When I dial Dr Rahul Ghule’s number for an interview, I expect the phone line to be busy. In fact, I am prepared for it. For the past four months, Dr Ghule has repeatedly tweeted his phone number urging anyone with COVID-19 or related ailments to get in touch. But Dr Ghule answers immediately. “Most people WhatsApp me,” he says.
Dr Ghule is the Founder and CEO of 1Rupee Clinic which has been running Emergency Medical Rooms across railway stations in Mumbai since 2017. The doctors at these rooms or clinics offer checkup and out-patient department services and charge one rupee as their consultation fee. There are 18 such clinics across the city’s suburban railway stations.
Dr Ghule is a proponent of prioritising community-service based healthcare, a paucity of which is acutely felt during the ongoing pandemic. It is no surprise then that 1Rupee Clinics have stepped in.
Dr Ghule is convinced that it’s not COVID-19 that’s fatal but a delay in treatment. He recently tweeted that COVID-19 was not a deadly disease if treatment is started on time. He wrote, “those who waste first 10 golden days, have more problems or bad prognosis.. So Be on time, save your life. You can surely win this war.”
Dr Ghule has been using Twitter to impart information, discuss his cases, and placate worries. He highlighted the case of a young man who had a 75% lung damage but was cured and discharged because of timely treatment and care. Dr Ghule also doesn’t fail to tell you that unlike most government hospitals that are usually preferred by low-income individuals, two KDMC corporators have sought treatment at his.
On September 9, Maharashtra recorded 23,816 fresh cases: its highest ever single-day surge. It has also been reporting 300+ deaths every day for the past week. The 1Rupee Clinics come in handy at a time when the state has been one of the worst affected by the virus.
The clinics were started to tackle a completely different, but highly fatal problem – accidents on the city’s ubiquitous railway tracks. But Dr Ghule has expanded their role during the pandemic.
Origins
In 2015, the Bombay High Court acknowledged that 3,352 people had lost their lives in 6,617 accidents on the city’s railway tracks the previous year. It noted that timely medical aid could have saved lives, and directed the Central and Western Railways to set up 24X7 Emergency Medical Rooms at each suburban railway station in Mumbai.
“The Central Railway floated a tender and we were chosen to run the clinics,” Dr Ghule says of his organisation, MagicDil which spearheads the one-rupee clinic concept. The first clinic opened at Ghatkopar station in April 2017, followed by several others across suburban railway stations.
But in 2018, Central Railway shut six of these clinics for failing to meet established stipulations. The Central Railway rules required an MBBS doctor to man the clinic at all times, but the 1Rupee Clinic team didn’t find it financially feasible to have an MBBS doctor at the clinic 24X7. The following year, however, Central Railway rescinded the clause, Dr Ghule says. Today, Dr Ghule and his team of 110 people run eighteen 1Rupee Clinics across the city’s major stations.
The clinics have been set up through a public-private partnership with the Central Railway. Central Railway doesn’t assist the clinics financially but offers basic amenities like space, electricity and water.
Dr Ghule, while keen on offering charitable services himself, doesn’t take donations to run the clinics. MagicDil runs profitable pharmacies at railway stations along with pathology labs which helps cover costs, he says.
Dr Ghule resolved to offer affordable treatment due to an incident five years ago. In 2015, his mother met with an accident. She suffered a severe head injury and was paralysed. His mother’s accident and the subsequent expenditure got Dr Ghule thinking about how the poor afford healthcare.
“My wife and I, both are doctors but we could do nothing. We are economically stable to provide my mother treatment in the ICU for the next one year but what about those who have limited resources?” he told OneIndia. That’s when he decided to start a charitable healthcare venture.
Affordable healthcare and the pandemic
In March, Dr Ghule’s team started conducting door-to-door screenings in Lower Parel, Worli Koliwada and the western suburbs of Andheri and Goregaon. In July, when the Kalyan-Dombivli Municipal Corporation was setting up a Dedicated Covid Hospital in Dombivli, 1Rupee Clinic applied for the tender.
“No one else applied because they were scared. We already had our team ready,” Dr Ghule says. Now they run a 467-bed Dedicated Covid Hospital in Dombivli. Dr Ghule claims that in the almost two months that they’ve been running it, there hasn’t been a single fatality in his hospital. An achievement he points to his doctors’ timely and proactive treatment.
On September 3, Pandurang Raikar, a journalist passed away in Pune due to complications related to COVID-19. Raikar had developed a fever sometime in the third week of August but his swab test on August 22nd came negative. Yet his condition worsened irrevocably.
Dr Ghule read about the case and found out that Raikar was given an antigen test when the RT-PCR test is far more reliable. Dr Ghule also believes that if Raikar were treated as soon as he had developed symptoms, he would have survived.
But delays–both by patients in seeking treatment and by public and private hospitals in providing it–have weakened India’s fight against COVID-19.
Nowadays, Dr Ghule is running a tight ship. He travels from his home in Thane to Dombivli, 25 kms away, every day and works for 17 hours a day, treating patients and answering queries both online and offline. Over the past two months, his treatment modalities have changed, too. “We initially had a few cases that needed a ventilator, but since then we have learnt and grown,” he says. “When a patient comes in, we don’t wait. We immediately perform a CT scan to evaluate the extent of lung damage and treat accordingly.”
1Rupee Clinics were conceived to ensure that a person injured in a train accident didn’t miss out on the initial hour of treatment: the “golden hour”, a concept Dr Ghule has adopted for the treatment of COVID-19 as well.
“The initial 10 days are golden. Symptomatic patients must immediately seek treatment” he says. “After that, even God can’t save you.”