In this photograph taken on July 15, 2020 doctors and nurses wearing Personal Protective Equipment (PPE) suits work at the Intensive Care Unit for COVID-19 coronavirus patients at the Sharda Hospital, in Greater Noida. (Photo by XAVIER GALIANA/AFP via Getty Images)

In suffocating full protective gear inside an Indian intensive care unit with no air conditioning, doctor Showkat Nazir Wani is risking his life battling brutal heat and treating coronavirus patients.

Almost 100 Indian doctors have died since the pandemic began, working punishingly long hours in temperatures that can top 40 degrees Celsius (105 degrees Fahrenheit).

“Wearing this PPE kit at the temperature of 40 degrees, it’s very difficult, I can say because you are drenched in sweat. Still, (we try) to do our best to save the lives of patients,” Wani, a resident doctor at the private Sharda Hospital in Greater Noida outside New Delhi, told AFP.

“It feels very hot and suffocating. But we have to wear it for our own safety,” the 29-year-old said before rushing to attend to a patient battling a lung collapse.

India on Friday hit a million coronavirus cases, the third-highest total in the world, with no sign yet of the infection curve flattening as new cases emerge in rural areas. More than 25,000 people have died nationally.

The country has some of the lowest per capita health care spending in the world and poorly paid staff working in dilapidated state hospitals are highly vulnerable.

The Indian Medical Association, a voluntary group of doctors which says 99 physicians have died so far, this week issued a “red alert”.

“Doctors need to take charge of the situation and ensure the safety of themselves, their families, their colleagues and staff,” it said in a statement.

Sharda Hospital has been providing free treatment to COVID-19 patients under instructions from the state government, which means facilities are basic and many patients are poor.

Not all patients are in hospital gowns. One was on a bed wearing a bedraggled T-shirt with bloodstains.

Because there is no air conditioning, doctors and nurses are quickly drenched in sweat.

Since they are enveloped head-to-foot in plastic protective gear, the sweat can’t evaporate to cool them down.

And as going to the toilet means removing all the gear and then putting a new set, some staff skimp on drinking enough water.

Nausea and dizziness can sometimes ensue, and in the long term the staff can risk serious problems including organ damage.

Abhishek Deshwal, who heads the hospital’s intensive care unit, said working in such heat while wearing the body suits was “doubly stressful for the staff”.

“But we are trying to do our best, we don’t have any other option.”

Some staff have quit or gone on long leave, forcing the government to rope in medical students and even retired staff.

The virus has also affected their relationships with families, and some have admitted being weighed down mentally.

Wani, for instance, has not seen his family based in Indian Kashmir since the outbreak began in March.

As a resident doctor, he is on “Covid call” 24/7, and has hardly had any time to socialise.

Dramatic scenes that unfold in the ICU play on his mind constantly, with every death affecting him “deeply”.

“Covid patients often get delirious. They refuse to eat, pull away their tubes and even get violent with us,” he said.

One of his patients once slapped a nurse and tried to hit him as well.

“But I try to be patient with them. I have often held their hands to reassure them because they are all alone without their loved ones, sometimes for days at end.

“I share these experiences with my parents over the phone. They are obviously very concerned for me but they appreciate my work. Their appreciation motivates me to work even harder.”