Nandurbar model: How a Maharashtra district is beating Covid-19 with its 'oxygen nurses'

Nandurbar, a tribal district in Maharashtra, has evolved a model that ensures optimum use of medical oxygen. The district had started planning for its oxygen needs in September last year and has installed three plants since then. Today, it's self-sufficient in oxygen and is supplying the excess to other districts.

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Nandurbar model: How a Maharashtra district is beating Covid-19 with its 'oxygen nurses'
Following the success of Nandurbar's 'oxygen nurse' model, the state government decided to implement it across Maharashtra last week.

The term 'oxygen nurse' was coined in Nandurbar, a tribal district in Maharashtra, for its optimum utilisation of oxygen cylinders. Following its success, the plan was implemented across Maharashtra last week. The state's health ministry said appointing oxygen nurses is an effective way to manage usage of cylinders.

Nandurbar's district collector Dr Rajendra Bharud, the brain behind this idea, said the administration decided to appoint a nurse for every 50 beds. The nurse had only one task -- to check the oxygen saturation level of each patient.

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"If any patient took off their oxygen mask, the nurse would insist that they wear it. If the patient's condition was improving and their oxygen level increasing, the nurse would reduce the flow of oxygen from the cylinder. If the patient's oxygen level was decreasing, the nurse would increase flow from the cylinder. This ensured continuous monitoring of oxygen," Bharud said, adding that this mechanism helps in the optimum utilisation of the scarce commodity.

Oxygen preparedness: District's farsightedness

Having studied medicine himself, Dr Bharud had prepared well in advance to ensure that his district did not face shortage of oxygen in case on an emergency.

He examined the situation in other countries and decided to install oxygen plants in his district. The first such plant was installed in September last year, followed by two other earlier this year.

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This made the district self-sufficient in oxygen even during the pandemic. Today, it is sharing the extra oxygen produced with the neighbouring district of Dhule.

Nandurbar District Collector Dr Rajendra Bharud.

Nandurbar's Covid-19 dashboard

Recently, while hearing petitions related to Covid-19 management, the Bombay High Court was informed about Nandurbar's Covid-19 dashboard.

The live dashboard has sections for ambulance, bed availability, and details of Covid-19 cases, all just a click away. It also provides the latest details of hospitals (both government and private) where beds are available, including ICU beds.

Contact details of hospitals and ambulance services in each talukas is also listed on this dashboard.

"The entire website has details of bed availability in private and government hospitals across the district. At present, there are about 200-250 beds that are vacant. There are many patients coming for treatment from neighbouring districts like Jalgaon and Dhule, as well as neighbouring states like Madhya Pradesh and Gujarat," Dr Bharud said.

Getting doctors from elsewhere

The district collector says while preparing for the pandemic, he was aware of the issues that plague Nandurbar, a district with 70 per cent tribal population.

"We had only two MD doctors for a population of 20 lakh. So, we had to request all private hospitals and clinics to open up and start treating people. Since we had only two doctors, they were heavily burdened because they had to treat patients with Covid-19 as well as non-Covid patients. We appealed to our juniors and batchmates and got doctors from Mumbai and Pune to come here and help us," he said.

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Apart from these measure, the strict lockdown in the district also helped in keeping the caseload low. As of May 7, Nandurbar has 5,757 active Covid-19 cases.

(With inputs from Vishal Thakur in Nandurbar)

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