Low wages, 24-hour shifts, and severe shortages of staff and protective equipment have put many doctors on the frontline of the brutal epidemic in India on the verge of collapse and fear for their lives.

Since the beginning of April, in this vast South Asian country (which has some of the most densely populated cities in the world), the coronavirus infection has caused at least 165,000 deaths.

Although India’s recent COVID-19 surge has recently eased, about 3,000 people still die every day, and the chronically underfunded healthcare system is still under tremendous pressure.

Radha Jain, a doctor in the capital of New Delhi, told AFP: “We are overworked, stressed and very scared.”

The Indian Medical Association stated that since the beginning of the pandemic, more than 1,200 doctors have died of COVID-19, including more than 500 doctors in the past two months.

Deependra Garg, a doctor working on the outskirts of New Delhi, knows directly how dire the situation has become.

His 48-year-old wife, Anubha, is also a doctor herself, and she contracted COVID-19 in April.

They started receiving treatment at home, but as her condition worsened, he, like many other families, had difficulty finding a bed.

He finally found one near 200 kilometers (120 miles) from their home. But Anuba, who was fully vaccinated, died within two weeks, leaving behind their 12-year-old daughter.

“We are on the front line 24/7. We are facing a large number of viruses, but we must continue to overcome all difficulties because we have chosen this career,” Gag said.

“We have no choice.”

Insufficient funds and excessive strain

The pandemic has exposed the structural weaknesses of India’s healthcare system, especially in state-run hospitals with outdated equipment.

As the latest outbreak spreads, there have been reports from understaffed hospitals that patients are lying on the floor and sharing beds in crowded wards because family members protected only by cotton masks are taking care of their loved ones.

Government spending on health care is less than 2% of the gross domestic product (GDP), one of the lowest rates in the world.

According to data from the World Bank, there were only 0.8 doctors per 1,000 people in India in 2017-about the same level as in Iraq. The two other countries hardest hit by the coronavirus, Brazil and the United States, were 2.2 and 2.6, respectively.

A report by the Center for Disease Dynamics, Economics and Policy in the United States before the pandemic estimated that India would need to add another 600,000 doctors and 2 million nurses to meet its healthcare needs.

Dr. Shekhar Kumar, who works in a private hospital in northern Uttar Pradesh, said that junior staff and medical students in the last year sometimes have to work in 24-hour shifts.

“Compared with last year, this time the patient needs a longer hospital stay, which increases the burden on the staff,” Kumar said.

He added that when their colleagues contracted the virus, they were even more nervous.

In Ahmedabad, India, a doctor takes care of a patient in an ambulance waiting to enter a COVID-19 hospital [File: Amit Dave/Reuters]

The doctors said that due to insufficient supplies of drugs and oxygen, they were forced to choose which patients to save first, which brought them trauma.

Ravikant Singh, the founder of the charity that helped build the COVID-19 field hospital, said he had trouble sleeping at night.

“This is a life-changing situation for doctors,” Singh told AFP.

“The worst thing is…We cannot save many lives due to lack of oxygen.”

Even after completing their punitive shifts, the doctors said they were worried about infecting family members at home.

Kumar said that he will continue to think about how the virus “lurks anywhere.”

“If doctors can’t save their (own) life, how will they save the lives of others?” he said.