8.4
The Oxygen crisis
The Battle for Breath and the 30-Minute Warning
By April 2021, the pandemic had entered its most merciless phase. Oxygen—a substance we in hospital administration had long taken for granted as a utility, like water or electricity—suddenly became the most precious commodity on the planet. In the halls of Sevagram, the sound of the hospital changed. The rhythmic hiss of ventilators and the bubbling of humidifiers became the dominant soundtrack of our lives, and for me, as Medical Superintendent, every hiss felt like a countdown.
The scale of the crisis was staggering. We were admitting close to 3,500 COVID patients annually, many arriving in a state of profound hypoxia, their oxygen saturation levels dropping into the 70s and 60s. We had expanded our capacity to nearly 400 dedicated COVID beds and 60 ICU beds, but no matter how many wards we opened, the demand for oxygen consistently outstripped our supply. I had served in this role for over a decade, navigating budget cuts and equipment failures, but I had never experienced anything remotely comparable to the “Oxygen Summer.”
The Interminable Thirty Minutes
The turning point came on a scorching afternoon in early April. I was in my office, buried under a mountain of mortality reports and supply chain logs, when Alpesh Raut, our biomedical engineer, rushed in. He didn’t knock. The look on his face told me everything before he spoke.
“Sir,” he said, his voice tight with a panic he usually suppressed, “we have less than thirty minutes of oxygen left in the main manifold. The truck from the supplier is stuck.”
In that moment, the weight of the entire hospital—hundreds of gasping patients, the frantic residents, the terrified families—seemed to settle on my shoulders. If that truck didn’t arrive, or if our backup failed, the tragedy would be unthinkable. What followed was a blur of frantic, high-stakes communication. I was on the phone with the District Collector, the transport authorities, and the oxygen suppliers, my voice swinging between professional demand and quiet desperation.
We pooled every possible resource, moving jumbo cylinders like chess pieces across the hospital to keep the ICUs alive for just a few more minutes. After thirty minutes that felt like a lifetime, a truck carrying 120 oxygen cylinders rumbled through the hospital gates. It brought relief, but it was a fragile one—those 120 cylinders would last us barely twelve hours. We were living in twelve-hour increments of survival.
Help from the Horizon: IndiaCovidSOS and TMC Navya
It was painfully clear that stop-gap measures and “hand-to-mouth” cylinder deliveries were no longer sustainable. We needed a structural revolution. On May 21, 2021, a message appeared on my WhatsApp that would change our trajectory. It was from Madhu Pai, a global health leader, asking if I could join a Zoom call to discuss the situation in rural India.
The call introduced me to IndiaCovidSOS, a volunteer collective of physicians, engineers, and professionals—mostly of Indian origin in North America—who were working tirelessly to mobilize support. I spoke to them about the quiet desperation in Sevagram, about how our residents were shuttling between buildings to check pressure gauges, and how we were fighting a war with blunt tools.
That summer, the cavalry arrived in the form of TMC Navya, led by Gitika Srivastava and Naresh. They coordinated a massive international effort to procure oxygen concentrators and medical supplies. This wasn’t just a donation; it was a feat of global logistics. FedEx and Air India operated nine flights, bringing supplies into the country that Tata Memorial Centre then distributed to 88 locations across 21 states. MGIMS was one of the primary beneficiaries.
Building the Fortress: The Oxygen Plant
The ultimate solution arrived on July 5, 2021. Under the supervision of AIROX Technologies and donated by Community Partner International, an AirSep oxygen generation plant was installed at MGIMS. With a capacity of 600 litres per minute—equivalent to over a hundred jumbo cylinders daily—it transformed our capability. We were no longer just waiting for trucks; we were creating our own “breath” from the very air of Sevagram.
The plant was energy-intensive, consuming 750 units of electricity a day, but its reliability was priceless. Our biomedical engineering team became the unsung heroes of this era, monitoring the liquid oxygen (LMO) tanks and the generation plant round the clock. We decided to eliminate portable cylinders wherever possible, investing ₹28 lakh to extend centralized oxygen and suction pipelines to 150 beds across the Neuro ICU, Surgery ICU, and Emergency blocks.
The Dividends of Crisis
The second wave forced us to confront an uncomfortable truth: our old systems were built for “normal times” that no longer existed. Before COVID, the hospital consumed over 90,000 oxygen cylinders annually at a cost of ₹1.5 crore. By repairing leaks and upgrading to centralized pipelines, we actually reduced our cylinder usage by half. We became more efficient because we had been pushed to the edge of catastrophe.
Looking back, the oxygen crisis revealed the pandemic at its most merciless, but also at its most collaborative. I learned that in a crisis, oxygen is more than just a gas; it is time, it is hope, and it is the thin, fragile space between life and death. Securing it for Sevagram was perhaps my most significant act as an administrator.