MUMBAI, Oct. 27 -- Outside the gates of Ghatkopar's Rajawadi Hospital, one of Mumbai's biggest civic-run peripheral hospitals, private pharmacists hover just beyond the entrance. Waving used prescriptions as props, they solicit business, calling out to patients in a crude and humiliating spectacle. To edge out competitors, some announce discounts and hastily escort patients to their shops. The scene resembles a local bazaar. With most of the BMC's 16 peripheral hospitals in the grip of a crippling drugs shortage, patients have little choice but to surrender to private merchants like these, profiting from the desperation of the sick. The shortage of drugs, medical equipment and devices, is not only a financial burden on patients who depend on civic hospitals, it has made the Brihanmumbai Municipal Corporation's (BMC) Zero-Prescription Policy announced in 2023 a non-starter. According to the much-hyped policy, the BMC had promised that all medicines would be available at hospital pharmacies - there would be no need to buy from private chemists. And, yet, on Thursday, only one of two pharmacy counters were functioning at Rajawadi Hospital - that too, intermittently. By evening, both were shuttered, as they are every day. Aasma Ansari, 30, who came in three times this week with a persistent throat infection, was distraught. "They give basic tablets but not the main medicines. Every time I come, they say stock isn't available. I am entitled to get my medicines at the hospital pharmacy; instead I spend more than Rs.300 on drugs that should be free." Sources in peripheral hospitals say around 70% of patients are told to buy at least two to three medicines from private pharmacies, each. Patients who depend on these hospitals wonder if it's purely coincidental that private pharmacies just outside the hospital gates are thriving. Peripheral hospitals procure their drugs from vendors approved by the BMC's central purchase department but, civic sources reveal, the list hasn't been updated since April, when the new financial year began. The shortage, senior civic officials say, grew worse around 10 months ago. One senior administrator at a peripheral hospital said apathy within the BMC and red tape around procuring drugs and medical supplies have reached alarming levels. "To work around the shortages, the local purchase department of each hospital has been floating tenders but this allows only a small quantity of drugs to be procured and for a limited period. This means we can't maintain consistent stocks of even essential medicines," a hospital source said. The shortage has reached a tipping point, where even simple analgesics and antacids are unavailable at hospital pharmacies. Worse, the BMC's promised generic medicine stores, which were to be set up in all civic hospitals, have not materialised. "My niece is currently admitted here as she delivered a baby five days ago, but they do not have basic medicines to treat her. Even saline and syringes aren't available," said Nathuram Kamble, 52, a local social worker. At Shatabdi Hospital in Govandi and Bhabha Hospital in Kurla, patients say they are prescribed only simple drugs by casualty medical officers. When symptoms persist, they have to return to the outpatient department, only to find their prescribed medicines unavailable. A patient at the hospital, requesting anonymity, said she waited nearly 30 minutes in line to get her medicines, only to be told that most were out of stock. "Outside, the same medicines cost Rs.300 to Rs.400. Inside, they would have cost Rs.20 or would have been free. I can barely afford this" she said. Another patient, this one at Rajawadi Hospital, said he had injured his elbow while pushing a cart but was given medicine only for a day. "When I came back, the doctor prescribed stronger medicines, but two were not in stock. I had to buy them outside for over Rs.500. I was in pain for days." A shortage of pharmacists at peripheral hospitals is adding to the chaos. Many are on contract and refuse night shifts, leading to the closure of pharmacy counters. A senior staff member at a peripheral hospital said, "After evening, there's no pharmacist here. Casualty medical officers give just one day's dose of basic drugs. The patient is told to return the next morning. But many don't come back. Antibiotic courses are left incomplete, which causes drug resistance. It's dangerous." While a drugs shortage is not new to civic peripheral hospitals, health activists allege that darker forces are at play. They say the crisis has worsened since the BMC rolled out its controversial privatisation model, where medical services at its 16 peripheral hospitals are being handed over to private players. Labelled 'Civic Health Collaboration', the initiative was fast-tracked in this year's budget, drawing flak from those who believe the BMC has no business offering key public assets, on a platter, to the private sector. Baban Thoke, a member of the Save Hospitals, Stop Privatisation movement, said that when the civic administration demonstrates that a hospital can no longer provide essential services, it becomes an excuse to privatise those services. "This is why even pharmacies are giving up, because it is being made to look like there is a continuous shortfall in public services," Thoke alleged. He pointed out that the shortage of drugs and medical supplies coincides with the privatisation push. A senior BMC health official denied ulterior motives in the drugs crisis, saying tenders have been floated to procure all the drugs needed to implement the zero-prescription policy. However, due to the complexity of the issue, there has been a delay. "We are aware of the ongoing shortage of medicines. Steps are being taken to streamline the procurement process so that essential drugs are made available regularly across hospitals without relying on local purchase," the official told HT....