AIIMS: Not in Robust Health

Hundreds—men, women, senior citizens and children—wrapped in colourful blankets, quilts and sweaters, scrambling to find a place to sleep in a subway close to the All India Institute of Medical Sciences (AIIMS) on a cold night in Delhi, are bound by one emotion—hope; hope their loved ones will be cured. Flimsy bedsheets and torn rugs spread on the dusty floor double up as mattresses, even for those who are swinging between life and death or are dealing with grave illnesses like cancer or tumour. An infant with a hole in his heart is among them.  

Some are first-timers, some are awaiting an appointment for follow-up treatments, and some have been living here for days, weeks or months, occupying the corners, their belongings stuffed in cartons and cloth bags. For a majority, who arrive from different states and are struggling to make ends meet, this subway or the state-run rain baseras (shelter homes) end up being temporary accommodations. For those who can’t find space, the footpath is the last option. Kind donors distribute food and blankets, sulabh shochalayas (public toilets), used by hundreds on a daily basis, are the last resort.

Data points at imbalance. While AIIMS Delhi was established in 1956, six others—Jodhpur, Bhopal, Bhubaneswar, Patna, Raipur and Rishikesh—became functional in 2012 as part of the first phase of the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY). Presently, there are 26 AIIMS in the country—20 operational and the rest under various stages of development. Despite this, thousands chose to come to AIIMS Delhi for treatment, bypassing the regional AIIMS.

Reasons range from trust, to reliable doctors, better facilities, smoother paperwork and affordable healthcare. As per the AIIMS Delhi website, the Outpatient Department (OPD) ends up taking 7,200 cases daily. Many of those whom we met on that cold Delhi night were from the neighbouring states of Uttar Pradesh and Bihar—home to two and one AIIMS, respectively.

The Union Budget has allocated Rs 5,546 crore to AIIMS, Delhi, an increase of about Rs 307 crore over last year’s revised estimates, even as patient footfall at the country's largest public hospital has risen far faster than funding—while there was a 400 per cent increase in patient numbers in the post-Covid period, overall allocation increased by about 170 per cent in the same time.

While AIIMS Delhi was established in 1956, six others—Jodhpur, Bhopal, Bhubaneswar, Patna, Raipur and Rishikesh—became functional in 2012 as part of the first phase of the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

Presently, there are 26 AIIMS in the country—20 operational and the rest under various stages of development. Despite this, thousands choose to come to AIIMS Delhi for treatment, bypassing the regional AIIMS.

For a majority, who arrive from different states and are struggling to make ends meet, this subway or the state-run rain baseras (shelter homes) end up being temporary accommodations.

Sarfaraz Hussain (53), his wife Abida (50) and son Anish (18) were lucky to get two beds at the rain basera, a tent erected outside AIIMS. It was too cold outside. Hussain occupied one bed, Abida the other. Anish somehow managed to sleep at night. They shared space with about 30 others who had come from faraway places for treatment. The Hussains came from UP. Sometime last year, Sarfaraz started losing his vision. But the doctors at the government hospital and private clinics could not figure out the reason. Weeks and thousands of rupees were spent. After losing all hope, they decided to bring him to AIIMS Delhi. The family has been coming for follow-up procedures post-surgery. Every time, Anish’s college-going elder brother has to take care of the grocery store Sarfaraz owns and Anish has to bunk school. Getting train tickets is another issue. “It’s a hassle, but we don’t trust the doctors back home. My father nearly lost his vision because of an improper diagnosis. We trust AIIMS Delhi,” says Anish.

Outside rain basera, Asha Devi, who had arrived from Khagariya, Bihar, was waiting near a bus stop, along with her daughter (18) and son (20). “There is no space in this rain basera. Someone told me a bus will take me to another,” she says. Her husband passed away a few years ago. She has been working as a domestic help to make ends meet, but has to bring her children to Delhi for treatment every now and then. When asked what they were suffering from, Asha Devi, who was ignorant of the English terminology of their illnesses, simply said: “Dimaagi bimari hai dono ko. Ilaaj lamba chalega.” When asked why she did not take them to AIIMS Patna, which is closer to her district, she says: “I went there, but wasn’t satisfied with what the doctors were telling me. AIIMS Delhi is an old and trusted institution,” she says.

Sitting on the footpath not very far was Gajram from Rampur, Uttar Pradesh. It was his seventh visit in two years, but for the first time, he did not get a place to stay, so he spread his torn bedsheet on the footpath. When asked what he was suffering from, he simply lifted his shirt and showed us a pouch where his bodily waste was accumulating. He then handed over a polythene bag, inside which he had kept all his medical files, reports and referral papers. The sheets of paper were filled with medical jargon uncomprehensible to Gajram, but he knew he needed to undergo two major surgeries so that his kidneys could be saved from complete failure. Mid-conversation, he starts sobbing, saying he does not have the strength to carry on. “The doctors back home keep referring me to AIIMS Delhi because of my complicated medical condition. It’s embarrassing for me to travel in buses or trains with this pouch, but there is no option.”       

The footpath led us to the subway. It was around 11 pm. Most people were asleep; some were looking for space. Among those were Hiralal Sahu and his uncle, who had arrived from Sultanpur in Uttar Pradesh. About a year ago, Sahu, who sells peanuts for a living, started facing difficulty in breathing. The doctors at the government hospital told him he had asthma and started treatment. There was no improvement in his condition, so he was referred to AIIMS Delhi, where he was told the accurate nature of his disease—pneumothorax (a collapsed lung). It had nothing to do with asthma. “I should have come here earlier. It affected my work. I have come for follow-up treatment. My uncle has come with me this time. I thought it would be better to show him to a kidney specialist here rather than taking him to private clinics in Sultanpur. I have learnt my lesson.”

Shashi Devi from Hardoi district in Uttar Pradesh, who was there for follow-up treatment, could not find space, so she was sitting in a corner with her bag. Her husband, who works as a night guard, had gone to the medical store outside to buy her medicines. “I have lost count of the number of times I have come here. My condition is improving, but slowly. Doctors said I need more scans,” she says. Not being able to pronounce the name of her disease, she simply says throbbing headaches, dizzy spells and frequent nose-bleeding episodes. “Every time we come here for two-three days, we have to lock our three daughters up as there is no one to look after them. They miss school. I keep enough ration at home, and the eldest daughter, who is 14, takes care of cooking,” says Shashi Devi.

Sitting in one corner of the subway with their luggage—many cardboard cartons, and cloth and jute bags—were Laxmi Devi and Komal. Wearing a multi-coloured woolen cap, eight-year-old Komal was eating puffed rice from a steel plate. The two had been living here—now their temporary home—for the past six months due to Komal’s ongoing cancer treatment. “Her surgery is done, but we have to be here for her chemotherapy. My husband is no more, so instead of travelling every time, I decided to stay put. My father comes from his village occasionally with snacks and money. We eat at the langar outside,” says Laxmi Devi, who is from Khagaria in Bihar. As we take out the camera, Komal smiles adorably, anxiously looking at the lens. When asked what she misses the most, she says, while removing the multi-coloured cap: “My school friends and my hair.”

Sitting in the lawn of the AIIMS premises was Salim Khan Pathan, 49, a farmer from Motegaon village in Washim district of Maharashtra. He had been staying there for the past six days. “There is a rod in my leg and it needed proper treatment, which wasn’t possible in my village. Also, the doctors there quoted an amount of Rs 70-80,000 for treatment. I am just a farmer. I have two children. I can’t spend so much. Here, I don’t have to pay more than Rs 15,000. Though it was a hassle to come all the way from Maharashtra in this condition, but it was just a practical decision.”