TRIHMS and Covid-19 pandemic in Arunachal Pradesh

[ Dr Moji Jini ]

  1. Corona Virus -19 is spreading faster than before and this trend is likely to increase.
  2. It has become a Sisyphean task to keep track of source and spread of corona infection now.
  3. Symptomatic cases of Covid-19 are soon going to overcrowd the Tomo Riba Institute of Health & Medical Sciences (TRIHMS) Dedicated Covid Hospital (DCH), Chimpu.
  4. Symptomatic cases are trickling in from other parts of the state to TRIHMS’ DCH, Chimpu. Critical cases and deaths are also going to increase in the state.
  5. The existing manpower of TRIHMS has been stretched out and divided between TRIHMS Medical College Hospital, Naharlagun and DCH, Chimpu. Moreover, many doctors, nurses and other staff infected by corona virus have been quarantined for the safety of patients and health workers.
  6. The TRIHMS at Naharlagun is overcrowded as other hospitals in the capital are intermittently closed down following diagnosis of Covid cases among their OPD and IPD patients. In fact, some doctors and staff from other hospitals of the Capital have been admitted at TRIHMS DCH, Chimpu.
  7. Thus, TRIHMS is delivering its share of services under the given circumstances of:
  8. Increasing load of both Covid and non- Covid patients.
  9. Having to manage two hospitals simultaneously which are 20 km away from each other. All facilities (and manpower) like ICU/ operation theatre/ labour room/ neonatal ICU/ dialysis/ radiology/ laboratory/CSSD- sterilisation are duplicated in both hospitals.

iii. Manpower shortage is aggravated due to corona infection among health workers.

  1. For fear of infection and increased burden of work many nurses and other staff have managed to get leave and transfer orders.
  2. Despondency, physical and mental fatigue now slowly showing up among health workers.
  3. In spite of all the above, the TRIHMS, as the only medical college and tertiary care Covid hospital have been able to scramble equipment, set up and adapt Covid treatment facilities many times over.
  4. As the designated ‘Centre of Excellence for Covid- 19 Management’ TRIHMS has Covid-19 expert team which formulates treatment

 protocol for Covid-19 treatment tailored for our state. The experience of the last couple of months has been very encouraging.

  1. The TRIHMS and all its health workers will continue to stand like the rock of Gibraltar in the fight against Covid-19 till the end of the pandemic and beyond. But the least that can be done is to take cognizance of all the difficulties under which TRIHMS and its health workers are functioning and appreciate their efforts under the circumstances. The same should also be said for all the other health workers working in the field also.
  2. Now, the Covid-19 pandemic is changing from local transmission to widespread infection and it is impossible to be contained by social and public measures alone. While widespread testing, contact tracing, social/physical distancing, use of masks and hygiene, public education must continue for what they are worth, but now time has come to focus more on efforts to minimise morbidity and mortality. Early identification and confirmation of all symptomatic cases, providing appropriate therapeutic support at appropriate time will minimise suffering and death.
  3. This fight against Covid-19 cannot be and should not remain the fight of the government or the administration or the health department or TRIHMS alone. It must be a concerted effort of all. But most importantly, it is the awareness and cooperation of the people which will immensely help the health department and the state government to dampen the spread of infection and minimise suffering and loss of life. The public being the major stakeholder should also own responsibility. In doing so, people need to also recognise the efforts and the limitation of the state government and its machinery (Health department and administration etc.).
  4. The TRIHMS is stretched to the limit now. Timely support is must.
  5. The 40-bedded Covid ward with ICU at TRIHMS’ DCH, Chimpu is nearly full and needs at least 50-100 additional beds immediately.
  6. Additional doctors (Physicians/ chest specialists / anaesthesiologists/ paediatricians/ medical officers).

iii. Additional 50 nurses needed immediately.

  1. Support staff: Lab technicians/ radiographers/ dialysis technicians/ attendants/ sanitary assistant.
  2. Un-interrupted supply of PPE/ drugs/reagents and consumables.
  3. Covid-19 patients’ management by TRIHMS so far:

Total patients hospitalised- 200

Total deaths-6

Total delivery/ obstetric cases-26

Caesarean section-17

On haemo- dialysis-6

Total RT-PCR tests done – 15, 000 (Approx).

  1. Private health institutions need to share the burden. Guidelines have been issued by the state government.

Finally, short of sounding self laudatory one cannot but say that Arunachal Pradesh has been very fortunate to have on its side a three year old medical college in the right time. Thanks to the state government for making it happen. Without a medical college, all the facilities and expertise available in the state today would have been impossible and Arunachal would have been beholden to neighbouring states like Assam and Meghalaya. One cannot imagine the nightmare that our people would have had to go through.

The least all can do is to hail TRIHMS and support it from all corners.

(Dr Jini is Director of the Tomo Riba Institute of Health and Medical Sciences, Naharlagun)

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