The recent death of a 39-year-old COVID-19 pregnant woman from South Mizoram’s Lawngtlai has once again brought forth the bad condition of infrastructure in the state, especially roads during the monsoon season.
Mizoram, which has a population of 1,091,014 according to the 2011 census, has one COVID-19 designated hospital: the Zoram Medical College (ZMC) in Aizawl, which is also home to the lone RT-PCR (Reverse Transcription-Polymerase Chain Reaction) laboratory in the state.
While the asymptomatic COVID-19 patients and patients with mild symptoms are admitted to the dedicated Covid Health Centres, Covid Care Centres and Community Covid Care Centres, the serious cases from all 11 districts end up in Aizawl, at the ZMC.
For Vansangpuii from Lawngtlai, however, the road to the hospital was where she met her fateful end.
“We have no complaints on the care that was provided to us. But the road was bad and the vehicle was out of shape,” said Rochungnunga, the 70-year-old father of the deceased.
Eight months pregnant Vansangpuii was due to have a child on August 15. Her untimely death is now a reflection of how it is the journey to the hospital, and not the disease, which can be the matter of life and death in Mizoram.
Vansangpuii tested positive for COVID-19 on July 11. “When I went to see her, they told me she would not be released for a while as she had developed symptoms. Later, at around 2 pm, they informed us that she would be referred to the Zoram Medical College and they started the journey around 7 pm,” said her father.
What Google Maps do not tell
The road from Lawngtlai to the Zoram Medical College, according to Google maps, is about 226.9 km. Under normal circumstances, it should take a few hours for an ambulance to cover this distance. But that is where all assumptions end.
One, Mizoram has hilly terrain, which means vehicles move slowly. This journey, for example, takes over 9 hours in summers at an average speed of 25 km per hour.
The journey, of course, takes much longer during the monsoon. It was only natural that Vansangpuii’s husband Lalhmangaihzauva and a nurse accompanied her in the ambulance.
Rochungnunga said he received multiple calls from his son-in-law as they made the journey to ZMC, and each time it was about the news of their ambulance breaking down.
“They called me from Thingkah (in Lawngtlai district), saying their vehicle broke down and they were looking for parts. Then, they called me when they were nearing Lunglei Civil Hospital (still 150 km from Aizawl), saying they were looking for oxygen. Around 3 am, I received another call saying their vehicle had broken down near Haulawng (around 120 km from Aizawl). My son-in-law was quite worried as they were running out of oxygen,” he said.
According to Rochungnunga, Lalhmangaihzauva started looking for oxygen in Haulawng and managed to acquire one through acquaintances.
“They gave her oxygen, but since the vehicle had broken down, they had to request for another ambulance from Thenzawl (about 90 km from Aizawl). They waited till daylight and the ambulance arrived at around 9 am. They resumed their journey, but she could not make it. She breathed her last while passing Mualthuam North village (119 km from Aizawl) at around 11 am,” he said.
Lalhmangaihzauva had spent over 16 hours, witnessed two broken vehicles, searched for oxygen, and yet, he saw his wife die. When she breathed her last, she was still 100 km from ZMC.
Mizoram: A state in dire need of ambulances
Dr LP Malsawma, the Chief Medical Officer of Lawngtlai District, told EastMojo, “We are in great need of an ambulance. We have one NAS (National Ambulance Service) ambulance in the Civil Hospital. The Chief Medical Office has one Maruti Eeco ambulance donated by the Mizoram Secondary School Teachers’ Association (MISSTA). There is one ambulance in Chawngte donated by C Ngunlianchanga (Lawngtlai West constituency MLA).”
Malsawma said they also outsource a Bolero ambulance from the Young Mizo Association, an apex NGO of the state, but since it is not the four-wheel-drive version, the Bolero cannot travel in bad road conditions. Neither can the Maruti Eeco.
On the ambulance used by late Vansangpuii, he said, “Since the dynamo in the Maruti Eeco ambulance was damaged, we borrowed a Maruti Eeco ambulance from LCMC (Lairam Christian Medical Centre), a private hospital. But after ten kilometres, the chamber of the vehicle was damaged. So the NAS ambulance was sent to the location. The accelerator of the NAS ambulance was also damaged on the way. So we requested Thenzawl Ayush to release their ambulance. If they had travelled smoothly, the patient could have reached ZMC on time.”
Malsawma shared concerns over the state of infrastructure in the district, especially with regard to the worsening COVID-19 situation in the state.
“We are running out of space in our Covid Care centres and it is very hard to make additional arrangements at this point. We are also running out of manpower.”
Currently, the district has one Dedicated Covid Health Centre, five Covid Care Centres, and 34 Community Covid Care Centres.
On the need for ICU facilities in the district, he said, “Health officials asked us if it will be possible to set up an ICU facility for COVID-19 patients in the district, to which we responded saying we need trained persons, staff nurses and doctors for the facility.”
EastMojo spoke to a doctor from Lawngtlai district, posted in one of the remote areas, on the facilities and infrastructure available for patients. The doctor, who preferred to remain anonymous, said, “In terms of facilities, the government has helped little. Everything is politicised. The government provides basic supplies, MLAs provide some aid. We live in a system where we never have enough but we are always given just enough so that the government does not have a bad reputation. The system just looks good from the outside, but internally, we are always improvising. If there were no donations, we would be in an even worse condition.”
On the need for COVID-19 facilities in Lawngtlai district, he said, “If there were COVID-19 facilities such as ICU beds for patients in a location that is nearer, maybe at least in Lunglei district, the situation would be much better. Some deaths could be avoided though some may be inevitable.”
“We cannot say that Mizoram has not done anything, but we can say that they have done little in terms of infrastructure. Our politicians are also not showing much progress if they really want to earn a good name for their parties. They have so many chances in this present situation but their calibre has not seemed to reach a level where they can envision the developments they could attain,” the doctor pointed out.
“Mizoram is just lucky because we have a low death rate. There are very few instances where the public are assured that the government will work on additional infrastructure and facilities for COVID-19 care. Instead, the government keeps instigating fear among the public, saying there are few vacant beds in Zoram Medical College. Instead of assurance, there is panic. Lockdown will never be the solution because this virus is not going anywhere. Instead, the government should focus on infrastructure,” the doctor added.
South Mizoram cries for adequate attention
VL Ruatpuii, a research scholar at the Mizoram University, who hails from Lawngtlai District, said, “It is very difficult for the southern districts to travel to Aizawl in the monsoon season. Apart from the distance, the road widening project going on under NHIDCL (National Highways and Infrastructure Development Corporation Limited) has worsened the road condition.”
Rochungnunga, Vansangpuii’s 70-year-old father, has only one wish now. “If they cannot provide us the same complex facilities that are available in the city, we hope they can at least provide us better facilities than what we have now and a vehicle that is fit and running.”
Transporting COVID-19 patients to ZMC not only takes up a lot of time, but the journey is also very exhausting due to the bad roads. “Unfortunately, lives have been lost as a result. Recently, a landslide near Bualte, a town between Lawngtlai and Aizawl, blocked the roads for two days,” Ruatpuii added.
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