india

Updated: Apr 18, 2020 16:55 IST

Three days after Odisha’s second Covid-19 positive patient — a 19-year-old youth studying in the United Kingdom — was admitted to AIIMS Bhubaneswar, Sanjay Dehury got a call from his boss.

The 21-year-old used to drive vehicles in marriage processions till he joined a company that outsourced workers for cleaning assignments. In October 2019, he began to work at AIIMS Bhubaneshwar as part of the hospital’s 250-member housekeeping staff.

On March 23, shortly after Odisha had gone into lockdown to prevent the spread of coronavirus, Manoj Sahoo, facility manager of Golden Hospitality Limited — the company hired to clean the hospital — gave him a new task to do. He requested Dehury to collect biomedical waste (blood, cotton swabs, beddings contaminated with blood or body fluid, needles and syringes kept in bags from the wards) and drive it to the disposal centre inside the hospital complex. Sahoo made a similar request to 18 other employees; 10 said yes initially, but in the end, only two agreed to do the work.

“The other housekeeping staff got scared and said there was a possibility of getting infected. The first day I reported for duty, I became very nervous as a few friends among the housekeeping staff asked me not to come. I did not report for duty for the next two days. But on the third day I thought if I do not go then someone else would do it. So I joined duty,” said Dehury, who lives with his father and brother in a village on the outskirts of the city.

Like other hospital staff, Dehury requires a lockdown pass to travel to AIIMS. Every day he travels by his two-wheeler to AIIMS.

In a non-pandemic world, transportation of biomedical waste requires a great deal of care. It must never be transported directly by hand due to risk of accidental injury from incorrectly disposed sharp items, or of transmission of blood-borne diseases. Hospital wards usually possess three colour-coded bins for different categories of waste, lined by corresponding colour-coded bags that are bio-degradable, leak proof and have a monogram of biohazard symbol.

In the case of coronavirus-specific waste, the precautions are stricter given what we know about the virus: that it can stay on some surfaces for long, and still remain infectious. Guidelines issued by the Central Pollution Control Board for handling biomedical waste of Covid-19 patients state that two bags are to be used for the collection of waste to ensure adequate strength and no leaks.

Each morning, Dehury dons his Personal Protective Equipment comprising a coverall, hat, gloves, goggles, N95 mask, footwears and boot cover, before he goes up to the ward. A dedicated bin, labelled ‘Covid-19’, is kept in the storage room that can only be handled by authorised staff like Dehury. Dehury then enters the highly-infectious isolation ward to pick up the soiled linen.

“After loading the colour coded bags onto a battery-operated vehicle, I drive it off to the biomedical waste facility where the vehicle is first washed with sodium hypochlorite solution.” At the site, Dehury also discards his own PPE, but keeps the N-95 mask on. “While the rest of the PPE are disposed of everyday, the mask is reused after disinfection,” he said.

Until recently, there were two patients in the Covid ward, including a 72-year-old man who died last week. Another 60-year-old patient from Bhubaneswar who was critical, is now stable and likely to be discharged soon as his test results have now returned negative.

Additional medical superintendent of AIIMS Bhubaneswar, Pravas Tripathy said Dehury makes him proud. “Many of the housekeeping staff were scared of catching the infection and we had a hard time in making them understand that there is little risk (if they follow the precautions),” he said.

Dehury earns Rs 12,000 a month and while a hospital official said that there were plans to “give a financial incentive to people like Dehury to keep them motivated,” nothing has materialised as yet. The hospital has converted one multi-storied hostel inside the campus to house all staff engaged in the Covid ward where 6-7 staff nurses and other attendants are staying. Dehury was given an offer to stay, but he chose to stay with his family.

After returning home at the end of his duty hours, he dips his clothes in dettol liquid and hot water. He then takes bath in soap and warm water. After having his meal, he heads to the verandah. “We have just one room. So if I sleep in the room, my father and brother sleep outside. So at times I sleep in the verandah while they sleep inside to maintain maximum distance,” he said.

In the tight quarters of his house in Suanga Nuasahi village, home to at least 300-odd people, it is difficult to maintain social distancing — one of the foremost requirements to prevent the spread of infection. Even the other residents of his village are trying to keep their distance from him and his family.

Soon after he began working as a biomedical waste collector, a photo in which he wore the coverall and mask began to circulate on WhatsApp. “After some friends in the village saw the photograph, villagers pressured me to not report for duty. I simply asked them if any of them were infected by Covid-19 virus, who would look after them? The villagers agreed but asked me to not mingle with other youth in the village. My house is at one end of the village and so it does not affect me. Earlier I used to play cricket with my friends. Now I no longer do that,” he said.