The scourge of the second wave of Covid 19 has brought our ill-prepared nation to its knees. The heart-rending images of the overcrowded hospitals bereft of fundamental necessities, particularly medical oxygen, the hapless citizens begging for care and mass cremations/burials have all exposed our governments and institutions. Yet the State seems to be shy of optimally utilising its instrument of last resort — the armed forces — to make the dysfunctional healthcare system perform more efficiently through better management.
In my view, there are two reasons for this reluctance. First, the government seems apprehensive about its incompetency getting exposed. Second, the military hierarchy has itself failed to advise the government about its capabilities/core competencies, and on how best to utilise the resources of the armed forces. It appears to have mechanically followed the directions it has received from various empowered committees, which ironically have no military representatives.
Experience of the first wave
In the first wave, the armed forces remained on the fringes, merely transporting Indians stranded abroad and constructing/managing the isolation centres for them. The government failed to use the Army to manage its most serious crisis for which the latter was most suited for – migrant labourers exodus. This added to virus spread.
The armed forces’ infamous contribution last year was to organise the spectacle of fly pasts, band displays, sailing ships and showering of petals on 3 May to honour the Covid warriors. Ironically, the timing coincided with the People’s Liberation Army’s preemptive offensive manoeuvres in Eastern Ladakh. Thereafter, national security became the priority. It is worthwhile to recall that we fought the 1947-48 Jammu and Kashmir War while simultaneously handling the Partition refugee crisis.
The armed forces have done exceptionally well to preserve their force through good management. Bulk of the personnel have already been vaccinated.
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Armed forces must not be left out of the battle
In fighting the second Covid wave, the armed forces must not be LOB — Left Out of Battle — an archaic military term wherein anticipating heavy casualties, units would leave five per cent of key personnel out of the battle to re-raise the unit. Valuable time has already been lost. The magnitude of the second wave was obvious by 15 April and I would have liked to see the armed forces standing by to swing into action, executing contingency plans to take over as crisis managers in major cities and districts with poor medical cover.
So far, the actions have been knee jerk, without a holistic plan. Indeed the armed forces have earmarked 10-15 per cent of the beds in selected hospitals for civilians. But this has brought it into conflict with its “own” as the hospitals were already choked with soldiers, their dependents and veterans who cannot utilise the civilian hospitals empaneled with Ex-servicemen Contributory Health Scheme due to overcrowding. There are many reports on social media about dependents/veterans facing serious problems in hospital admission. On Tuesday, there were reports that were later denied by the Army, of Base Hospital, Delhi Cantonment facing O2 crisis.
The Indian Air Force (IAF) and the Indian Navy have done well to post-haste transport O2 containers and tankers from abroad and within India. But the organisational skills and transport facilities of the military have not been utilised for the critical last mile distribution.
The DRDO, through out-sourcing, has constructed four Covid hospitals in Ahmedabad, Varanasi, Lucknow and Delhi. Except the one in Delhi, the other three are in the constituencies of the top three politicians of the ruling party. These facilities are being managed by the armed forces and have sucked in disproportionate resources of doctors/ medical support personnel and medical equipment. The armed forces have very limited reserves of personnel left for the crisis which is still unfolding.
In my view, the full potential of the armed forces is not being utilised. The armed forces are not in the decision-making loop and military representatives have not been consulted. This is evident from the absence of their representation in the 11 empowered groups set up last year to coordinate the management and control of the Covid-19 pandemic across India. This is when the armed forces have the capacity to directly influence almost all domains of the empowered groups. The Chief of Defence Staff (CDS) and the Services Chiefs have held much publicised face-to-face meetings with the Prime Minister. One wonders what purpose such meetings would serve in the absence of formal minutes being recorded or directions being given.
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How best to utilise the armed forces
The disturbing reports being flashed on TV screens and newspapers everyday showcase the scale of the crisis India faces today. What they also suggest is that no one is in charge to coordinate the fight against Covid. Governments work in watertight compartments and are overtaken by events in a crisis. This is true the world over.
India’s armed forces have 1.5 million trained personnel and, by now, they are Covid vaccinated, spread across the length and breadth of the country. The primary strength of the military is in the field of organisation and crisis management. It has a large workforce and vast resources for transportation. In critical cities/towns/areas, the management of the fight against Covid must be taken over by the military. War rooms must be set up to coordinate the battle.
Procurement/transportation/allocation of O2, other critical medical resources, allocation of hospital beds, transportation of patients and dead can be coordinated and augmented by the armed forces. I see no reason as to why the situation, for example, in Delhi cannot be turned around in 48 hours. However, the government will have to formally authorise the Army and allocate the resources.
The armed forces have approximately 13,000 officers (doctors/specialists/nursing officers) and one lakh medical support staff. Veteran officers and medical personnel can nearly double the existing resources. 130 military hospitals are already committed, taking care of soldiers, dependents and veterans and can do little more than the 10-15 per cent capacity already committed for civilian patients.
However, the armed forces have the capacity to create 100 field hospitals with 100 beds each. With the help of private doctors, medical students and additional medical equipment, many more temporary facilities can be made operational in a short span of time. It is these resources which can be superimposed on the civilian hospitals to take on the overload. War rooms can coordinate the deployment of the field hospitals in critical areas. It is counter-productive to commit military resources to standalone large facilities like the DRDO-constructed hospitals.
Military engineers can convert requisitioned buildings/sheds/factories into hospitals and also construct new ones using prefabricated material. All that the armed forces will require will be funds, ICU equipment, ventilators, medicines and other essential equipment. War rooms can also coordinate and augment the door-to-door vaccination programme.
Our war on Covid is hampered by lack of organisation, coordination and management. The government must press into service its instrument of last resort, which has proven capability for the same. India needs an honest, disciplined and swift response of a scale as large as the crisis. Only one institution’s name comes to the mind — the Indian Armed Forces.
Lt Gen H S Panag PVSM, AVSM (R) served in the Indian Army for 40 years. He was GOC in C Northern Command and Central Command. Post retirement, he was Member of Armed Forces Tribunal. Views are personal.
Edited by Anurag Chaubey