UPSC Mains 2021 · GS IV · Q10 · 20 marks · 250 words · Case study

The coronavirus disease (COVID-19) pandemic has quickly spread to various countries. As on May 8th, 2020, in India 56342 positive cases of corona had been reported. India with a population of more than 1·35 billion had difficulty in controlling the transmission of coronavirus among its population. Multiple strategies became necessary to handle this outbreak. The Ministry of Health and Family Welfare of India raised awareness about this outbreak and to take all necessary actions to control the spread of COVID-19. Indian Government implemented a 55-day lockdown throughout the country to reduce the transmission of the virus. Schools and colleges had shifted to alternative mode of teaching-learning-evaluation and certification. Online mode became popular during these days. India was not prepared for a sudden onslaught of such a crisis due to limited infrastructure in terms of human resource, money and other facilities needed for taking care of this situation. This disease did not spare anybody irrespective of caste, creed, religion on the one hand and ‘have and have not’ on the other. Deficiencies in hospital beds, oxygen cylinders, ambulances, hospital staff and crematorium were the most crucial aspects. You are a hospital administrator in a public hospital at the time when coronavirus had attacked large number of people and patients were pouring into hospital day in and day out.

  1. (a) What are your criteria and justification for putting your clinical and non-clinical staff to attend to the patients knowing fully well that it is highly infectious disease and resources and infrastructure are limited?
  2. (b) If yours is a private hospital, whether your justification and decision would remain same as that of a public hospital?

हिन्दी में

कोरोनावायरस रोग (कोविड-19) महामारी तेजी से विभिन्न देशों में फैली है। 8 मई, 2020 तक भारत में कोरोना के 56342 पॉजिटिव मामले सामने आए थे। भारत को, जिसकी जनसंख्या 1·35 बिलियन से अधिक है, जनसंख्या में कोरोनावायरस के संचरण को नियंत्रित करने में कठिनाई आई थी। इस प्रकोप से निपटने के लिए कई रणनीतियाँ आवश्यक हो गई थीं। भारत के स्वास्थ्य और परिवार कल्याण मंत्रालय ने इस प्रकोप के बारे में जागरूकता बढ़ाई और कोविड-19 के प्रसार को नियंत्रित करने के लिए सभी आवश्यक कार्रवाईयाँ कीं। भारत सरकार ने वायरस के संचरण को कम करने के लिए पूरे देश में 55 दिनों का लॉकडाउन लागू किया। स्कूल और कॉलेज में शिक्षण-सीखना-मूल्यांकन और प्रमाणीकरण के वैकल्पिक तरीके सामने आए। इन दिनों ऑनलाइन मोड लोकप्रिय हो गया। भारत इस तरह के संकटपूर्ण अचानक हुए हमले के लिए तैयार नहीं था क्योंकि मानव संसाधन, धन और ऐसी स्थिति में देखभाल करने के लिए बुनियादी ढाँचे के रूप में अन्य सुविधाओं की कमी थी। इस बीमारी ने एक तरफ तो जाति, पंथ, धर्म की परवाह किए बिना किसी को नहीं बख्शा और दूसरी तरफ ‘अमीर-गरीब’ दोनों को भी नहीं छोड़ा। अस्पताल में बिस्तर, ऑक्सीजन सिलेंडर, एम्बुलेंस, अस्पताल-कर्मचारी और श्मशान की कमी सबसे महत्त्वपूर्ण पहलू थे। आप ऐसे समय एक सार्वजनिक अस्पताल में अस्पताल प्रशासक हैं जब कोरोनावायरस ने बड़ी संख्या में लोगों पर हमला किया और अस्पताल में मरीजों का दिन-रात आना-जाना लगा रहता था।

  1. (a) पूरी तरह से जानते हुए कि यह अत्यधिक संक्रामक रोग है और संसाधन तथा बुनियादी ढाँचे सीमित हैं, अपने नैदानिक और गैर-नैदानिक कर्मचारियों को रोगियों की देखभाल करने में लगाने के लिए आपके मानदंड और औचित्य क्या हैं?
  2. (b) यदि आपका निजी अस्पताल है, तो क्या आपका औचित्य और निर्णय वैसा ही होता जैसा कि सार्वजनिक अस्पताल में?

How a topper answered the closest question

Toppers wrote this one in a test series: “You are the Health Secretary in a state where there is an outbreak of dengue and chikungunya diseases. There have been reports of negligent attitude of some private hospitals in the city. Also, the public hospitals do not have the required infrastructure and staff to meet such increased number of cases in a short span of time. Additionally, the staff is demoralised by the increased working hours and the public outrage. Despite the efforts of the local authorities this issue emerges year after year. 1. What are the immediate steps which should be taken in such a situation? 2. Suggest some long term measures to ensure that such a situation is not repeated.”

Namrata JainAIR 12 · CSE 2018 · 361 wordsTheir whole copy

Opening

The stakeholders are: The ethical issues in the above case study are:

Body · points


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Society ------ Hospitals and Doctors The ethical issues in the above case study are:

  1. Negligency and Complacent behaviour to not address long term solutions despite the occurrence of outbreak frequently.
  2. Poor doctoral ethics (mainly private) with greater focus on profit.
  3. Tackling the issue for public welfare keeping long term solutions too in mind.

Following should be the immediate steps to be taken:

  1. Fogging measures ensuring no more case emerges on immediate basis and doctors to be made available without any delay. → This will ensure safety of the one's who are protected till. → Doctors will ensure the proper delivery of treatment to the needy patients.
  2. Ensuring private hospitals are working in full capacity and giving assurance by the physical presence by pacifying and solving the problem jointly by taking community members, media, local politicians, Civil society in active role.
  3. Contact with other states for doctoral help and the techniques to solve by forming high level committee.
  4. Asking for centre's help to show cooperative federalism to ensure public's safety and health.

Following can be the long term measures:

  1. Strengthening public hospitals infrastructure as well as capacity to handle patients.
  2. Long term awareness generation programmes by advertisement in newspapers, television as well as by nukkad nataks and such local programmes.
  3. Taking public hospital staffs concern: by paying fair wages, security as well as solve their concerns.
  4. Allocation of proper amount of budget in health and ensure it is used wisely for development and strengthening hospitals as well as delivery system.
  5. Make private hospitals accountable and use of fear appeal of action if negligency is shown in future.
  6. Fogging measures to be taken timely.
  7. Grievance Redressal mechanism and cell to tackle the issue before it grows to such a large extent.
  8. Increase the capacity of staff to tackle the health cases and ensure there is no shortfall.
  9. Taking help of role model who can influence public (celebrity etc) of the precaution and preventive measures.

Close · a summary

Thus, health of the public is of chief concern which must be addressed with due precautions and tackle the case or situation before it aggravates.

6 more toppers’ answers to this question, part by part, and how they all approached it: open the question.

Toppers’ answers to other close questions

Source: UPSC, Civil Services (Main) Examination 2021, General Studies Paper IV, Q10. The paper on upsc.gov.in. Themes and links to toppers’ answers are by UPSC Grade, not by UPSC.