The green-uniformed individuals you see in movie after movie, rushing to meet ambulances, or reaching out to victims of healthcare emergencies or accidents and comforting them en route to the hospital, aren’t doctors or nurses. They are paramedical health professionals—the first line of contact with patients. At a time when India’s health system cowers before the COVID-19 challenge, paramedics are first responders in the battle—taking samples for tests, bringing patients to quarantine facilities, helping them get critical care in ICUs—risking their own lives. Unfortunately, these dedicated warriors never get due credit; long duty hours, low salaries and no social recognition are their lot.
“Inside the laboratory, they risk their lives when they collect samples of COVID-19 infected patients and open it. When they go out, they are thrashed and insulted by people. What can be more challenging?,” says Dr Deepak Sadwani, founder of Prognosis Lab, which has been approved to conduct COVID-19 tests.
Dr Sadwani says how one of his woman lab technicians was evicted by her landlord while another young employee was beaten up near his lab in Dwarka.
No government has made any effort to create a regulatory body–like the Medical Council of India (MCI) for medical practitioners and the India Nursing Council (INC) for nurses–for paramedics and develop a standard training module. Indeed, many privately set up councils go under the garb of a genuine regulatory body, duping gullible students. How, then, are paramedics trained?
Private universities and institutes have devised courses to train paramedics for specialised medical fields such as ambulance services, first aid, occupational therapy, respiratory therapy, hospital aid, radiology etc. They run certificate, diploma and degree programmes sans any government approval. Besides, some government institutes offer short-duration skilling courses. The Healthcare Sector Skill Council, under the National Skill Development Council, has training standards for short-term paramedic courses. Yet, these haven’t brought standardisation in training. That’s a shame, for experts say a good paramedic takes half the burden off a doctor by their timely interventions on critically ill patients. In a country like India where the doctor-patient ratio is far from ideal, well-trained paramedics are crucial to plugging the gap.
Mukesh Sharma, an assistant lab technician, worked for six months as an intern without any salary in a private lab last year. After he finished his course and expected to get a salary, the lab fired him, hiring another intern instead. Likewise, hundreds of paramedics are jobless despite a diploma course and work experience.
“People equate us with casual labourers, says Rajit Kumar, a paramedic working in a small nursing home in Noida. “When I take patients on a wheelchair to their cars, they often offer me a tip. I feel bad. Perhaps they feel we are poorly paid…. Can they do it with a doctor or a nurse?” asks Kumar, who earns Rs 12,000 a month, pulling 12-hour shifts.
Mohammed Hasnain Reza of Fortis Memorial Research Institute says that in a corporate set-up paramedics get respect and remuneration equivalent to nursing staff but not in the huge unorganised sector. “Paramedics command social respect and good remuneration in south India. It is because they are empowered and skilled to handle critical patients. The courses are excellent; training is up to the mark. That’s not the case in the north and east,” Reza adds.
Experts hope paramedics’ exemplary service during the COVID-19 crisis should spur the government to remedy the lapses and scale up both their skills and morale.