14STATUS OF URBAN HEALTH INFRASTRUCTURE TO COMBAT COVID-19 IN BIRBHUM
DISTRICT, WEST BENGAL
Mahuya Sen
Associate Professor (Geography)
Birbhum Mahavidyalaya, Suri (Affiliated under Burdwan University), India
Email: mahuyasen74@gmail.com

How to cite this paper:
Sen Mahuya (2023) Status ofurban health infrastructure tocombat COVID-19 in Birbhum
District, West Bengal, Journalof Global Resources, Vol. 09
(02)
DOI:
10.46587/JGR.2023.v09i02.014

Received: 21 April 2023
Reviewed: 15 May 2023
Final Accepted: 27 June 2023

Abstract: The outbreak of Covid-19 was declared a Public
Health Emergency of International Concern on 31st January,
2020. Every country can take at national, sub regional andlocal levels to reorganize essential health services in the
pandemic context and maintain a safe access to every citizen.
To deal with this catastrophic Corona Virus India is making
preparedness with its high urban population density,
deficiency in hygiene and sanitation facilities and most
crucially insufficient treatment capacity. The first 2000
cases were reported in 56 days. The next 2000 in 15 days
and the next 2000 cases in a week. According to the data
released by the state health department, West Bengal took
just 5 days from June 3 rd to June 7th to register the next 2000
cases. Till Tuesday (9th June) total cases in the statestood at 8985. With increased number of testing and theentry of migrant labourers, there was a sudden spike inthe number of cases. The returning migrant workers from thehighly infected zones after an unplanned lockdown delivers
a major catastrophe at our doorstep. The objective of thestudy is to focus on the arrangement of health services for thisdisaster in Birbhum District, West Bengal. According to thedirection of the Bengal health department, separate hospitals
for Covid-19 patients are to be set up in each district in order
to arrange a local set-up before the contamination expands
into the community transmission stage.
Key words: Covid 19, Catastrophic, Contamination,
Community Transmission, Migrant111

Introduction
Several significant health challenges required united efforts and multi-sectoral approach tomaintain hasty pace of urbanization in India. The National Urban Health Mission (NUHM)
launched in 2013 provides us a unique opportunity and tangible mechanism to improve urban
health. To strengthen various initiatives of this scheme medical colleges were set up – most ofthem being in urban areas – can expediently afford important academic, research, and referral
support to develop urban health. The NHP-2017 has given special emphasis in this subject more
expansively. The most recently discovered Corona virus causes disease COVID-19 which is
infectious and may cause illness in animals or humans. In humans, several corona viruses are
known to cause respiratory infections ranging from the common cold to more severe diseases
such as Middle East Respiratory Syndrome (MERS) and severe acute respiratory syndrome(SARS). Many countries around the world have seen cases of COVID-19 and several have seenoutbreaks. The first case of COVID-19 in India, which originated from China, was reported on 30
January 2020. The outbreak of Covid-19 was declared a Public Health Emergency ofInternational Concern on 31st January, 2020. This pandemic situation in India is part of theworldwide pandemic of corona virus disease 2019 caused by severe acute respiratory syndrome
corona virus 2. Every country can take at national, sub regional and local levels to reorganize
essential health services in the pandemic context and maintain a safe access to every citizen.
To deal with this catastrophic Corona Virus India is making preparedness with its high urban
population density, deficiency in hygiene and sanitation facilities and most cruciallyinsufficient treatment capacity. India's performance to the virulent disease as 'Comprehensive
and robust,' terming the lockdown restrictions as forceful but vital for containing the spread andbuilding necessary healthcare infrastructure were praised by the United Nations (UN) and theWorld Health Organization (WHO). The government's rapid and stringent actions, emergency
policy making, emergency investment in healthcare, fiscal stimulus, investment in vaccine anddrug R&D are noted by the Oxford COVID-19 Government Response Tracker (OXCGRT). The
first 2000 cases were reported in 56 days. The next 2000 in 15 days and the next 2000
cases in a week. According to the data released by the state health department, West
Bengal took just 5 days from June 3rd to June 7th to register the next 2000cases. Till Tuesday(9th June) total cases in the state stood at 8985. With increased number of testing and theentry of migrant labourers, there was a sudden spike in the number of cases. The returning
migrant workers from the highly infected zones after an unplanned lockdown delivers a major
catastrophe at our doorstep. As of 20 June 2020, the Ministry of Health and Family Welfare
India currently has the largest number of confirmed cases in Asia and has the fourth highest
number of confirmed cases in the world. India's case fatality rate is relatively lower at 2.80
percent, against the global 6.13 percent, as of 03 June, 202
Objective
The objectives of the study are:
• To focus on the growth of urban population in the district.
•To highlight the existing urban health service of the study area.

•

To find out arrangement of urban health infrastructure for this COVID-19 disaster in
Birbhum District, West Bengal.

Methodology
The study is related to recent phenomena so the literature review is done from the different
newsp apers. It is also quite difficult to collect primary data through traditional method sokeeping in mind the order of Govt. “Stay at home and stay safe” pertinent data are collectedfrom the office website of the state health department, West Bengal (through internet)
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and interviewing local health staff, nursing staff, media person, through RPA (rapid phoneappraisal) method ( Lahiri Dutta, Kuntala, June, 2020). Based on collected data relevant maps
and diagrams are prepared and analysis is made.
Location of the Study Area
The study area, Birbhum District, is in the western part of the state of West Bengal being
surrounded by the districts of Bardhamman on South and South West, Murshidabad in the Eastand North East respectively along with the State of Jharkhand in North and North West. The
location extension of the district is from 23°33´30”N-23°33’45”N latitudes and 87°47’00”E87°49’00”E longitudes. The district comprises of three sub- divisions namely Suri, Rampurhat
and Bolpur. The study area have19 blocks showing in the map (Figure 01). Rampurhat
subdivision contains eight blocks, Suri sub-division encompasses seven blocks and Bolpur
subdivision has 4 blocks . Suri is the sadar town of the district.
Figure 01: Location Map

Results and Findings
The government had drawn up plans to deal with a worsening of the pandemic in the country.
This included seven ministries working together to set up additional quarantine and treatment
facilities across the country. The Ministry of Textiles was to ensure the availability of protective
and medical materials. The Department of Pharmaceuticals was to ensure the availability ofessential medicines. The Ministry of Consumer Affairs, Food and Public Distribution was asked
to ensure availability of essentials. To take social distancing measures as a preventive strategy,
Govt. announced compulsory screening, He also announced a ₹150 billion (US$2.1 billion) aid
for the healthcare sector. This money would be used for developing testing facilities, PPEs,
ICUs, and Ventilators and for training medical workers. People were asked to avoid routine
checkups and elective surgeries to reduce the burden on the health system, follow the guidelines
set by Ministry of AYUSH to improve immunity anddownload the Aarogya Setu app to track one’s
health.
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Demographics and Existing Health Care Facility
The percentage of urban population has increased from 8.6 (258420 persons) in 2001 to 12.8
(4,49,448 persons ) in 2011 Census. Urban decadal growth rate had a considerable jump fromduring 1991-2001 to during 2001- 2011 at 73.9 per cent . As per 2011 Census there are six
Municipalities and fourteen Census Towns in Birbhum district. According to population size wiseclass Bolpur, Suri and Rampurhat Municipality fall in Class-II category and other three
Municipalities viz. Sainthia , Nalhati and Dubrajpur Municipality fall in Class-III category. Out of
14 Census Towns of the district 5 Census Towns belong to Class-IV, 8 Census Towns belong
to Class-V and one Census Town viz. Kalipur (CT) belongs to Class-VI. In urban areas, it is
two tier systems with Urban Health Centre (UHC)/Urban Family Welfare Centre (UFWC) for
every 1,00,000-population followed by general hospital. The three-tier health infrastructure
system, viz. Community Health Centre, Primary Health Centre and Sub Centre in District, Blockand Village level respectively. Urban health care infrastructure of the district consists of 01
district ( Suri sadar) hospital located at the district headquarter, 2 Sub-divisional hospitals
situated in Rampurhat and Bolpur subdivisions. The total urban population of the district is
4,49,448 in 2011. 520 beds are available in the district hospital and 411 beds are in the two subdivisional hospitals. Besides, 396 beds are available in the private sector nursing homes, 382
beds in other hospitals, which means a total of 1709 hospital beds distributed among 47
secondary and tertiary level healthcare facilities in urban Birbhum. So, 263 persons are served
per bed in urban area. The NUHM division of the Ministry of Health and Family Welfare has
engaged medical colleges in supporting urban healthcare services. In this study area the medicalcollege situated in Rampurhat is the only one. Number of existing doctors in the district are 195
whereas 135 posts are vacant. So, the present doctors population ratio is 1: 17961. It isfrighteningly below the recommendation by WHO. India’s doctor-to –population ratio -1: 1445. Itshould ideally be 1: 1000. Number of existing staff nurse are 591 whereas 127 posts are fallen
vacant. So, the nurse population ratio is 1: 5926.
Special Health Care Facility of COVID
First step as preventive measures against this deadly virus, thermal screening of each patientcoming to hospital has started from the first day of emergency. According to the direction of theBengal health department, separate hospitals for Covid-19 patients are to be set up in each
district in order to arrange a local set-up before the contamination expands into the community
transmission stage. According to guidelines, each such hospital would be equipped with at least
20-30 beds with ventilators and dialysis units. The hospital should have a total strength of atleast 100 beds, which could be augmented in a crisis. These hospitals would also have apathological laboratory, which could be turned into a testing unit for Covid-19. Doctors and othermedical personnel attending to Covid-19 patients in Calcutta have given training to theircounterparts at different hospitals across Birbhum district through video conferencing. They
received training on how to treat patients from admission to diagnosis, and also proper
procedures of sanitisation of wards and the use of personal protective equipment. The study
finds that in Birbhum District at the first stage only one private hospital (Glocal – Ultra Care) is
dedicated to COVID. This hospital accommodated with 1 super, 2 doctors, 1 specialist, 2 MO
(Medical officer, 3 Nurse and other skilled, unskilled personnel. They are doing shifting duty. A
part of Rampurhat Medical college and Hospital, Bolpur sub-divisional Hospital, Suri Sadar
hospital are arranged as isolation ward for the suspected case who have respiratory problems.
Three sub-divisional hospitals are also prepared a fever clinic with 2 doctors and 4 nurses.
Fever clinics are also set up in abattle mode. In Bolpur subdivision Doctors are discharged
their duty for 14 days and another 14 days they are stayed in a hotel (Tourist lodge for doctors,
Nursing staff are stayed at Ashirbad lodge after completing their duty).Critical patients aretransferred to nearest Covid hospital Sanoka at Durgapur. But no testing laboratory is set up.
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A part of Rampurhat medical college and a Private Nursing home is prepared for Covid hospitalto cater the urgent needs. Another nursing homein Bolpur is to be taken for this purpose. These
hospitals have 40 beds in each which are grossly inadequate for the crisis. Recently in district
town Suri Pathological laboratory with the facility of RT-PCR has started with a capacity of 200
patients per day. To combat the disaster more hospitals should be arranged in the coming days.
The districts have set up quarantine centers in various empty government buildings. The districts
have been asked to increase number of quarantine centers and to set up at least a large
quarantine center in every block. Swab Test is operating in four blocks of Bolpur sub divisionnamely Illumbazar, Nanoor, Bolpur, Labpur and five blocks in Suri sub-division namely Sainthia,
Suri 1 & 2, Dubrajpur, Khoyrasole.
To maintain the proper health infrastructure to fight against COVID19 recruitment
process is started in an emergency basis. The different districts of West Bengal such as Kolkata,
Cooch Bihar, Maldah, Purulia, Diamond Harbor, Bankura, Paschim Bardhoman, Birbhum were
given urgent notice for different contractual posts under NHM at CMOH , post of Pharmacist,
Lab Technician, Composite Recruitment Notice for different post on contractual basis, Noticefor House staff ship, Molecular Biologist, for GDMO for M. R. Bangur COVID- 19 Hospital, postof DPC-RNTCP, for the post of COVID-19 Volunteers of CMOH, post of DEO for COVID-19,
composite engagement order post of District Epidemiologist under NHM on temporary basis
25/05/2020 to 28/06/2020, Composite engagement order post of District Microbiologist under
NHM on temporary basis 28/05/2020 and 28/06/2020, Composite engagement order post ofDistrict Data Manager under NHM on temporary basis 28/05/2020 to 28/06/2020, Engagement
order post of Legal Assistant in integrated Law cell under West Bengal state Health & Family
Welfare samiti 28/05/20201 & 1/06/2020, Data Entry operators at COVID 19 Lab for Office On
a war footing preparedness particularly the Birbhum District has displayed recruitment Notice fordifferent contractual post under NTEP for CMOH, Rampurhat HD on 04/06/2020 to 12/06/2020,
for the different post on contractual basis for RTPCR Laboratory for COVID 19 test at Suri Sadar
Hospital, Beerbohm on 24/05/2020 to 30/05/2020, Recruitment for Birbhum (Covid19) on
24/05/2020 to 30/05/2020, Engagement Order of Staff Nurse (SC Category) under NUHM at
Rampurhat Health District on 30/04/2020 to 07/05/2020. The state government has set up
special quarantine facilities for migrant workers returning in Shramik Special trains.
Figure 02: Number of Containment Zones in the Birbhum District
12
10
8
6
4
2
0

Rampurhat

Bolpur115

suri I

sainthia

Bolpur Municipality

Nanoor

LabpurIllambazar

Nalhati I

Rampurhat Municipality

Nalhati II

Muraroi II

Rampurhat II

Mayureswar I

Mayureswar II

Muraroi -I

Number of containment zone on
29.05.2020

Suri

Number of containment zone on
25.05.2020

From figure no. 02 it is observed that on 29.05.2020 highest number of containment zones
are in Nalhati I, then Muraroi II and Muraroi I having the 2nd and 3rd position respectivelyregarding
number of containment zones in the district, as they have received the maximum number of
migrant labourers from outside state. It is observed that Rampurhat subdivision is showing thehighest density containment area in the Birbhum district. Highest number of containment area
on 29th May, 2020 are found in Muraroi II, Muraroi I, Nalhati I, Nalhati II Blocks respectively.
This may be due to the peripheral location of these blocks and the highest density of populationand large number of migrant labourers have returned in large number to their home towns.
Whereas Bolpur subdivision has medium density containment zone with highest number ofcontainment area in Nanoor Block on 9th June, 2020. Rajnagar, Dubrajpur and Suri II block
have no containment area till now. These blocks are fallen in low density containment areaof Suri sub-Division.

At present, Birbhum has one Covid-19 hospital in Bolpur, which has 40 beds and admitted
181 patients so far. The Officials said a private nursing home in Rampurhat had earlier beenshort-listed to turn it into a Covid-19 hospital but the plan was dropped because it lacked
adequate infrastructure. The district’s current number of beds for Covid-19 patients is inadequate
because of the rising cases. The health department has selected the defunct TB sanatorium,
Niramoy, at Dubrajpur as the second Covid-19 hospital and started renovating it and will beturned into adedicated Covid-19 hospital shortly in Birbhum. Patients with mild symptoms are to
be admitted here. The district administration makes plan to start another Covid-19 hospital insidea private hotel in Tarapith.
Conclusion
India as well as our district are rapidly urbanizing. Before 2002 needs of healthcare of the urban
population have not received adequate attention. The National Health Policy (NHP) 2002
acknowledged the need to focus on urban population. The government has launched National
Urban Health Mission (NUHM) in 2013 to create comprehensive healthcare infrastructure in aplanned manner. But it has been very slow to take off and expand impetus. The NHP-2017
emphasizes the need extensively and move forward. Recently COVID-19 is affecting the wholeworld. To deal with the pandemic effectively lockdown is merely for buying time by which thehealth infrastructure can be readied Health Infrastructure, is observed to be the major
determinant of Health Status of the people. Urban Health infrastructure of the district is not up to
the mark and as an effect health status of the people is affected. The district has minimal
resources about doctors, medical staff and other health infrastructure. The district is facing116

severe shortage of respiratory devices & ventilators. It would be tough to operate with thesesmaller numbers. Due to high population pressure in West Bengal the infrastructural facility isfound to be insufficient dealing with double or triple number of population than they are capable
to handle. This reduces their efficiency and thereby causes poor health service. Huge number ofpatients are being referred to the Medical College as well as District Hospitals due to lack ofinfrastructural support in the rural health centers and this is making the hospitals crowded,
unhealthy and less efficient. The medical colleges necessitate working closely with the state
governments in providing technical support to perk up healthcare services in urban areas. The
central Government spends just about 1.09 percent of GDP on public health. National healthpolicy is to increase into 2.5 percentof GDP by 2025. Among nine states of the country west
Bengal is one of the lowest spenders on healthcare. Some reforms in this sector need to focus
on key areas such as district hospitals and primary health centers (PHCs) need to bestrengthened, medical seats to be augmented. District hospitals should be equipped to handle
epidemics. Government needs to spend in vaccine manufacturing. Private sector resources
require to assist public sector efforts is especially in times of a crisis like COVID-19. The country
as well as district must tie in private sector to create capacity. The study area needs morediagnostic tests, hospital beds, ICUs, ventilators, and so on.
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Dept. Of planning, statistics & programme monitoring.
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6. Misra, R.P. (2007) Geography of health , concept publishing company, New Delhi-110059.
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