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Never signed so many death certificates, says Patiala official, calls it ’emotionally tiring’

In Punjab's Patiala, official issuing death certificates says he never thought a time would come when papers with details of the dead would pile up on his table every day.

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Patiala: It is 4 pm and Rajwinder Singh is yet to have lunch. For the past two months, Singh, the sub-registrar and statistician at Rajindra Hospital in Punjab’s Patiala district has been working even on weekends, sometimes till 3 am, tallying personal details of the dead with hospital records and signing death certificates.

As the second Covid wave in the country sent the number of deaths spiraling, people like Singh — who have the job of certifying the deaths — have been among those who have found themselves struggling under the burden of work.

For Singh, who has been doing this work for the past 20 years across medical colleges in Punjab, the past two months have been the busiest in two decades. They have also been emotionally draining.

“I have never signed so many death certificates in my entire career. Even in my worst nightmares, I never thought a time would come when there will be a rush outside this office and papers with details of the dead will pile up on my table every single day,” said Singh.

“We have been issuing over 40 to 50 death certificates in a day, after completing all formalities and typing in the requires details — a process which takes approximately three weeks,” he added.

With over 1,019 deaths between 1 January and 21 May, Patiala accounted for 11 per cent of Punjab’s death toll during the second wave — one of the highest in the state. Understandably, offices handing out death certificates have been swamped.

According to data shared by Rajindra Hospital (attached to the Government Medical College, Patiala), Punjab has reported 8,963 Covid deaths (between 1 January and 21 May), with a case fatality rate (CFR) of 2.6 per cent, against the national CFR of 1.3 per cent. As of 8 June, Patiala was still reporting an average of 10 deaths a day.

The number of death certificates issued by the Municipal Corporation, Patiala, between March and May has also seen an overall increase of almost 35 per cent from last year, said sources in the corporation.

According to the data procured from the municipal corporation, over 279 death certificates were issued in March this year, as compared to 181 in March 2020. In April, over 309 certificates were issued, against 147 in April 2020, and in May, the figure stood at 274, against 397 certificates issued during the same period last year. The figures for this year, however, do not include certificates issued by the one other agency that issues the certificates.

The municipal corporation is one of two agencies issuing death certificates in the district — the other is the Rajindra Hospital, which has the authority to issue certificates for deaths that happen at the hospital. The hospital functions under the Directorate of Medical Education and Research Department, Punjab Government and “sends us an update on how many death certificates they have issued in a year,” said Poonam Deep Kaur, Municipal Commissioner, Patiala.

Which is why, while last year’s data on certificates issued includes those issued by Rajindra Hospital, this year’s data hasn’t been collated yet.

For deaths at other hospitals, private or government, hospital authorities collect the data of the deceased and send it to the municipal corporation virtually, which is then scrutinised and cleared by the corporation, said Kaur. The corporation then sends the death certificates to the hospitals, from where they are collected by families of the deceased.

Deaths at home are reported at Sewa Kendras, set up across the district, where families can apply for death certificates, explained Kaur.

Meanwhile, the constant living with the dead has exhausted Singh, mentally and emotionally.

“It is emotionally draining, tiring. Looking at the details of so many people who have died, so many youngsters who have passed away, is definitely taking a toll on us. In normal times we issue approximately five-six certificates a day. But this wave took so many lives and it hit us hard in the month of May, when papers started piling up on our desk,” he lamented.

The lack of manpower has added to the burden of those like Singh, who have been working round-the-clock to certify the mounting deaths.


Also read: How diet, lifestyle & attitude have led Punjab to record India’s highest Covid death rate


Shortage of staff

At Rajindra Hospital — the biggest government facility in the district — the office issuing death certificates is working at 40 per cent capacity. A team of four here manages the entire workload. One person enters the records of deaths in his computer, while two others work on the birth records.

All the certificates are verified by Singh and then signed by him. One person hands over all the certificates to the people.

When ThePrint visited the department in the first week of June, Karan Kumar, the operator in charge of keying in data for all deaths, was seated at his computer, busily tapping in at the keyboard. Before him was a queue of people, waiting to register complaints that ranged from delay in issuance of death certificates to errors in the document, such as misspelt names or incorrect addresses and age. Along with entering the data, Kumar also had to attend to them.

“I have been working till 3 am in the night, entering the deaths data alone. Sometimes mistakes do happen. People then come here asking us to make corrections, which is another long process and cannot be done from here (once printed, any change in the certificate needs to be requested at the Sewa Kendras. The corporation then issues a fresh certificate),” he says.

Since the second wave hit the country, Kumar said, “in a day we are getting details of over 100 patients, which is four times the work we did earlier. The hospital sends us cumulative data of two-three days. Then we start our work here”.

Within two days after the death, details of the deceased are tabulated by doctors who had been attending to them and passed on to the office from where the death certificates are made and issued.

Medical Superintendent of Rajindra Hospital, M.S. Rekhi said he was aware of the shortage of staff in the department issuing death certificates.

“We are doing our best to notify the deaths in time and issue the death certificates at the earliest. But we are overburdened. It definitely is emotionally draining,” he said.

To minimise mistakes, and the time needed to correct those, he said the hospital was “asking family members of the deceased to come and check the details of the dead before issuing the certificate so that the required changes can be done before the certificate is issued.”

Admitting that the department needed more staff, he said, we are working to resolve the issue. This situation has improved (since the beginning of June, deaths have come down) and we hope it will only get better from here”.

(Edited by Poulomi Banerjee)


Also read: For years this Punjab man planted trees so village could breathe. Then, his lungs gave way to Covid


 

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