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Mobile hospitals inside cargo containers — how India is preparing for next disease outbreak

The hospitals, to be set up through new PM health fund, will be stationed in Delhi & Chennai and moved during disasters or disease outbreaks to buttress India's health infrastructure.

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New Delhi: Building on the idea of turning railway coaches into Covid-19 isolation centres, the Government of India has decided to set up two mobile hospitals inside shipping containers that can be moved to any place where there is an emerging disease outbreak or disaster.

The two hospitals will be fully paid for by the Centre from the Pradhan Mantri Atmanirbhar Swasth Bharat Yojana, and in peacetime, they will be stationed in New Delhi and Chennai.

Each of the hospitals will comprise at least 30 containers (usually used for transporting goods) apart from medical equipment, doctors and paramedical staff. The locations have been decided based on how quickly the hospitals can move to any destination in India. The hospitals will be kept fully ready at all times and moved at short notice as and when needed.

“Both of these hospitals will be paid for fully from the PM Atmanirbhar fund, and states will not have to give any money. Procurement and recruitment will also be done by the Government of India, and we will put them in place as soon as possible,” said a senior health ministry official.


Also read: In a first, panchayati raj & urban local bodies to spend Centre’s Rs 13,192 cr on health


State of hospital beds in India

According to a report by the 15th Finance Commission, India is estimated to have a total of 18,99,228 hospital beds (over 60 per cent of which are in the private sector) — roughly 1.4 beds per 1,000 people.

“This is lower than in many comparator countries: China’s bed density exceeds four per 1,000; Sri Lanka, the United Kingdom and the United States have around three per 1,000; and in Thailand and Brazil hospital beds exceed two per 1,000 persons,” says the Finance Commission report, which features a whole chapter on the state of healthcare in India.

“Within India, hospital bed densities are particularly low in Bihar, Odisha, Chhattisgarh, the erstwhile state of Jammu and Kashmir, Jharkhand, Manipur, Madhya Pradesh and Assam. Gujarat, Uttar Pradesh, Maharashtra, Andhra Pradesh, Haryana and Telangana have relatively low densities of public hospital beds, but this is made up by the availability of private beds,” it adds.

The decision to build mobile rather than static hospitals came as the Covid-19 pandemic showed how erratic outbreaks can be. While concerns at the start of the pandemic had been about the infrastructure and hospital shortage in rural areas, during the pandemic, it was cities like Mumbai, Delhi, Pune and Chennai that bore the brunt of cases, and hospital services were stretched.

The isolation centres in train coaches, though, were only sporadically used, largely because of the lack of air conditioning.

Health and wellness centres

In her Budget 2021 speech, Finance Minister Nirmala Sitharaman had announced an allocation of Rs 64,180 crore under the PM Atmanirbhar Swasth Bharat Yojana for six years for health system strengthening.

Among the interventions that Sitharaman proposed is support for 17,788 rural and 11,024 urban health and wellness centres (HWCs).

A health ministry official told ThePrint: “When we did a stock-taking of the progress in health and wellness centres under Ayushman Bharat, we found that in order to meet the target of 1,53,000 HWCs by 2022, we would be a little short of funds. When we did the calculation, we found we were about 28,000-odd centres short.”

That is why the decision was taken to fund these centres through the Atmanirbhar Swasth Bharat Yojana, the official added.

In the Budget documents, an allocation of Rs 1,650 crore under the Pradhan Mantri Swasthya Suraksha Nidhi (a health contingency fund that is being created from the health cess) has been made for Ayushman Bharat HWCs for the 2021-22 financial year. Each HWC is estimated to cost about Rs 15 lakh on an average. However, unlike the mobile hospitals, these will be built with monetary contributions from states in a ratio of 60:40 or 90:10 (for special category states).

The special fund is also to be used for several other initiatives, including setting up integrated public health labs in all districts; establishing critical care hospital blocks in 602 districts; strengthening the National Centre for Disease Control, its five regional branches and 20 metropolitan health surveillance units; and strengthening public health units at 32 airports, 11 seaports and 7 land crossings.


Also read: Total allocation for health ministry up only 7%, no increase in budget for Ayushman Bharat


 

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