - patients lying on stretchers and in corridors. Others waited outside for help, a few gave up to look elsewhere.

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Built during the colonial days and once described in 1925 as a "temple of medical learning", Darbhanga’s main hospital is considered the second-best in the state yet it is dilapidated and urgently needs an upgrade.

My father is a former civil servant, and I am an experienced journalist who has worked throughout the region covering crisis and conflict. But despite our connections, we were repeatedly told there was no oxygen available. No hospital beds. No ventilators.

To compound the urgency and my worries, my parents and my brother-in-law began to feel ill. Their symptoms suggested they too had Covid.

We all returned home where Sarita and Pankaj’s son, Shivaya, four, (named after Lord Shiva, one of the highest gods of Hinduism) was waiting with the family’s domestic helper.  Even he could tell things were not good. He asked often "where is mummy."

I had managed to secure tests for all the family and the following day – April 20 – my parents and my brother-in-law were shown to be positive. Happily, I had been able, most importantly, to find a hospital bed for Sarita.  She was hooked up to a ventilator.

Looking at her struggling for breath, to hold on to her life, I realised she was one of the lucky ones. It may seem a strange thing to have thought when looking at a loved one fighting for life but she at least had care and the aid of a ventilator. 

How many of those we had seen in the queue, how many of those across our vast country of the wealthy and the poor had been unable to find a bed, a means to battle on with the assistance of modern medicine?

With my sister safely in hospital my priority became my parents, whose oxygen saturation levels were going down. Again, we were repeatedly told no beds were available until, hours later, we found a room in a local hospital with oxygen.

I was told that both my sister and parents "must have" the anti-viral drug Remdesivir which had completely vanished from the Indian market but was being widely sold on the black-market for as much as £1,000. It would usually cost around £30 a vial.

During the pandemic, social media posts have proved useful to source drugs. So we deployed our friends and relatives to search the internet and social media platforms, and ring around big cities to see where we could perhaps buy Remdesivir.

Finally, and thankfully, someone in Hyderabad, a south Indian city 1,000 miles away, offered us some. Negotiations began and we were able to purchase a few precious vials. I sent a trusted friend to collect them. He put them on a plane from Hyderabad to the state capital Patna. A taxi then brought the life-saving package to us.

Not only were we having to supply the drugs for my parents, but their food too. “We only provide medical care and nothing else,” were the terse words from the doctor who also owns the hospital.

There was little effort to isolate patients. Around us, family members cared for their loved ones, all only too aware they too were being exposed to infection. The stench, the groans, the tears, the fear filled these wards.

Facilities at these small hospitals are primitive. Most have just a single doctor - here the same owner-doctor gives treatment, runs administrative issues and all other matters, so sometimes the quest for money seems to overshadow the desire to care.

To me, they are less doctor, more businessman, and some even employ bouncers to deal with any troublesome families who dare to complain. Patients die of neglect or the apathy of medical staff, it is often alleged. It is necessary sometimes to order water for patients privately from outside the hospital because staff refuse to bring them any.

If buying injections from the black market was costly then there was no respite from the hospital either.

Staff began calling me to deposit money on a daily basis. Some hospitals don’t accept any medical insurance  and want upfront payment or a big deposit. So we had to withdraw cash from an ATM and pay them every day in advance.

India is in a shameful, tragic position. Last year, when the country stopped all international flights to prevent the spread of coronavirus when cases were increasing, I started travelling across India to cover the impact of this unknown virus and how it was playing havoc with our unprotected population. 

In those weeks, I have been in and out of crematoriums and hospitals and had witnessed scenes that are beyond my worst nightmares.

But this second wave has been so much worse. Black market oxygen, rows of patients struggling to breathe — the pandemic made me want to cry to see how this has exposed our vulnerabilities. Helpless, scared families comforting their loved ones lying on pavements outside hospitals; the exhausted, brave nurses and doctors, the lines of pleading relatives desperate to have their oxygen cylinder filled before others, will stay with me forever.

So too will the story my sister would later relay. “There was two dead bodies lying on both sides of me in the ICU, from morning to evening, and no one came to remove them, it made me scared."

It is an irony that while it is disgusting, the black market has worked for many, including my family. Thanks to the drugs, the oxygen and other items we secured privately, and at great cost, my sister, her husband and my beloved parents survived. I count my blessings and know many, many families have not been so lucky.How can India, with the world’s sixth largest economy spend so little (1.26 per cent of GDP) on healthcare? 

Our vaccine programme has been described as a scandal. Instead of stockpiling the doses it would need, by March India was supplying vaccines to 74 nations and exporting far more doses than it had used to inoculate its own citizens.  

As a journalist, I have witnessed terrible scenes of trauma covering the pandemic and its dreadful impact on life, but I realise it is not until your own family is struck down, that you realise just how devastating it can be.