by Dr Stephen Alfred
Stephen is the founder and director of Bethany Hospital in India.
Bethany Hospital is a 200-bed hospital situated in Thane, a suburb on the outskirts of Mumbai with a population of 5 million people. It was established in 1997 with a vision to communicate the love of Christ through quality healthcare, catering especially to sections of the community who would otherwise find these services beyond their means. In normal times, managing a hospital of this size is never easy. But in March 2020, we were faced with the unprecedented Covid-19 crisis.
Within days, one of our buildings was set apart as a dedicated Covid-19 centre. Starting with 15 ICU and 45 ward beds, we had to eventually scale up to the building’s full capacity of 75 beds. Overnight in April 2020, scores of Covid-positive patients along with tens of thousands of migrants were unable to go back to their villages and were stranded on the streets and in the slums of Thane. As small businesses closed and as the city went into lockdown, the situation became acute. Additionally, healthcare staff working in the Covid unit at Bethany had to be isolated from the other staff. The logistics of arranging accommodation for more than 100 staff members overnight was overwhelming.
Yet, in all this we have seen the hand of our Lord who has been so faithful. Two local schools came to our rescue and gave us use of their premises to create a makeshift hostel with food being supplied by our hospital caterers. The cycle of staff becoming infected and contacts being isolated put immense pressure on an already depleted workforce. The Lord has blessed us with excellent staff who worked beyond the call of duty to care for patients.
Unchartered Waters
The first wave brought a lot of uncertainty both medically and administratively. With Mumbai and Thane being among the most Covid-affected areas in India, the pressure on the hospital was unrelenting. Municipal authorities kept up the demand for more beds.
To make matters worse, in April 2021, barely a few months after the first wave had abated, we were in the throes of the second wave. The rapidly rising numbers took us by surprise. It stretched us to almost breaking point. The nationwide demand on oxygen and medical supplies was turning a huge crisis into an even bigger calamity.
At one stage, our fully occupied 75-bed Covid unit had 11 patients on ventilators on high-flow oxygen. It drained our stock so low that we were in danger of running out of our oxygen supply within three hours. But the Lord miraculously intervened and averted a tragedy, resulting in no casualties.
The challenges were colossal, but so is the God in whom we trust. We would have been overwhelmed, had it not been for the many who prayed and interceded for us before the Throne of Grace. To them we are indebted.
During the first two peaks, our centre had around ten patients on ventilators at any given time. By 31 July 2021, we had treated more than 3,800 Covid-19 suspected and positive cases as inpatients at our facility and around 4,500 as outpatients. Of these, around 96% recovered completely and were discharged. The mortality rate stands at 3.7%. The number of patients screened for coronavirus symptoms up until 31 July 2021 was over 116,500. At the same time, we have seen 12,700 non-Covid inpatients who were admitted and treated along with over 98,000 outpatients.
In July 2021 we were commended by the governor of the state for being the best Covid-treatment establishment in the city of Thane. We give God the glory, it has been marvellous in our eyes.
By the end of September 2021, things were settling down, the hospital was beginning to breath normally again and rules were relaxed. As the Covid section was scaled down from 75 to 25 beds, the non-Covid unit was overwhelmed with many patients coming from villages with advanced and inoperable malignancies.
The respite that followed was short lived. At the beginning of December, just as we were getting back to some form of normality, Omicron hit us. The authorities then asked us to scale up our coronavirus response activity and Bethany went back to having a Covid unit with 80 beds. By God’s grace, the overall mortality and morbidity has been extremely low. By the end of January 2022, our Covid section had treated around 4,680 inpatients and 7,000 outpatients.
The Lord has blessed us with excellent staff who worked beyond the call of duty to care for patients.
But for the Grace of God
Despite what has been a daunting and, at times, depressing situation, we have much to be thankful for to our Lord. God blessed us with a six-member core management team. Strong in faith, they manned the Covid war room with dedication and commitment. Each day demanded much from them: decisive decision-making; facing challenges that evolved daily; and a punishing schedule that had some of them spending six months working day and night without a break. They rose to the occasion.
Many of our healthcare workers who know the Lord have been able to communicate the glorious gospel to several patients who were admitted and even to some who passed on to eternity. We keep praying that the seed sown will bring forth much fruit.
Our healthcare staff have been outstanding in their respective roles. They worked tirelessly to bring relief and comfort to patients. In the course of their efforts, many among them were infected – the fear and the isolation can be quite debilitating – but all recovered and returned to work with absolutely no loss of life.
Administratively, we have been tested to the hilt. With our Covid section operating at full capacity all year round, we were pressed on all sides. The number of patients needing hospitalisation almost always outstripped the available beds. The pressure from authorities to take in more patients, coupled with interference from politicians and bureaucrats, added to the complexity of the task at hand. It’s only by the grace of God that we were not crushed under the weight of such expectations.
To our relief, the non-Covid section of the hospital continued to function. Emergency laparotomies, surgeries and deliveries were regularly scheduled. The radiation therapy department saw about 60 patients a day. Patients also came in for chemotherapy, even at the peak of Covid. Everyone was screened as per protocol.
To God be the Glory
To keep the hospital running under such extraordinary circumstances required an above normal flow of funds. Bethany has taken a substantial financial hit due to the expenses of its Covid centre. There are several reasons for this, including: the significantly higher cost of treating a Covid patient due to barrier nursing and use of personal protective equipment (PPE); healthcare staff working shorter shifts and having to be paid more as an incentive; and the policy to treat our staff and their relatives infected by Covid free of charge. However, praise be to God who miraculously supplied finances through unexpected sources; we would otherwise have struggled to function as a hospital.
What the Future Holds
Many of you have been with us through our journey with Covid-19 over the last two years. It has been difficult but the Lord has taught us many valuable lessons. We have seen the presence of our Lord with us so clearly and faithfully and, although difficult, we would not have it any other way.
As I write this in January, we have had two peaks and are in the height of the third. It has been 20 months since we first opened our hospital to Covid-19 patients. Although our initial steps were taken nervously and reluctantly, we have seen the Lord lead us graciously to manage what is now a hospital fully able to meet the coronavirus requirements. We expect to keep the Covid section open for another 12 months by which time, we are hoping and praying that the pandemic would have run its natural course and become endemic. Another challenge at present is dealing with non-Covid cases. Patients reporting late for treatment or missing their appointed follow-up out of fear leads to them coming in with added problems.
Looking ahead, what lies before us seems overwhelming. Only the heart of God is capable of handling the aggregate of human suffering and pain; your heart and my heart are not big enough. God, however, burdens our hearts so that we can be His hands and His feet, and with His grace and strength, press on to fulfil His ministry .
