India’s Oxygen Paradox: It’s Available, But Not Accessible

The Covid-19 crisis in India has dwarfed the statistics of almost all other countries with their daily cases, test positivity rates and covid-19-related deaths. However, these numbers seem, the reality is that they are much worse due to underestimating. Right now, the most pressing problem in India is oxygen, with documented scarcity in many Indian cities. What is disconcerting about the oxygen shortage in India is this paradox: oxygen is available in the country, but cannot be transported to where it is needed, mainly due to the lack of infrastructure.

The Oxygen Paradox: It Is Available But Not Easily Accessible

I spoke with Ramanan Laxminarayan, a Princeton epidemiologist now based in Delhi, who is the director of the Center for Disease Dynamics, Economics and Politics. He is working to remedy the oxygen paradox through his new Oxygen campaign for India. Having written several field stories of India’s Covid-19 crisis for the New York Times, he is now working with local oxygen manufacturers and NGOs to bring oxygen from the factories where it is produced to the hospitals where it is needed. As he explains, ” the main challenge is not necessarily an oxygen supply problem. Its getting oxygen from manufacturers to hospitals and patients. It’s a transportation problem. It’s the last mile.”Laxminarayan has developed a model to help close this gap, which he calls the last mile delivery model, and is implementing it across the country.

The last mile Model

In Laxminarayan’s last mile delivery model, manufacturers ‘ oxygen is transported with the help of their volunteer-based fleet to hospitals across the country. His team has established centers in several hospitals, called oxygen help desks, to then distribute oxygen to patients who need it. Deployment began in Delhi and in the coming days and weeks will be expanded to hospitals in Bangalore, Ranchi, Kolkata, Guwahati and Chennai.

In this model, patients arrive at the hospital’s oxygen help desk, complete an initial needs assessment and return home with an oxygen cylinder or oxygen compressor for home use. Laxminarayan explains: “most people won’t be able to get a hospital bed right now, but at least they can get a cylinder or compressor to take home.”The service is free, and the classification between the oxygen compressor and the oxygen cylinder is based on one main criterion: access to electricity. “Oxygen compressors are lighter to carry, but they require electricity, which is not an option for many poor people in this country who may not have a reliable source of electricity,” he says. On the other hand,” oxygen cylinders are heavy and need to be recharged, but if someone doesn’t have electricity, this is their only option,” he adds.

In addition to supplying oxygen at home to patients, the campaign also supplies oxygen to hospitals. “Hospitals don’t have oxygen at the moment. If hospitals can’t get oxygen, then we can’t rotate the beds to get new patients. The last mile delivery model can help with both the oxygen problem and the lack of hospital beds, ” says Laxminarayan.

Oxygen supply is a collaborative effort

The Laxminarayan campaign is working in collaboration with groups such as Give India, the Swasth Foundation and others to bring oxygen from where it is produced to where it is needed. There are many other organizations that are also doing the valuable work of bridging the oxygen paradox gap, including the Hemkunt Foundation, the Uday Foundation, Aid India and others. It is a very complicated system with many moving parts but with a shared goal: to get the oxygen out of the factories and put it in the hands of the patients who need it most.

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