Nexus of Good: Through 'private' support
The framework through which an IPS officer from Bengaluru leveraged CSR funds for ramping up public health infrastructure during the pandemic is awe-inspiring
The second wave of the pandemic spread like a 'tsunami' in India. It was worse than the first one. Several factors could be responsible for the huge spike in the number of cases and relatively higher level of severity during the second wave. It would be a herculean task for any government to handle a pandemic of such scale and impact.
Among many other things, augmenting medical oxygen to treating post-Covid complications like black fungus and ramping up critical care infrastructure to saving lives were the major challenges faced by governments. In this backdrop, PS Harsha, an IPS officer, was appointed as nodal officer and head of the mission on April 30 to set up 500 ICU beds in each of the eight BBMP zones.
At the time he was appointed as a nodal officer, the situation was very challenging. In the first week of May, Bengaluru had about 10,937 beds reserved for Covid-19 patients, out of which about 559 beds were ICU beds and about 478 beds were ICU beds with ventilators. When the city was still around two weeks away from the peak, more than 95 per cent of the beds were occupied. Shortage of ICU beds and ventilators was faced by most of the hospitals. To make matters worse, oxygen was also in short supply.
The mission had three main objectives. First, to immediately assess the requirement of critical care infrastructure including oxygenated beds, HDUs and ICUs. Second, to visualise a feasible operational plan and an implementation structure to create the infrastructure as assessed by experts and relevant departments of the government tackling the Covid-19 crisis. And, the third, to put up an elaborate action plan with an implementation framework delineating clearly the roles and responsibilities of various departments of government and functionaries. To facilitate the above upgradation of infrastructure, ensuring adequate manpower availability was necessary.
Karnataka Government adopted a whole-of-government and whole-of-society approach to ramp up health infrastructure on a war-footing. The Chief Minister gave a clarion call to the corporate sector to come forward and join hands with the government to combat the virus. Bengaluru, home to several marquee MNCs, received overwhelming response to CM's call and several companies came forward to leverage their CSR initiatives towards Covid-19 relief and rehabilitation efforts. However, coordinating and collaborating with all these agencies and institutions to enhance scale and speed was the real challenge. In order to reduce the turnaround time and optimise costs, it was decided to go ahead with brownfield approach instead of greenfield approach, where the government identified public hospitals and teaching hospitals attached to medical colleges. The idea was to use existing general beds and convert them into ICU beds, so that healthcare personnel and other required manpower could be readily made available.
The Karnataka chapter of Indian Institute of Architects and Columbia Asia Hospitals came forward as technical partners to this mission, for conducting the baseline assessment for the facilities identified for bed augmentation. They agreed to carry out these services pro-bono. A team of senior architects, along with experts in the field of hospital design, assisted in conducting surveys at the hospital and preparing the proposal, including cost estimations for the same.
The Confederation of Indian Industry (CII), through its Karnataka chapter and CII Foundation, acted as a conduit to channelise CSR funding from corporates into healthcare facilities. Also, CII, through its foundation, has facilitated an institutional mechanism to channelise individual contributions to this mission.
Within a couple of months, 2.82 crore vaccine doses had been administered in Karnataka — the highest among all South Indian states. Initially, due to a lot of rumour mongering, there was vaccine hesitancy. But subsequently, this hesitancy was gone. Print media, TV and hoardings were used to promote vaccination drives. However, what really worked was the reassurance from religious leaders and celebrities. Intervention by the local district administrations that interact with people on a daily basis also helped in convincing people, even in rural areas.
Outcomes of this initiative were very encouraging. Though the mission had initially started for infrastructure upgradation in the city of Bangalore, there was tremendous response from district administrations to scale up the mission across Karnataka.
Plans were set afoot to augment bed capacity. About 24 beds were set up in Jayanagar General Hospital by Embassy and AZU in the initial phase itself. CV Raman General Hospital got 56 beds through contributions from 3M, Hitachi, ABB Power Grids and Volvo Group. Another 24 beds became operational in Epidemic Diseases Hospital which was set up in collaboration with Embassy Group, McAfee, AXA, Yahoo and Capital Land Swiss Re. In addition, 100 beds were added at Yelahanka by Boeing, Celko Foundation and KPCL. 190 beds set up by Texas Instruments, Modulus and Swasti Agency are underway at Rajiv Gandhi Institute of Chest Diseases (RGICD).
Infosys also provided equipment worth INR 1.5 crore in Anekal General Hospital, KR Puram and Yelahanka General Hospital. Wells Fargo (in collaboration with UnitedWay) set up 100 bedded modular hospital at Gadag Institute of Medical Science (GIMS), Gadag. 40 beds were augmented at Indira Gandhi Institute of Child Health (IGICD) by 3M, Embassy, CII Foundation Swiss Re foundation, ICEMA. The Oxygen plant was set up at IGICD by Lowe's India and Sambhav Foundation. M/s HDFC Bank Limited undertook infrastructure upgradation activities at ESI Rajajinagar hospital. Indian American Foundation set up 100 beds at Shikaripura Taluk General Hospital in Shivamogga District. Organisations like M/s Doctors for you, M/s LabourNet, etc., took an initiative to partner with the government in bridging the manpower shortages, wherever required.
In addition to the above, infrastructure upgradation activities were initiated at various other hospitals like HMT Hospital, Taluk Hospital in Doddaballapur, Devanahalli, Nelamangala and Hoskote and ESI Hospitals in Indiranagar and Peenya, etc. Also, plans were prepared to set up oxygen plants in Kodagu, Shimoga and Gadag districts through the CSR mode.
Harsha and his entire team of dedicated personnel made it happen. The use of CSR funds and the initiative to involve corporate was an outcome of a well-defined strategy by the team. Apart from utilisation of CSR funds, the industry was willing to contribute 50 oxygen concentrators and 50 non-invasive Bilevel Positive Airway Pressure (BIPAP) ventilators. Such proactive interventions reflect the confidence that the government had built with the industry to augment necessary health infrastructure through CSR initiative. Government's decision to take the CSR route to ramp up critical health infrastructure, even as the second wave retreated, reflected the continued focus to ensure preparedness for the third wave.
The initiative taken under the inspired leadership of Harsha has set multiple benchmarks in public-private cooperation. It is a wonderful example of Nexus of Good. It also illustrates that there is enormous scope for cooperation between the public and private sectors when it comes to handling a crisis.
Views expressed are personal