DELHI, India—Anish left his 10-day-old daughter with his mother while he waited at a crematorium with his wife’s body. He and Jyoti had stuck together through all the challenges of pregnancy during the pandemic and had been looking forward to raising a family. “Eight days after Jyoti gave birth to our baby girl, she started feeling breathless. Initially we thought that this must be just a postpartum issue but within no time her oxygen levels dropped from 80 to 40 on the pulse oximeter,” explained Anish.
As she gasped for breath, Anish managed to get her admitted to a private hospital in southwest Delhi and provide oxygen support but soon that too wasn’t enough. Even with support, the oxygen saturation in her body plummeted to 30. “She needed an ICU bed. We called everywhere, pleaded with everyone, but it wasn’t available,” he said.
Ten days after giving birth to a healthy baby, Jyoti, a 32-year-old mother, died of COVID.
The second wave of COVID-19 in India has taken the parents of many children like Jyoti’s infant daughter. Some find themselves in the care of relatives and guardians, others remain alone at hospital emergency rooms and homes not knowing what to do with their parents’ bodies. Some have lost one parent, while others have lost both. Concrete data is unavailable, but child protection authorities say that distress calls about children whose mothers and fathers died of COVID have significantly increased.
The rise in COVID-19 cases in India over the past two months has been ferocious. On Feb. 28, the country recorded 15,510 new cases in 24 hours. Four weeks later, that number had risen almost fivefold to 72,330. On Saturday, India became the first country in the world to record 400,000 new COVID cases in one day.
The unprecedented speed and magnitude of new infections have paralyzed the health system: Hospitals are at capacity, and medical oxygen in short supply. Reports of people of all ages dying in the streets because they cannot gain hospital admission abound. In contrast to earlier COVID waves around the world, India’s latest surge appears to be hitting younger adults hard. “Sixty-five percent of COVID-19 patients in Delhi are below the age of 45 years”, said Arvind Kejriwal, Delhi’s chief minister, on April 11. Since this is an age group that includes many young parents, the consequences are profound. It’s also a cohort that was not permitted to get vaccinated until recently because of the Modi government’s policies. With infections skyrocketing, Kejriwal urged the central government to open up vaccinations to everyone irrespective of age.
On April 24, at around 3 a.m., the helpline number of the Delhi Commission for Protection of Child Rights received an SOS call.
The parents of two siblings, aged 15 and 16 years old, had died within a day of each other. The two had sat with the bodies not knowing what to do. “We arranged for a cremation space at the Seemapuri cremation ground and ambulance services,” said Anurag Kundu, chairperson of DCPCR. “We also provided medical assistance for both the children. At these times all the child needs is to be held and consoled.”
Delhi is a city under siege. Its hospitals are overwhelmed, and life restricted by a 24-hour curfew. Delivering basic yet critical services like counseling and support for bereaved children has become a challenge. “We are doing the best we can on the phone, but we need to have services on the ground,” said Bharti Ali, executive director of HAQ: Centre for Child Rights, a Delhi-based nongovernmental organization. “We have been demanding that the government make childline services an emergency service, so [social workers] can at least commute freely during the lockdown and reach out to children who need help.”
Across the country, stigmatization and fear have contributed to this tragedy. On April 26, an 18-month-old infant was found starving as he lay next to his mother’s body. She had died two days before in her house in a small town in Maharashtra, the state with the highest number of cases in India. With the father away, the mother was by herself. Police say that neighbors didn’t want to check on the family fearing COVID. Ultimately, the landlord called the police concerned about the stench and the baby was saved.
“Unfortunately, children being orphaned is not a new phenomenon, but we see that it has been incredibly accelerated by the sheer force of this pandemic,” said Kundu from DCPCR. “We have received six to seven SOS calls in just three to four days.” He thinks the cases of children being orphaned are at least 10 times higher than reported. “That’s just for Delhi. The nationwide count will be much more.”
Social media posts and WhatsApp volunteer groups have been circulating messages seeking urgent help for children affected by COVID. These include pleas to adopt those whose parents have died.
According to India’s Juvenile Justice (Care and Protection of Children) Act, 2015, a child orphaned due to loss of both parents can be placed in foster care with extended family or in group foster care. The child can also be put up for adoption or sent to child care institutions run by both the government and NGOs until they are 18 years old.
If relatives decide to take care of the child, a background check is done with the assistance of the Child Welfare Committee. “I am not a proponent of institutional care,” said Kundu. He added that for reported cases in Delhi, children orphaned by COVID are often—although not always—cared for by their relatives.
Last week, one 14-year-old boy in Delhi who lost both his parents to COVID-19 called the DCPCR helpline. His relatives refused to adopt him and offered to only support him with meals. Child authorities had to send him to institutional care.
Foster care, adoption, or even institutional care can be difficult experiences, especially for orphaned girls. “With girl children, exploitation and abuse is a big concern,” said Ali. “In both situations of staying with relatives or institutional care, children could be psychologically silenced and kept away from reporting the abuse and violence inflicted on them.”
Nearly 40 percent of the country’s child care institutions do not have adequate measures in place to prevent physical or sexual abuse of children, according to a 2020 national audit of shelter homes in India, commissioned by the National Commission for Protection of Child Rights.
The rise in demand for these services, as well as budget cuts, is likely to make the challenges confronting the institutional care system worse. “During this second wave, there is very little acceptance from the government about this crisis,” said Ali. “The government will have to increase its investment in child protection services, which is currently only at 0.03 percent of the total Union Budget and is consistently going down.”
“My ammi [mother] will die if I don’t get her oxygen now. She only has another hour of oxygen supply left and the clinic says they have no more,” 15-year-old Shafiq (not his real name) told me over the phone. For more than a week he had been singlehandedly taking care of both his parents who were COVID positive.
Few people in India have health insurance. Coming from a lower-middle-class family, Shafiq doesn’t have money to pay for medical expenses. For the first few days he cared for them at home in northeast Delhi. Later, with the help of an NGO, he managed to find two beds for them in a small clinic in his neighborhood.
“After they were admitted in the clinic, they started to feel better. My abba [father] is recovering well, but my ammi’s health is getting worse,” said Shafiq, sounding desperate to help his mother.
While there are cases of COVID-positive parents leaving children behind across all different socioeconomic backgrounds, more economically vulnerable children often bear the added responsibility of becoming the caregiver. Arranging for medical help for their parents by themselves at a time when there is an overwhelming shortage of oxygen cylinders, ambulance services, and hospital beds seems impossible for these children. Many also bear the guilt of not being able to save their parents.
What will be the long-term impact on the lives of these children is impossible to determine at this stage. What is known is that in many cases, their loss could have been prevented, had it not been for India’s overwhelmed health system.
“The fatality rate we are seeing now is not a property determined by the lethality of the virus; it is due to a collapsed health system,” said Bhramar Mukherjee, an epidemiologist. “Each number is not a mere statistic, but the face of a loved one. The system can fail to report many deaths, but families cannot.”
At an apartment in Delhi, Anish holds onto his baby and breaks down: “My child has been orphaned. She will never know her mother. I will do everything I can for her, but I can’t replace a mother.”
Only a few miles away from Anish, Shafiq frantically makes another plea: “Please, please send my ammi an ambulance now or she will die. Can you help?”