Many Indians cannot prove that their loved ones died of Covid. And that can be a problem

But the hospitals in the Indian city of Varanasi had run out of space, oxygen, medicine, tests – everything.

“They told us everywhere that it was bad and people were lying on the hospital floors and that there were no beds at all,” the 33-year-old said.

In theory, the program should help people like Srivastava. But experts believe the true death toll could be many times the official number of 450,000 – and some victims’ families may end up missing out on compensation because they either do not have a death certificate or the cause of death is not listed as Covid19.

The Indian government has promised that no families will be denied compensation “solely because” that their death certificate does not mention Covid-19.

But days after the compensation plan was announced, the rules are still unclear – and it is causing stress for many Indians who are struggling to feed their families after losing a breadwinner during one of the world’s worst Covid outbreaks.

Covid-19 victims cremated at Nigambodh Ghat Crematorium in New Delhi on April 28, 2021.

The countless died

At present, the criteria for compensation are relatively straightforward.

Families can receive the payment if their next of kin died within 30 days of a Covid-19 diagnosis, whether the death occurred at the hospital or at home according to the guidelines approved by the Supreme Court on Monday. They are also eligible if the family member died while in hospital for treatment for Covid-19 — even if the death occurred more than 30 days after diagnosis.

To be considered a Covid case, the deceased must have been diagnosed with a positive Covid test or have been “clinically determined” by a physician. And to apply for compensation, the relatives must present a death certificate stating that Covid-19 was the cause of death.

But for many in India, these guidelines pose a massive problem.

Even before the pandemic, India under-covers its dead.
The country’s underfunded public health infrastructure means that only 86% of deaths nationwide were recorded in public systems at normal times. And only 22% of all registered deaths got an official cause of death, certified by a doctor, according to community medicine specialist Dr. Hemant Shewade.

This problem has intensified under Covid, with studies suggesting that millions of people like Srivastava’s mother are not included in the death toll.

In July, the US-based Center for Global Development estimated that during the pandemic, India could have had between 3.4 and 4.9 million more deaths than in previous years – meaning the government’s official Covid-19 toll could be several times lower. than reality.

The figures suggest that the Indian government underreported the number of pandemic deaths, a claim the government has rejected.

As Covid sweeps India, experts say cases and deaths are not being reported

Although victims have a death certificate, many do not explicitly state Covid-19 as a cause as they were not officially diagnosed, said Jyot Jeet, president of the Delhi-based organization SBS Foundation, which conducted free cremations during the second wave.

Instead, many Covid victims’ death certificates say “either that they died of lung failure, respiratory disease, cardiac arrest,” he added.

The guidelines say that families can apply to change the cause of death on a death certificate and claim that no families will be denied compensation “solely on the spot”, their death certificate does not mention Covid-19.

A district-level committee will review their application and examine the deceased member’s records — and if they agree that Covid was the cause of death, they will issue a new death certificate stating it in accordance with the guidelines.

However, no further information has been provided on what criteria the committee will use to measure the cause of a month – old death and what evidence families must provide.

“It’s absolutely complicated,” said Pranay Kotasthane, deputy director of the India-based Takshashila Institution think tank, adding that if the government is determined to help people rather than control the police, the plan could benefit families.

CNN has contacted India’s Ministry of Health for comment.

Bureaucracy

After Pooja Sharma’s husband died of Covid-19 in April, she felt helpless and alone with no idea how to support their two young daughters.

Her husband, a grocer, was the breadwinner of the family. But as his condition worsened, he told her to take care of their children.

“I did not know how I would do it,” said the 33-year-old mother, who lives in India’s capital region of Delhi. “I have not been to school and did not know what I could do to make money.”

Sharma says her husband’s death certificate states Covid as the cause – but she may still face one uphill. The program promises that families will receive their compensation within 30 days of proving their eligibility, even though previous government initiatives – both before and during the pandemic – have faced long delays and frustrating bureaucracy.

“Underprivileged or poor communities are the hardest hit – first by Covid and secondly by the system,” said Jeet, president of the SBS Foundation. Due to their low literacy levels, he added that it is “a tedious task” for families to navigate the complications of the system, which include collecting appropriate papers, filling out forms, communicating with local district officials and providing medical information.

Pooja Sharma and her children at home in front of a photo of her deceased husband who died of Covid-19 in April in Delhi, India.
The country’s most recent census in 2011 showed that 73% of Indians are literate, and the figure is even lower for women in rural areas, where just over 50% can read and write.

Kotasthane, the think tank director, also worries about people’s ability to access payments. “The cost of getting the compensation should not be more than the compensation itself,” he said.

Sharma has already run against the government bureaucracy for a state-sponsored program she applied for in June.

“I filled out all the paperwork with the help of others. I went to government offices every day,” she said. “I have not heard anything from them. I do not think money will ever come.”

Although she will apply for the new compensation program, she said she is not sure of receiving any payments – and no matter what, it is not enough to compensate for her loss.

“I do not know if I will get that amount of money at all,” Sharma added. “50,000 rupees will not give me my husband back. My life will not be the same.”

Too little too late

Many share Sharma’s feeling of disappointment and the feeling that the compensation offered is too little, too late.

The second wave effectively traumatized an entire nation, exposing the government’s mistakes and sowing deep anger among a public that largely felt abandoned by its leaders.

Many factors played into the severity of the second wave. The government was slow to act and had not prepared in advance, leading to crippling medication lack of supply in the most desperate moment. The medical system collapsed – at the height of the wave, more than 4,000 people died every day, many on the streets and outside hospitals filling previous capacity.

India's second Covid wave hits like a tsunami 'as hospitals span under weight

The shortage also led to a boom in the black market, where the price stuck oxygen bottles and medicines. Without government help, many families had no choice but to empty their savings and borrow money to buy overpriced goods, hoping to save their loved ones.

Simran Kaur, founder of Pins and Needles, a non-profit organization that supports Covid widows in Delhi, said some women face debt while caring for several young children alone and without a breadwinner.

“They already have so much debt because they went overnight from earning a monthly salary through their husbands to earning nothing,” she said.

“A one-time payment from the government will not solve everything. It will not educate her children, pay their rent or put food on the table. It may sound good on paper, but it is not enough.”

The compensation could possibly help India’s poorest families. But for most families, especially those who have lost more members to Covid, “50,000 rupees will do nothing,” said Srivastava, who lost her mother.

Since the second wave, he and his sister – who were both sick of Covid while trying to save their mother – have recovered from infection. There are still deeper scars and anger against a government that “had done almost nothing to prepare Covid,” he said – but “there is no choice but to recover from the tragedy.”

“In India, people accept fate, they say it was God who did it, comforted themselves and continued,” he added. “We have a habit of enduring the tragedies. But it is the government that must make an effort.”

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