Covid-19 Triggers Cycle Of Debt For Millions Of Indian Families

02 Jul 2021 12 min read  Share

With Covid-19 treatment bills in lakhs, desperate families borrowed from friends and relatives, used online fundraisers and sold assets, including gold, land and vehicles. Now, those debts are coming due.

Shivang Gupta, a 28-year-old Ghaziabad-based civil engineer, spent Rs 30,00,000—across three Delhi-NCR hospitals—since his family of four got Covid-19 in April. He lost both his parents/BY SPECIAL ARRANGEMENT

New Delhi: “Main kaise batau apna dukh? Naa beta raha, naa gaon mein zameen… Kaha jau?” How can I describe my sorrow? My son is gone, so is my land...where should I go? 

Chandan Dolai, 51, washes cars for a living in Gurgaon, a Delhi suburb and a city of multinationals, startups and soaring towers. Around 1 pm on 23 May, at a government hospital in India’s capital, Dolai’s 25-year-old son, Arun, died of Covid-19. 


In the three weeks that Arun battled the coronavirus, his father spent his meagre savings of Rs 29,000, sold his “two bigha land in his native village in West Bengal,” and sought donations from the “kothi walas”, those who owned the cars he had been washing since 2004.


“I spent over Rs 550,000 on my son’s treatment—paid Rs 50,000 for an oxygen cylinder, paid Rs 200,000 at Kriti hospital in Gurgaon, then Rs 139,000 at another hospital in Gurgaon where my son was moved, before he was taken to GTB hospital in Delhi,” said Dolai, listing expenses incurred on ambulances, medicines and travel.

A supervisor at a company in Gurgaon, Arun got fever on 30 April. For days, his father tried to book an RT-PCR test and finally got a slot for 9 May. A day before the test, Arun began to have trouble breathing. His father arranged an oxygen cylinder for Rs 50,000—money that he had borrowed from many people.

A doctor that Dolai knew suggested he take his son to a hospital; he also told him the intensive-care unit would cost about Rs 40,000 a day. “So, I called up my elder brother in West Bengal, and told him to sell off my two bigha land… I got Rs 400,000 for it,” said Dolai, as he broke down over the phone. “I just wanted to save my son. He’s gone, and so is my land… I have nowhere to go now.”

The brutal second wave of Covid-19 has taken the death toll since 2020 to 399,459 as of 1 July 2021, according to health ministry data, but it is evident that deaths have been undercounted nationwide (here, here, here and here), with more than a million estimated fatalities.

Millions more have been pushed into poverty: 75 million, according to this March 2021 study from the Pew Research Center, a global think tank. The earnings of 230 million slid below the national daily minimum wage of Rs 375 during the pandemic, according to this study from the Azim Premji University, and as per this report by the Centre for Monitoring Indian Economy (CMIE), “over 10 million Indians have lost their jobs because of the second wave of COVID-19, and around 97 per cent of households’ incomes have declined since the beginning of the pandemic last year”. 

To cope with unexpected health costs, families of Covid-19 victims sold land, jewellery, vehicles, and home appliances. Some took loans from relatives and employers, while a few raised money on crowdfunding platforms, such as Ketto and Milaap.

Online fundraising platform Ketto has hosted “4,000 Covid-related campaigns between 20 April and 31 May this year… while Milaap hosted 2,000 campaigns only for Covid-19 treatment”, the Indian Express reported on 13 June.

On Wednesday, the Supreme Court observed that the National Disaster Management Authority (NDMA) had “failed to perform its duty,” and directed it to come up with guidelines for ex-gratia to those who lost family members due to Covid-19. The SC directed the NDMA to recommend guidelines within six weeks. 

Article 14 spoke to a dozen families from six cities about their financial distress and the cycle of debt that had entrapped them.


With A Little Help From Fundraisers

The last time A, 27, a Delhi-based DJ (the family asked that we not name them), had to worry about the family’s finances was when he was a teenager. His parents had just separated, and the responsibility of raising A and his elder brother S fell on their mother’s shoulders. 

“It was a difficult time but not this bad,” said A, leaving the house as he spoke to us, so his mother would not hear. “We never imagined it would get this bad.”

Around 20 April, his brother, a gym trainer, fell sick, and four days later, when his oxygen saturation level dropped to 88, A rushed him to Holy Family hospital in Delhi in an autorickshaw. 

“For the first few days, he was in the hospital’s emergency ward, and then an acquaintance misguided us about a bed vacancy at a Mehrauli hospital. I paid Rs 25,000 to an ambulance service to and fro from one hospital to the other—a total distance of roughly 25 km,” said A.

Since then, they have spent their savings of Rs 5 lakh, borrowed money from S’s close friend, his former employer, from their church group and started an account on Milaap. “My mother mortgaged whatever little gold jewellery she had, and got Rs 80,000, which we have used in the treatment. The fundraiser was set up by bhai’s close friend when we exhausted all avenues of help. Just the hospital bill so far is around Rs 11 lakh,” said A. “Now, my brother is no longer on ventilator support but needs surgery. He will be hospitalised for more days, and his recovery at home too will take time.”

Parked outside their humble home in southeast Delhi are two bikes—a Suzuki, and a Royal Enfield. “I may have to sell one of them, not the Royal Enfield. That is bhai’s bike… I am a DJ, bhai is a gym trainer, and both professions have suffered greatly since last year. We were anyway surviving just on savings. Now, those are over too,” he said, adding that the fundraiser had been helpful.

When Devanand Telgote, 26, a UPSC aspirant in Telhara, in Maharashtra’s Vidarbha region, fell sick on 25 April, the symptoms were first managed at home. In early May, when he began to have difficulty  breathing, he was rushed to a private hospital. By 5 May, only Rs 5,000 was left in Telgote’s father’s bank account, said the 26-year-old’s childhood friend Sumit Kothe. 


“That’s when wefriends of Devananddecided to collect some money through people who knew him. In a day, we collected Rs 600,000. His condition deteriorated, and the doctor said he needed to be shifted to a specialised hospital in Hyderabad. The air ambulance only costs a bomb… We wondered how to raise money, and that’s when Devanand’s friends from IIT-Bombay made the Milaap account. His father, an ex-armyman, wanted to sell his fields and home… How could we let that happen? On 15 May, he was airlifted to Hyderabad, where he is being treated at KIMS hospital. We raised over Rs 1 crore through the campaign,” Kothe told Article 14.

Telgote’s health update as of 15 June on the Milaap campaign is upsetting: “Doctors have come to the conclusion that a lung transplant would be required for Devanand… We need to raise more funds as the estimate for the transplant itself is Rs 45-55 lakh.”

Malini Aisola, co-convener of All India Drug Action Network (AIDAN), said that the spike in fundraising requests due to Covid-19 is unprecedented, and one of the reasons is “multiple members of a family falling sick this wave, unlike the last time.”

“All I Wanted To Do Was Save Him”

Even when he was undergoing Covid-19 treatment at a private hospital in Manipur’s Imphal last month, 52-year-old Irom MaipakNational Award winning cinematographerwas worried about the financial stress his family was under due to the virus. “He reassured me that he will be back home soon, fit and fine, and will earn money through more projects, so we can repay the loan we’ve taken for his treatment,” said Maipak’s wife Thounaojam Rita Devi, a primary school teacher. “He was worried, even in that condition.”


On 19 May, after calling his wife and asking her to rush to the hospital because he couldn’t breathe, Maipak passed away. He is survived by the couple’s two children, in class 8 and 10 respectively. 

“I spent around Rs 10,00,000 on the treatment. When he fell sick, I didn’t care about the money,” she said. “All I wanted to do was save him.”

Devi’s two sisters in Bengaluru lent her Rs 200,000, she borrowed more from a local money lender, sold some gold jewellery for Rs 200,000, and exhausted their savings of Rs 300,000. “Primary school teachers aren’t paid a lot of money. I will retire in a few years,” said Devi, as she fought back tears. “I am so worried, burdened.” 

A day before he passed away at Imphal’s Raj Medicity hospital, Maipak had tested negative for the virus, and had been shifted to the ward. Devi alleged that “this negligence led to his death. His oxygen saturation dropped, and when I spoke to the doctor treating him, he didn’t know why my husband had been moved to the ward. I am grieving, I am worried about the children’s future, and I want justice”.

In the last few months, AIDAN’s Aisola has been flooded with cases of patients’ kin alleging profiteering by hospitals, and inflated bills. 

“Many states fixed the maximum daily treatment rates for Covid-19, for various categories of beds, at private hospitals,” said Aisola. “In Delhi, we’ve noticed blatant non-compliance by hospitals, and no attempt by the government to enforce the order.”

Last June, rates for isolation beds and ICU beds with and without ventilators at Rs 8,000-Rs 10,000, Rs 13,000-Rs 15,000, and Rs 15,000-Rs 18,000, respectively, were fixed by a committee led by NITI Aayog member Dr VK Paul. 

Aisola said there was a “deep power imbalance”. 

“Given the lack of any grievance mechanism in respect of the rate caps, families are unable to raise complaints or get assistance against violations and overcharging by hospitals,” she said. “Most lack the ability or resources to pursue a legal battle, especially when facing continued illness or the death of a loved one.” 

AIDAN went to the Delhi High Court regarding the lacunae, ambiguities and loopholes in the order capping treatment rates for Covid-19.” Aisola said, “We have suggested a pro-active audit mechanism to identify overcharging and strict penalties against non-compliance. There should be recovery against overcharged amounts which should be refunded to the families.”

Like in Delhi, a similar price-capping at private hospitals was introduced in Karnataka last year“with the rates ranging from Rs 5,200 to Rs 25,000 depending on the category and severity of infection is both for Ayushman Bharat-Arogya Karnataka (AB-ArK) patients and other insurance/cash paying patients, The Hindu reported. Allegations of overcharging have emerged, and a group of volunteers has taken it upon themselves to help bereaved families with scrutiny of such bills.


Heaps Of Bills

Shivang Gupta, a 28-year-old Ghaziabad-based civil engineer, spent Rs 30,00,000across three Delhi-NCR hospitalssince his family of four got Covid-19 in April. Early May, he lost his 67-year-old father to the virus, and on 23 June, his mother Manju Gupta too succumbed to post-Covid complications. 

“I moved her from Max hospital in Patparganj to a government hospital because I could no longer afford private hospitals, and I started a fundraising campaign on Ketto to help with the bills,” he said. 

Gupta said that he had depleted his savings and his brother’s savings. Their sister had sold jewellery worth Rs 250,000. 

“I believe there is a discrepancy in bills but I don’t have it in me to fight this legally. These are big names, I can’t take them on. First, I lost my father, and had no time to even grieve. Now, I have lost my mother too,” he said. “I have taken loans from every possible source. I will do double shifts to pay them back.”

While hospital bills can still be contested due to the available paperwork, those who bought oxygen cylinders and Covid-19 treatment drugs such as Remdesivir in the black market out of desperation have no redressal.

In early May, Rewari-based stockbroker Puneet Dewan was told by doctors treating his 72-year-old father for Covid-19 at a Jaipur hospital that he needed to acquire a Tocilizumab injection. Apart from calling up almost everyone in his phone book, Dewan also tweeted about this.

Dewan finally found someone who quoted Rs 400,000. “It was so cruel, it broke my heart. I needed the injection urgently and I didn’t have that much money,” he said. 

His father’s friend in Dubai, friends and clients, lent him money, and he considered selling his car. “There is no one keeping an eye on people taking advantage of our majboori,” said Dewan. “I found someone who quoted Rs 700,000, and then finally someone else sold it to me for Rs 37,000, the market price.”

It was too late.

His fatherSubhash Chandra Dewan, a retired government officer in Rajasthan’s Rewaridied in the Jaipur hospital. 

“I lost my mother last year, my father this year. I have got his death certificate but the CGHS (Central Government Health Scheme) approval hasn’t come through yet. I was sitting on a huge debt and it would have taken me years to repay,” he said. “My sister gave money that we had set aside for her marriage, and I took all the money out of the fixed deposit account to pay back most people. I still have some debt and no savings. Before this, I had not even taken Rs 5 on loan… Iss bimari ne hume tod diya hai (this illness broke me).”


In mid-April, a 26-year-old filmmaker and sole breadwinner of his family of three ran around hospitals in Delhi with his parents who had contracted Covid-19. 

“Even before Covid-19 struck, we were selling off some jewellery to make ends meet. My father was diagnosed with a mental illness due to which he stopped working a few years ago. Things at home were okay but this has been a huge blow,” he told Article 14 on condition of anonymity. “Overall, my parents’ treatment cost around Rs 500,000, most of which was raised by well-meaning strangers, and I had to borrow money from my maternal uncle and aunt.”

A portion of the treatment cost went towards paying ambulance services, he said. “At the time, one had to go from hospital to hospital with the patient and hope to find a bed. The free ambulances wouldn’t stay, and the private ones cost an obnoxious amount of money. I remember paying Rs 33,000 from Malviya Nagar to Okhla to Gurgaon. I just couldn’t negotiate at the time… It was a matter of life and death,” he said. 

The 26-year-old is now looking for a job in marketing, so he can earn more and pay back the loans.

(Somya Lakhani is a Delhi-based journalist.)