A few years back, the top brass of the Indian Army’s Northern Command decided to put a twist to a war game. The Udhampur-based command, which defends a 2,000-km-long horseshoe-like territory from the plains of Jammu to the rugged deserts near the border of Uttarakhand, was examining the possibility of war with Pakistan. That year, they decided to throw China into the mix, what if the command had to simultaneously battle two countries? The war game was played out, saw China going on the offensive in the first two days with Pakistan joining in. The conclusions, as one planner put it mildly, were worrying. The army, even with the support of the air force, would find the going extremely tough. In an off-the-record media interaction a few years ago, a senior member of the present security establishment dismissed a two-front war scenario as “improbable” because it did not factor in India’s not insignificant diplomatic heft.

War games are not definitive, they often play out worst-case scenarios and illustrate cold hard ground realities for commanders who fight on the ground. One such reality is currently in play in what the government calls the “western sector”, the eastern shoulder of its newly created Union territory of Ladakh. The Indian army faces off against the Chinese PLA (People’s Liberation Army) which carried out one of its most determined incursions in decades in early May this year. The intrusions at three locations across India’s perception of the 800-km-long Line of Actual Control (LAC) in eastern Ladakh, are the biggest in recent years. The intruding troops encamped across the LAC could number over a thousand in all the locations with support troops, armour and artillery, in the rear behind the LAC. They are faced by an equal number of Indian troops as shown in mobile phone videos of the standoff (see pictures) at the Galwan River Valley and Pangong Tso which were widely circulated on social media.

Defence minister Rajnath Singh said in a June 2 TV interview that the PLA had intruded in “sizeable numbers” but that talks were on to resolve the standoff. A restoration of the status quo is expected at a June 6 meeting between the lieutenant generals of both armies at the Indian border point of Chushul-Moldo in Ladakh. This is the first meeting of Corps Commanders from both sides. Army officials say nothing less than a PLA pullback to their pre-May 5 positions will do.

The meeting will be held on the Chinese side of the border point, officials say, because the PLA had called for it. US president Donald Trump’s May 27 offer to mediate between the two countries, turned down by India, and a significant June 2 statement from secretary of state Mike Pompeo that ‘China had moved up its forces along the LAC’ also played a significant role in defusing the standoff.

Regardless of the outcome, the army will continue to be reminded of its vulnerabilities in the only theatre where it faces both its adversaries. The Galwan Valley in eastern Ladakh, where the Chinese soldiers are currently encamped, is barely 100 kilometres as the crow flies from the watchtower-like Saltoro Ridge overlooking the Siachen Glacier where Indian troops observe Pakistani positions. The PLA troops were part of an annual military exercise on the Tibetan plateau, who were then diverted to carry out the intrusions across the LAC when the war games ended. The plan, Indian military analysts feel, might have been at least three months in the making. “These (the intrusions) were not a local commander’s decision,” says Lt Gen. S.L. Narasimhan (retired), mem­ber of the National Security Council Advisory Board and a keen China watcher. “They were coordinated at the (Chengdu-based) Western Theatre Command at the very least.”

Government officials believe the Chinese probes are a direct fallout of the August 5 bifurcation of Jammu and Kashmir and Ladakh into Union territories. Ladakh, particularly a triangular wedge of territory the Indian Army calls ‘Sub Sector North’, becomes crucial in this equation. It sits between Gilgit-Baltistan, occupied by Pakistan, and Aksai Chin, the arid easternmost fringe of Ladakh. Analysts say the Chinese incursions are part of a wider strategy of throwing India off balance in a territory whose geo-strategic importance is only set to increase as the government expands its air and road infrastructure, allowing its troops to patrol hitherto inaccessible frontier regions.

“Ladakh is a lakshman rekha for India,” warns P. Stobdan, India’s former ambassador to Kyrgyzstan. “We cannot afford to allow the Chinese in here. Once they come here, they are entering a water-rich area with three rivers, the Shyok, Galwan and Chang-Chenmo.”

The Winter Soldier

A large oil painting of a bearded, turbaned general on a rearing steed adorns the wall of the Maneckshaw Centre, the Indian Army’s sprawling glass-fronted convention hall in the military cantonment in New Delhi. General Zorawar Singh, who captured Ladakh for the Dogra rulers of Jammu and Kashmir in 1840, pioneered offensive high-altitude mountain warfare, the reason he joins a galaxy of Indian army greats. A map on the painting traces the general’s fascinating trans-Himalayan campaign route as his army marched out of the plains of Jammu, crossed the Himalayas and finally ascended the Tibetan plateau to die in battle facing the bitter cold and a combined Tibetan and Chinese army in 1841. Recognised as an independent kingdom by the British, Ladakh remained with Jammu and Kashmir even when Maharaja Hari Singh of Kashmir signed the Instrument of Accession and acceded to India on October 26, 1947.

The biggest alteration in the boundaries since China captured Aksai Chin in the 1962 border war with India and obtained the Shaksgam Valley from Pakistan in 1963 came in 2019. On August 6, 2019, Union home minister Amit Shah diluted Article 370 and bifurcated J&K and Ladakh into Union territories. Shah called Kashmir “an integral part of India” and, significantly, spoke about Aksai Chin, a territory over 37,000 square kilometres to the east of Ladakh, occupied by China in the 1950s. “When I talk about Jammu and Kashmir, Pakistan-occupied Kashmir and Aksai Chin are also included in it,” Shah said. It was the first time in several years that a top government functionary had mentioned the Chinese-occupied part of Ladakh.

A week later, on August 13, foreign minister S. Jaishankar flew down to Beijing to allay the Chinese leadership’s fears over the bifurcation. Jaishankar told his Chinese counterpart Wang Yi that the creation of Ladakh had “no implication for either the external boundaries of India or the LAC with China” and that “India was not raising any additional territorial claims”. Wang replied that the establishment of the Ladakh UT “which involves Chinese territory, has posed a challenge to China’s sovereignty and violated the two countries’ agreement on maintaining peace and stability in the border region”. The new map of Ladakh must have rung alarm bells in Beijing. It depicted Ladakh for what it really is, a gigantic swathe of territory the size of Andhra Pradesh, stretching from Afghanistan’s Badakshan province and including the provinces of Gilgit-Baltistan and, significantly, all of Aksai Chin. On December 5 last year, Shah reiterated India’s claim on Aksai Chin. “We are ready to give our lives for it,” he told the Lok Sabha.

Analysts like Stobdan believe the bifurcation has opened up a totally new geopolitical arena. India has changed the narrative on the LAC, and had forcefully reasserted its territorial claims. “As long as Ladakh was a part of J&K, China wasn’t a major factor. After the August 6 abrogation, the Chinese are saying that now that Ladakh is a separate entity, we have a stake here. They want to act before India starts internationalising Aksai Chin.”

The PLA stepped up its incursions in 2019, with a majority of them occurring in the western sector. The deployment patterns had begun changing on the Tibetan plateau years prior to this. Since the 73-day Doklam standoff in mid-2017, Indian military planners had begun to notice a change in the numbers and intensity of the PLA’s ann­ual exercises on the Tibetan plateau. It featured newer models of tanks, fighter jets and self-propelled artillery. The timing of the exercise was also interesting, most were being held in peak winter when the Tibetan plateau was largely unaffected but when 15-feet-high snow cut off the mountain passes of J&K and Ladakh.

Winter is when the Ladakh garrison, the Leh-based 14 Corps which guards the 800-km-long LAC, is at its most vulnerable. Snowfall between September and March cuts off the Srinagar-Leh and Manali-Leh highways which are vital for moving supplies to the 14 Corps.

But it will also take a full-fledged war, nothing less, for the PLA to march across the Shyok river. Such a scenario appears far-fetched at the moment, say military planners. The PLA are playing a high-altitude version of their traditional board game, Wei Qi, encircling rather than finishing off opponents. “Our perception of the LAC is immaterial to them. The PLA is now sitting on their perception of the LAC. If we actually look at the Ngari prefecture map (easternmost part of Tibet), the game becomes clear,” says Lt General D.S. Hooda, former Northern Army commander.

Lt General D.B. Shekatkar, who chaired a 2016 defence ministry committee on military reforms, sees the Chinese incursion as a ploy to throw the Indian army off balance and to increase the buffer zone between India and Aksai Chin. “They want to test our resolve and see how we react when they intrude into such a sensitive region,” he says. The Chinese, he feels, would like to increase their influence towards the Karakoram Pass, particularly areas like Daulat Beg Oldie, where we have built roads and a landing strip has come up to prevent an Indian military thrust towards Xinjiang or Tibet.

Locals in Ladakh have seen a gradual salami slicing of Indian territory over the years. A thin Indian army presence, they say, has seen many areas of Ladakh now literally absorbed as Chinese territory. Their greater fear is the altering of the LAC. “What is the LAC? It is not a permanent line, it has always been changing in favour of China. With every incursion, the LAC changes and they (the Chinese) usurp our pasture land. This time, too, they have done it,” says Rigzin Spalbar, former chairperson of the Ladakh Autonomous Hill Development Council. Ladakhi nomads are discouraged from grazing their livestock along the LAC by the army who is keen to avoid confrontations in central Ladakh near the Pangong lake. This reticence, he says, has cost India territory in the finger area overlooking the lake. “The Tibetan nomads on the other side come with their livestock and, invariably, the PLA follows in their wake.” Army officials say there is no question of the border being changed. The Indian army is unlikely to stand down or allow the PLA to have its way in the standoff. It may eventually be resolved and the PLA might even fold up its tents and go back. But even if they do, it begs the question: where along the 3,448-km-long LAC will they walk in next?

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A gloom has set in upon the staff of King Edward Memorial (KEM) Hospital, the biggest municipality-run hospital in central Mumbai’s Parel area. Everyone associated with the hospital looks dejected. Around 1,000 resident doctors work without adequate food, nurses fear for their safety as they file in, all norms of social distancing ignored, into packed buses meant to ferry them to their homes. Relatives of the COVID-19 patients admitted in the 3,000-bed hospital are terrified, some of them clueless about how to cremate the infected bodies of their loved ones.

KEM is just the tip of iceberg that is Mumbai’s overburdened health system. A video that went viral in the first week of May exposed the ill-preparedness of another large civic facility in the city, the Lokmanya Tilak Municipal General Hospital, popularly referred to as Sion Hospital. The viral video showed patients in a Covid ward lying close to dead bodies wrapped in black plastic. A worrying situation as around 80 per cent of the symptomatic and critical patients are admitted in civic or government hospitals.

The conditions at KEM Hospital, says a senior doctor, who did not wish to be named, are worse than at Sion Hospital. According to him, the sweepers and class-four staff at the hospital have refused to pack the dead bodies saying it is not their job. “I have seen patients’ relatives carrying infected bodies without any protection,” he adds. “This is not only inhuman, but it also makes them highly vulnerable to infection.”

The Brihanmumbai Municipal Corporation (BMC) has been paying a daily allowance of Rs 300 to class-four employees working in Covid wards. They are expected to maintain cleanliness, take the patients’ blood samples for testing and pack the dead bodies. But due to lack of cooperation and volunteers, the BMC has started offering Rs 1,300 per body to anyone willing to pack it. It does not matter whether they can do it properly or not. The patients’ relatives are forced to carry the blood samples to the doctors. Many have been seen entering the Covid wards wearing only a mask whereas a personal protection equipment (PPE) kit is a must.

KEM has divided its patients into its two wings. The biggest wing in the hospital’s old building, is now a dedicated Covid ward. The non-Covid patients are being treated in the new building. However, KEM is likely to run out of beds by May 31. The senior doctor says with restaurants not an option and the hospital cafeteria shut, resident doctors were skipping meals because of lack of proper food arrangements. “The Tata Group has been providing them with snacks and juice since day one, but it is a supplement, not a meal.” The resident doctors were having to stand in long queues to get the food packets. “It has happened many times that several doctors did not get any food because they were busy treating patients.” The situation has improved since May 15 after some NGOs stepped in to ensure proper meals reach doctors.

On May 18, a delegation of resident doctors called on state medical education director Dr T.P. Lahane and apprised him of some of the issues they were facing. He assured them that their issues will be resolved soon. india today reached out to Dr Lahane, but he declined to comment, as did Amey Ghole, chairman of the BMC health committee.

The sorry conditions at Sion Hospital were again highlighted after assistant inspector of police Amol Kulkarni died of COVID-19 on May 15. Kulkarni, who was posted at the police station in Dharavi, a Covid hotspot, complained of difficulty in breathing on May 13. Sion Hospital advised him to home quarantine instead of admitting him. Two days later, he was found lying unconscious in his bathroom and since his family could not get an ambulance in time, he died on the way to the hospital. The report for his Covid test came after his death.

Like KEM, Sion Hospital, too, is taking non-Covid patients. Dr Avinash Saknure, president of the Sion unit of the Maharashtra Association of Resident Doctors (MARD), admits overcrowding of patients has resulted in chaos. “No doctor will want two patients on one bed, but you need to understand the situation,” Saknure told India Today TV. “Sometimes we have been admitting patients two and a half times over our capacity. Treating everyone is important.” The doctors, too, feel bad about the situation, but are helpless beyond a point. “We are on the brink of an emotional breakdown watching patients die. It’s difficult,” says Dr Rishabh Chheda, a resident at Sion Hospital. “We are facing a pandemic at a time when hospitals are not ready for it. There is a severe crunch of resources.”

Mumbai has been recording an average 1,200 Covid cases every day. On May 17, it recorded 1,595 cases, the largest one-day number so far. The Maharashtra government has maintained that 70 per cent cases are asymptomatic, 27 per cent symptomatic, and three per cent are critical. The state government has divided the health facilities into three categories, Covid care centres (CCC), dedicated Covid health centres (DCHC) and dedicated Covid hospitals (DCH), depending on the severity of cases. The CCC is further divided into CCC1, to quarantine high-risk suspects, including those who cannot maintain physical distancing at home; and CCC2, for asymptomatic positive patients, or those with mild symptoms. Patients with moderate symptoms like continuous cough, cold and fever are admitted in DCHCs. The government has decided to admit co-morbid patients, those with pre-existing conditions like hypertension, heart ailments and diabetes, in DCHs. It is also where critical patients who require ventilator support or need to be monitored in the ICU are admitted. Those who have difficulty breathing or whose oxygen levels are below 94, or whose health condition can turn critical are also admitted in DCHs.

At present, there is no dearth of beds in CCCs and DCHCs, which have 57,000 and 10,000 respectively. The problem arises in DCHs which have only 4,800 beds. Manisha Mhaiskar, an IAS official on special duty in BMC, says they plan to increase the number of beds to 8,000 by the end of May. “We are constantly augmenting beds, from 1,900 beds on April 15 to 2,900 on May 1, to 5,200 on May 17,” she says. “However, as about 1,000 patients are testing positive daily, we need to be adding 100 to 200 beds every day. BMC is adding 100 beds daily, and with discharges, hospitals are being able to accommodate another 100. But it is a constant race to be ahead of the virus.”

Mumbai’s growth in Covid cases has slowed down from doubling every three days in the first week of April, to every 13 days by May 17. It needs to reach a point where cases double every 17 days to reduce the load on hospitals. Health minister Rajesh Tope admits availability of facilities in DCHC and DCH categories is a problem. “The problem in DCHC is that oxygen is required, and in DCH more beds are needed. The work of augmenting the number of beds is going on,” he says.

If the whole of KEM Hospital were to be designated as a COVID-19 hospital by the end of May, its current capacity of 3,000 beds will be cut down by half considering the ideal distance that needs to be maintained between two beds. Mumbai’s KEM and B.Y.L. Nair hospitals have already started reducing the gap from eight feet to four to accommodate more beds. Mhaiskar, though, does not see any problem with this. “Even if the distance between two beds is reduced, the doctors and health workers are wearing PPE kits. No one is allowed there without a PPE kit. The BMC is trying to optimise the space by giving equal importance to safety safeguards and to bed augmentation.” While Dr Mohan Joshi, dean of Nair Hospital, says a space of eight feet is ideal, he realises hospitals have to be pragmatic to accommodate the growing number of patients. “Idealism cannot work when there is such an influx of patients. No government hospital can turn away a patient. We have to be accommodating,” he says.

The BMC officials are facing a problem in updating the availability of beds in private hospitals. The protocol states that if a patient is discharged from DCH, the hospital has to inform BMC’s disaster cell. Since this will be real-time data on vacant and occupied beds, the BMC can direct patients to a hospital accordingly. However, Dr Daksha Shah, BMC’s executive health officer, says, “The hospitals are not keeping the BMC updated about discharge of patients.”

The government believes the decision by the Indian Council of Medical Research (ICMR) to discharge asymptomatic patients in 10 days will improve availability of beds. A state-level task force led by Dr Sanjay Oak, former dean of KEM Hospital, has recommended that 70 per cent beds in around 30,000 private hospitals, including nursing homes, should be acquired for DCHCs and DCHs. Tope mooted an idea to reserve 30 per cent beds in private hospitals for five kinds of treatments, deliveries, brain stroke, heart disease, cancer and accidents, and the rest for Covid. “We can pay private hospitals to recover their losses,” he says. Private hospitals are negotiating with state authorities over the rate of treatment. The government has assured them it will bear the cost of treatment of Covid patients, hoping it encourages them to treat more patients.

Looking at the trend of growing number of cases, the state is expecting a surge in June and July. If the virus races ahead of the health preparations, the nightmare will only get worse for the Maximum City.

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Indian workers and students stranded abroad amidst the Covid pandemic heaved a sigh of relief this week as the government announced a plan to bring them back. The home ministry said that beginning May 7, they could return via special Air India flights, for a fee.

The ‘Vande Bharat’mission will run for a week, with 64 flights slated to bring 14,800 citizens back from 12 countries. These are the UAE , US , UK, Singapore, Bangladesh, Malaysia, Saudi Arabia, Kuwait, Philippines, Oman, Qatar and Bahrain. Indians wanting to avail of the service must undergo a COVID -19 rapid diagnostic test.

The home ministry will take a final call on the list of returnees. The ministry has released guidelines on who gets preference for travel, blue-collar workers, migrant labourers, women, children, senior citizens and those at risk of losing their visas.

Most of the Indians will fly in from the UAE, 10 flights have been scheduled for this country. There will be seven flights each from the US , Bangladesh and Malaysia.

Five flights each are scheduled from Saudi Arabia, Kuwait and the Philippines. The remaining countries will have two flights each.

Kerala, Tamil Nadu and Delhi are expecting the highest number of returnees during the first phase of the repatriation programme.

An estimated 1.7 million migrant Indians are stranded across the globe at present. The armed forces have also been working on a plan to bring citizens home by ship. Two Indian Navy ships have set sail to bring 1,000 Indians home from the Maldives. They will arrive in Kochi.

Upon reaching India, all returnees will be quarantined for 14 days. Home ministry guidelines released on May 5 clarify that the returnees will bear the cost of their quarantine. This issue of paying at every step has become a controversy.

Last month, when Air India briefly opened international bookings, many Indian students in the US complained that the airline was charging them a fee to reschedule flights to June. Now, all those wishing to return from the US have to pay Rs 1 lakh for a one-way flight.

Those coming from the UK will have to buy tickets costing Rs 50,000 while tickets for Indians returning from the Gulf countries will be around Rs 15,000.

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