How an IAS officer made a Maharashtra tribal district oxygen-sufficient

A doctor-turned-bureaucrat, Dr Rajendra Bharud, the collector of Maharashtra’s Nandurbar has managed to keep the district running with adequate supply of medical oxygen, hospital beds, isolation wards for Covid-19 patients and a well-planned vaccination drive at a time when the entire country struggled to meet the logistical challenges that a gasping healthcare system posed.

The district collector of a small tribal-inhabited district in Maharashtra saw the deadly second wave of coronavirus disease coming and prepared a series of contingency plan, at a time when the country, including the western state, struggled to meet the logistical challenges that a gasping healthcare system posed.

Last September, Dr Rajendra Bharud had anticipated that there the cases could go up any moment, and that an oxygen plant could come handy if more people fall sick because of the disease.(Twitter/@IASRajBharud)

A doctor-turned-bureaucrat, Dr Rajendra Bharud, the collector of Maharashtra’s Nandurbar has managed to keep the district running with an adequate supply of medical oxygen, hospital beds, isolation wards for Covid-19 patients and a well-planned vaccination drive.

Today, the district has 150 vacant beds and two oxygen plants that have a combined capacity to produce 2,400 litres per minute. Not only did the district manage to control the positivity rate of the infection but it also slashed it by around 30%. Its robust healthcare system has led many from the neighbouring region in Madhya Pradesh and Gujarat to seek admission in Nandurbar.

Vision of the second wave

Nandurbar didn’t have any oxygen plant when the pandemic struck early last year. But Bharud got down to setting up a liquid oxygen plant in the tribal-inhabited district in September last year when the cases of coronavirus infection gradually began to go down.

He had anticipated that there the cases could go up any moment and that an oxygen plant could come in handy if more people fall sick because of the disease. Without much ado, he got a plant set up with a capacity of 600 litres per minute.

His fears came true in no time. According to media reports, when the second wave of Covid-19 hit Maharashtra this year, Nandurbar reported as many as 1,210 cases in a single day. Dr Bharud and his team felt that one oxygen plant was not enough, given how the people were contracting the disease.

He mobilised funds to set up two more plants at the district hospital, pushing the capacity of the oxygen plant to 1,800 litres per minute. He said the district is expecting to ramp up the capacity to 3,000 litres per minute.

Dr Bharud said the money was a crucial requirement in setting up a robust healthcare system that needs adequate ambulances, ventilators, beds, oxygen plants, vaccines, medicines, trained medical staff among others. The officer used a combination of resources, including district planning and development funds, state disaster relief funds, and mobilised the CSR units to meet expenses.

He said his team provided the doctors in the district with all the resources they need to set up oxygen plants in the district. Not only that but his team also made sure that oxygen pipes were given as soon as saturation levels started dropping, instead of waiting for the critical stage.

“This way, patients use only 30% of oxygen, as against 90% in the latter situation. When oxygen starts dropping, it directly affects the brain and kidney, which makes it harder for patients to recover fast. Hence, oxygen levels need to be managed and taken care of in the early stages itself,” Dr Bharud told a news portal recently.

The 2013 batch IAS officer wishes that no patient should suffer for the want of oxygen.

Optimum use of available resources

To prepare for exigencies, the district administration converted schools and community halls into Covid-19 centres and set up 7,000 beds just for isolation while equipping 1,300 beds with ICU or ventilator facilities.

The district administration next set up a situation room and created a website to help control the panic and guide the citizens.

Not only that but the district administration roped in local doctors and trained them to perform vital medical procedures such as intubating a patient and monitoring their oxygen level.

Isolation coaches, but with comfort

Dr Bharud then requested the Western Railway to provide them with isolation coaches. In no time, the Indian Railways provided a 21-coach isolation ward train for Covid-19 patients in Nandurbar. Each coach can accommodate 16 patients who are provided with bedrolls, pillows, napkins. The facility has nine coolers, two oxygen cylinders and one bathroom with three toilets per coach.

Union railway minister Piyush Goyal responded to Dr Bharud's call on Twitter. "Railways is devoting all its resources for fighting COVID-19. Isolation coaches has started functioning at Nandurbar, Maharashtra with COVID-19 patients being admitted," he wrote on the micro-blogging site.

Last-mile vaccination drive

He has also made sure that vaccination drives against Covid-19 do not run into any roadblock. Of the 300,000 people in the district above the age of 45, as many as one lakh have already received their first dose of vaccine despite the lack of awareness around inoculation drives among the tribal populace in the district.

“Instead of calling people to us for vaccination, we allotted 16 vehicles to every part of the district to give the vaccine. This way, people didn’t have to travel on hilly terrains. We roped in teachers and sarpanches to spread the word about the seriousness of the situation, and it worked,” the collector told the news portal.

Dr Bharud has received kudos from people from all walks of life. From filmmaker Nandita Das, Biocon chairperson Kiran Mazumdar-Shaw, entrepreneur Amit Paranjape, to bureaucrats, IAS officers and doctors, many took to Twitter to praise Bharud for this initiative.

Maharashtra human rights commission secretary Tukaram Mundhe, himself an IAS officer, gave the example of Dr Bharud's initiatives to highlight how inspired leadership contributes to social well-being.

Meanwhile, Biocon chairperson Kiran Mazumdar-Shaw went a step ahead to say how pandemic preparedness and rapid response is largely missing in India.

Dr Bharud's life is a tale of wonder, too. He was raised by his widowed mother. Battling all odds, Dr Bharud completed his schooling in a small village in Dhule. His father died of malaria before he was born while his mother worked as a labourer on farms to fund his studies. He earned his medical degree from Mumbai's KEM hospital and Seth GS Medical College and has been an inspiration to the public health department and district collectors across Maharashtra.