In the emergency room of a public hospital in northern India, a man tries to revive his mother who had just died from symptoms of COVID-19.
On another bed, a young man who had tested positive sits and makes an effort to breathe as two exhausted family members sprawl on the tiny bed.
The only doctor in the emergency department at this hospital in Bijnor, a small town in India’s most populous state of Uttar Pradesh, 180 km east of Delhi, can barely handle the flood of patients arriving, in rickety ambulances or in the backs of cars.
India’s brutal second wave has hit its small towns and countryside, destroying a fragile health system that is not equipped to cope with a public health crisis of such magnitude.
Doctors are hard to find, intensive care units are expensive and scarce, and patients pack their bags in emergency rooms.
People come and go, trying to help everything from buying oxygen cylinders to resuscitation.
“We are doing our best, the numbers are important,” said Ramakant Pandey, the top district official in Bijnor. Unlike the first wave, this one is more severe, he said.
“We also don’t have a lot of time between when a person is infected and when they become serious.”
Four people died at Bijnor hospital within an hour on Tuesday, including Jagdish Singh, 57, who had arrived a few minutes earlier. His son Gajendra said he took him to hospital thinking it would help increase his oxygen levels.
At the hospital, he said he ran around trying to get oxygen, then lost his father.
Dr Naresh Johri, who was leading the emergency with two assistants, said he was unable to speak to the press as per the rules of the service.
Medical oxygen has become a major concern with top hospitals in Delhi and other major cities issuing SOS calls saying they are running out of vital gases due to the crushing patients.
The government is now trying to source supplies from overseas and local industry. While the situation in Delhi has improved, small towns like Bijnor are struggling.
Many choose not to go to the hospital, believing that they will not get much care. In the village of Jhaalu, 11 km (7 miles) from Bijnor, members of Shakeel Ahmed’s family were reading the Quran while he was at the end of his rope.
“We try to avoid hospitals, we don’t trust the system,” said his brother Bhure Ahmed.