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As desperate families go to market, exorbitantly priced oxygen concentrators are making them unaffordable for Covid-19 patients homecare. Now the crisis is that leisure oxygen-generators are being sold for medical oxygen concentrators, reports Saifullah Bashir

SRO Kashmir volunteers unloading a recent cylinder purchase. The man in the front is Dr Javeed Ahmad, the group head of the Disaster Management Wing.

Mohammad Azan Khan, 30, a resident of Srinagar is desperate to secure an oxygen concentrator for one of his Covid-19 positive relatives. Khan approached many people but machines are either out of stock or the chain of social groups have already given them to the needy.

Khan finally decided to buy from a dealer.

“I arranged Rs 40,000 but once I approached the dealer he told me that the cost of a 5ltr concentrator is now Rs 55000,” Khan said regretting that he returned home empty-handed.

In the ongoing second Coronavirus wave, the price of concentrators has skyrocketed. From a common person to an NGO, all have the same story to tell. The supply of life-saving equipment is also low and it is becoming extremely difficult for the NGOs to replenish their inventory.

“Our first consignment of 100 concentrators was literally snatched from us by the Uttar Pradesh government,” said Hakim Mohammad Ilyas, founder of the NGO, Ehsaas International. “Whether legal or illegal, they snatched it while transporting.”  It took an effort by the NGO to recover the consignment.

Even these basic machines have grown precious and costly. “Last year we purchased a concentrator at Rs 46000, now it costs Rs 75000,” he said. Now the NGO has stopped transporting these machines to Kashmir. They are investing more and airlifting them to Srinagar.

A new consignment of the Oxygen Concentrators in the NGO, Athrout office.

In the mad rush of possessing an Oxygen concentrator, people are landing themselves in trouble. Now even laymen make concentrator purchases and literally take “killers:” home. It is becoming difficult to distinguish between the medical-grade concentrator and the concentrator which is being used for mild Chronic Obstructive Pulmonary Disease (COPD) patients.  These concentrators become killer machines for patients who need a better oxygen supply.

“Sometime back we received the consignment of 70 concentrators of that kind.  But they were not meant for Covid patients,” Hakim said, insisting that before purchasing oxygen concentrators, people should consult experts and do research.

China is the leading manufacturing power on earth and it is the most polluted country as well. “There is a new tradition in the working class,” one Kashmir activist who is into social work, said. “Once they reach home, they put on their leisure oxygen generator at home that gives them 90 per cent of oxygen for half an hour. This they do for neutralising the impact of the polluted air on their lungs.”

In recent days, these rejuvenating oxygen concentrators appeared in the Kashmir market and were sold as well. When the Chinese manufacturer, Yuwell, got a tip-off of this happening, they put on their website that the particular brands are not manufactured for the Covid19 patients.

These “duplicate concentrators” are being sold at Rs 50,000 to people not aware of how these work.

“We have cases where people have bought these duplicate concentrators at Rs 65000. It is better to use a vacuum cleaner for air, there is no difference,” said Syed Muhammad Afaq, who heads SRO Kashmir’s, project Oxygen Kashmir.

It was the NGO Athrout that first raised the alarm about the fake concentrators.

“Some sadistic people and distributors/companies are out there on the prowl to exploit this situation and put people’s lives in danger for their personal gains,” a tweet by Athrout said on May 15. “Various brands of oxygen concentrators pose a serious threat to the life of Covid patients. These oxygen concentrators can have 1-9 litres flow rate options, but as you increase the flow rate their oxygen purity level decreases that could damage vital organs.”

Asim Nisar, one of the volunteers said these devices designed to give 70 per cent pure oxygen at a  flow of 2 litres per minute, give merely 30 per cent pure oxygen if the flow increases to five-litre, a minute. “This is as good as that of the routine air,” he regretted. WHO recommendation is the patient must get 82 per cent pure oxygen in therapy.

SRO Kashmir procured seven highly expensive HFNC machines which can deliver up to 80 LPM of Humifificated O² to critically sick patients. These can only be used in hospitals.

Kashmir’s traditional medical equipment suppliers are selling the right machines. “But there are people who see an opportunity in the crisis and have imported a substandard system,” one insider in the market said. “As desperation to have some protection at home has made the buyer sort of a blind person but the tragedy is the seller is literally deaf to science and knowledge.”

Interestingly, these life-saving machines continue to be heavily taxed despite the pandemic. They invite 12 per cent Goods and Service Tax (GST) applied. Before the GST regime, they would attract only five per cent Value-added Tax (VAT).

“NGOs buy these machines in bulk; we could have purchased more than 20 machines from the money which we spend on tax,” Hakim said. “It would have been better if the tax could be waived off,”

The massive price hike has put dealers in distress. They said that due to the increase in demand, the price has been increased by manufacturing companies.

Basharat Ahmed, a Srinagar based distributor counted many factors which are responsible for the increase of price in concentrators.

“All manufacturers have hiked the price but not as much as we see in the market,” Basharat said. “I assume that some people are hoarding the machines amid a spike in demand.”

Basharat said that he has seen dealers selling concentrators at the price of Rs 80000 in Delhi. “In this situation what can a Srinagar based dealer do?” he asked.

The medical equipment supplier said the companies have hiked Rs 5000 per machine but when a desperate customer approaches any dealer and in case the concentrator is not in stock, the customer is not ready to wait for a couple of days, he lands in the hands of unscrupulous people.”Whenever a customer buys a concentrator he should ask for a GST bill. It will help him get the machine at a genuine price,” Basharat suggested.

A worker checks the pressure of oxygen tanks at a temporary COVID-19 hospital in Srinagar on Monday, May 10, 2021. Leading NGO, Athrot in partnership with the government set up 100 bedded oxygenated facilities at Hajj House in Srinagar. KL Image: Bilal Bahadur

In this situation, Kashmir’s chain of charities continues to make bulk purchases. This week Athrout received a fresh lot of oxygen concentrators. It was good news for hundreds of people who were waiting for weeks. The NGO said they paid Rs 12,000 extra per machine and they got supplies after two months of wait.

“We paid Rs 55000 per concentrator. Before Covid19, the price was Rs 43000. Also, we ordered them in March,” said Athrout Chairman, Bashir Nadvi. Other machines including Bilevel Positive Airway Pressure (BiPAP) and Continuous Positive Airway Pressure machine (CPAP) have also witnessed a slight hike in price. It has now 400 Oxygen generating machines in its inventory.

Even SRO Kashmir, the other major player in the Oxygen supply, has added to its inventory 50 New Oxygen Concentrators. This is in addition to two “highly expensive HFNC machines”, which have the capacity to deliver up to 80 LPM of Humifificated O² to critically sick patients.

“These are most modern machines valuing Rs 4 lakh a piece and we are acquiring seven,” Syed M Afaaq said. “These replace the traditional high flow oxygen theory in which most of it goes waste. This system humidifies the intake and warms it a bit and avoids irritation to the patient, deliver 90 per cent and reduces hospital stay.”

These small machines make big difference. They help people to keep their patients in home quarantine comfortably. This eventually reduces the load on public health infrastructure. Kashmir hospitals have already exhausted their capacity of ICUs.

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