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Moral Failure of India

The chamber of horrors in which the country is now was not caused by any man or government.

This month, Arvind Kejriwal, the chief minister of Delhi, the capital of India and home to millions of people, tweeted that the city was experiencing an “acute shortage” of medical oxygen. The message was enlightening on several levels: first, its use of social media, instead of working through official channels, points to a lack of confidence in the government of Prime Minister Narendra Modi (although this is also due, at least in part) , the fact that Kejriwal does not belong to Modi’s party); second, Kejriwal’s tweet emphasizes how Twitter has become the primary means by which Indians ask for help.

Individual stories of people finding oxygen or a hospital bed via Twitter cannot hide the reality: there will soon be no more beds. The drugs are running out. There are not enough ambulances to transport the sick to care, nor are there enough vans to transport the dead to cemeteries. There are not enough cemeteries, nor enough wood to burn the necessary pyres.

Placing the blame for the coronavirus disaster in India – hundreds of thousands of new cases and thousands of deaths each day, both of which are certainly greatly underestimated – at Modi’s feet would be easy. Certainly, much can be attributed to his government: after the virus landed on India’s shores, it imposed a brutal halt – which hit the poorest and most vulnerable in large part – without consulting the country’s leading scientists, but did not the time to improve the country’s health infrastructure; its administration offered little in terms of support to those who lost their jobs or income as a result of restrictions; and instead of taking advantage of low case counts in previous months, his government offered an air of triumphalism, allowing huge Hindu religious festivals and crowded sports competitions to continue. Modi’s ruling Hindu-nationalist party was accused of accumulating life-saving drugs and held election rallies and over-dissemination events that would make Donald Trump blush. (Not to mention how the authorities used the pandemic to invoke a draconian colonial-era law to restrict liberties, while Modi’s government on several points blamed minority groups for the outbreaks, arrested questioning journalists and, more recently, demanded that platforms social media, including Facebook and Twitter, exclude critical posts to authorities, apparently as part of the fight against the virus.)
India’s experience with the pandemic will be defined by this huge second wave. But the chamber of horrors in which the country now finds itself was not caused by any man or government. It is the greatest moral flaw of our generation.

India can be classified as a developing or middle-income country and, by international standards, does not spend enough on the health of its people. However, this masks many of India’s strengths in the health sector: our doctors are among the best trained on the planet, and, as we already know, our country is a pharmacy for the world, thanks to an industry built around make cost-effective drugs and vaccines.

What is evident, however, is that we suffer from moral malnutrition – none of us more than the rich, the upper class, the upper caste of India. Nowhere is this more evident than in the health sector.

India’s economic liberalization in the 1990s brought with it a rapid expansion of the private health industry, a change that eventually created a system of medical apartheid: world-class private hospitals serviced by wealthy Indians and medical tourists from abroad; state-run facilities were for the poor. Those with money were able to buy the best care available (or, in the case of the richest, flee to safety in private jets), while elsewhere the country’s health infrastructure was kept taped. The Indians who bought the way to a healthier life did not see, or chose not to see, the growing abyss. Today, they are holding their pearls while their loved ones are unable to obtain ambulances, doctors, medicine and oxygen.

I covered health and science for almost 20 years, including as a health editor for The Hindu, a leading Indian newspaper. That time taught me that there is no shortcut to public health, there is no exclusion from it. Now the rich are on the side of the poor, facing a reckoning that has only plagued the vulnerable in India.

Looking away from the tragedies that surround us, remaining divorced from reality, in our little bubbles, are political and moral choices. We are not aware of the fragility of our health system. The collective well-being of our nation depends on showing solidarity and compassion for one another. Nobody is safe until everyone is.

Our actions combine, one small act at a time – not pushing for more attention to the vulnerable, because we are safe; not requiring better hospitals for all Indians, because we can afford excellent health care; assuming that we can isolate ourselves from the failings of our country in relation to our compatriots.

An earlier tragedy in India shows the shortcomings of this approach.

Shortly after midnight on December 3, 1984, in the Indian city of Bhopal in central India, a tank from a pesticide factory leaked, releasing methyl isocyanate into the night sky. What would happen in the hours, days, weeks, months and years that followed was the worst industrial disaster in the world.

Officially, the Indian government says 5,295 people have died in total – others put the death toll much higher – and hundreds of thousands have suffered chemical poisoning. The preparedness and immediate consequences of the incident were chaotic: the company that owned the plant did not keep its safety and security measures up to date, and residents and medical professionals in the area did not know how to protect themselves.

Over time, toxic plant pollution has contaminated the soil and groundwater around the site, resulting in above-average rates of cancer, birth defects and respiratory disorders. The area is still a toxic mess. The company, local and state government and federal authorities in India always blame each other. The deaths started decades ago, but the suffering continues now.

I moved to Bhopal after the spill and grew up there, a city full of people carrying the intergenerational cost of what is now known simply as “the gas tragedy”. Outside Bhopal, many Indians do not remember the city beyond a vague sense of some long-forgotten disaster. The gas tragedy is remote for them, remitted to history. But living in Bhopal and seeing the impact the spill had, I learned early in life that monumental failures, like monumental successes, are collaborative efforts, involving both the actions people take and the signs they ignore.

Many things went wrong and many people were responsible: The safety systems that could have delayed or partially contained the leak were all out of operation at the time of the accident; meters that measured temperature and pressure in various parts of the plant, including crucial gas storage tanks, were so notoriously unreliable that workers ignored the first signs of trouble; the cooling unit – necessary to keep chemicals at low temperatures – has been shut down; the flare tower, designed to burn the methyl isocyanate that escaped the gas purifier, required a new pipe.

What has happened since then is perhaps more instructive. The Indians in general forgot about the tragedy. The people of Bhopal were left to deal with the consequences. The richest Indians never had to visit the city, so they ignored it. However, his apathy signals a choice, a decision to look the other way while his fellow Indians suffer.

Photojournalist Sanjeev Gupta, a native of the city, has spent years documenting the consequences of the disaster. Once in a while, when the media’s attention returns to Bhopal because of a new chapter in the long-running legal drama, his photos are usually the ones that adorn the reports. According to Gupta, the mass pyres now burning in Bhopal’s crematoriums as a result of coronavirus deaths are worse than anything he saw in 1984.

However, we inadvertently built the system that is failing. Perhaps the COVID-19 crisis teaches us, as the gas tragedy should have taught us, that our decisions – to be silent while others suffer – have consequences.

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