KEEPING THE HEROES SAFE

We cannot stop COVID-19 without protecting our health workers. A set of gloves, mask and gown have become the new imperatives, not just for the healthcare ecosystem but also for the global leaders in their resolve to address the global challenge at hand.

India, like most parts of the world, is in a race against time to procure personal protective equipment (PPE) for the safety of its medical teams, fighting to halt the spread of coronavirus. According to a Reuters report, India needs at least 38 million masks and 6.2 million PPEs to fight the global pandemic. Challenges though remain beyond just numbers. In the global demand surge for PPE, as many as 50,000 of the 1.7 million recently imported PPE kits, failed the quality test in India. A shortage of these kits is being felt across the world, as countries close borders and India relies heavily on imports. The rise in demand and incidents of faulty kits has pushed the Government of India (GOI) to ramp up domestic production of the much-needed PPE kits.

The increase in demand of PPEs has made it extremely difficult for healthcare workers, beyond the frontline workers, to get access to the equipments. The eyecare hospitals in India are facing similar challenge of sourcing quality PPEs, while responding to the emergency cases reported at this time. Malpractices of black marketing, circulation of cheaper and sub standardized commodities and subjective price hike, has further made it difficult for eye hospitals to source the PPEs.

The prices have also surged exponentially. According to WHO, surgical masks have seen a sixfold increase, N95 respirators have trebled and gowns have doubled. Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder.

GOI has been encouraging domestic companies to increase the production of PPEs and has recently issued guidelines for the hospitals, describing the quality and specifics of PPEs to be used in different settings.

Sadguru Netra Chikitsalya (SNC) in Chitrakoot, Madhya Pradesh, an Orbis partner, has initiated a special initiative to meet the in-house demand of PPE. Given the acute shortage of PPE in Chitrakoot, and transportation & logistics issues due to national lockdown, SNC has come up with the idea of producing the PPEs within the hospital premises.

The partner hospital involved Women Self Help Group (SHGs) to produce masks, gowns and PPEs for their doctors, with unmitigated focus on quality, design, process and of course capacity building of the women involved in the initiative. The SHG is a part of the Sadguru Mahila Samiti, a unit of Shri Sadguru Seva Sangh Trust (SSSST).

Here is how the Program is being rolled-out

• 13 women from the SHG have been diligently working, in close coordination with the team of doctors from SNC to stitch masks, gowns and PPEs. The women belong to the marginalized community from the nearby villages in Chitrakoot. PPE kits are being produced from non-woven fabric with 35-45 mm thickness.

• All women undergo a basic training program of 3-4 days in the hospital, based on their pre-training stitching skills. The trainer, too, has learnt some of the advanced skills in the domain by exploring the larger manufacturing units of PPE in other cities.

• Every kit being produced by the women undergoes a rigorous process of quality check before distribution. A seven-member Quality Control Team, including ophthalmologists, pathologist, general surgeon and optometrist, does the quality control on a regular basis.

• The kits produced by the SHG is being purchased by the hospital at INR 200, compared to the market price of INR 400-500 per kit.

Orbis has had a very long association with SNC, with it being the first Orbis partner of Orbis in the country. Since 2003, Orbis in India has closely worked with SNC to strengthen pediatric eye care services and provide comprehensive refractive error services among school going children. The Children’s Eye Center (CEC) developed with Orbis support examines and treats more than 35,000 pediatric patients and performs around 2600 surgeries annually.

Yogita, from a small village, Banda, walks her way to SNC, every day to be a part of the team making PPE kits. Her father, who works as a daily wage labourer at a nearby construction site earns less than INR 200 a day. His old age though is making it more difficult for him to do any physical labour, and most days go by without work. The family of four members was completely dependent on father’s income, until Yogita started working with the SHG.

Recalling old days, Yogita tells us how she had persuaded her parents to let her join a vocational training course in sewing. Yogita's father supported the idea but her mother was rigid, as it involved training fees, cost of sewing machine and her moving to some place far from their village.

Recognizing her skills and keen interest in sewing, Sadguru Mahila Samiti, Chitrakoot offered her training and a job. Yogita now works full-time, making the drapes and gowns for the surgeons and patients. She now has a bank account and is supporting her family with monthly earning of INR 10,000.

Yogita’s earnings are fueling her sister’s dreams, as she says “This training and job have transformed my life. I want to support my little sister with her studies to become a nurse.”

There is a limited number of patient inflow during the national lockdown, which is currently implemented until May 04, 2020. This has also restrained hospital operation, as it only caters to the emergency cases.

Given the ‘New Normal’ of social distancing and COVID fears, the hospital also expects a shortage of masks and gowns, particularly for the next 1-2 years. Also, with an expected increase in patient flow post lockdown, SNC plans to scale-up the production of PPE by engaging more SHGs in the coming months.

Going beyond the internal requirements of PPEs, SNC also plans to expand the production to supply PPEs among their network hospitals in Madhya Pradesh.