MUMBAI/CHENNAI (REUTERS) - It's been over a month since his mother died, but Mr Vishal Meghwal can still hear her struggling to breathe as he desperately messaged friends to lend him money for the drugs she needed.

The coronavirus pandemic had already cost the 24-year-old his savings and his income from painting houses in Ajmer, a city of tombs and shrines in north-west India. Losing his mother was the biggest blow of all.

"I have never been in a situation like this," Mr Meghwal told the Thomson Reuters Foundation by phone from Ajmer. "I have loans to repay now. There is no work. And my mother is no longer by my side."

Mr Meghwal is one of tens of thousands of Indians having to contend with the triple burden of bereavement, joblessness and debt after a brutal second wave of Covid-19 that brought the country's fragile health system to its knees.

Repeated lockdowns have caused unemployment to soar and wiped out the savings of many households in India, where families impacted by the pandemic had to fund treatment for sick relatives themselves, often borrowing the money.

As case numbers fall, the country has begun to unlock. But the virus has left deep scars on its economy, which suffered its worst ever contraction last year, and families face the daunting task of repaying large debts with work still scarce.

The central bank has slashed growth forecasts, with economists pointing to a range of data - from the rate of cheques bouncing to the amount of mortgaged gold jewellery up for sale - showing the scale of the hardship.

Costly treatment

When his mother fell ill, Mr Meghwal managed to get her a bed in a government hospital. But he had to buy everything she needed - from drugs to oxygen masks - from pharmacies that had doubled their prices.

"We were never rich. But we were never poor either," said Mr Meghwal, who painted houses his father built before the pandemic. "My father and I were both earning. And we ate well. But we exhausted our savings on food and bills to survive last year's lockdown after we stopped getting work."

With unemployment in India touching a 12-month high of 11.9 per cent, Mr Meghwal only makes about 300 rupees (S$5.48) a day working as a porter, and he worries endlessly about repaying the 60,000 rupees he borrowed for his mother's treatment.

Two weeks before Mr Meghwal lost his mother, Ms Renu Singhal was rushing her husband in an autorickshaw through the streets of Agra, the city in northern India that is home to the famed monument to love, the Taj Mahal.

The 45-year-old housewife's husband died in her arms, up-ending her happy family life and leaving her with unpaid bills, rent and meagre savings.

"It was all over in 24 hours - his fever spiked, I rushed him to hospitals and he died in an autorickshaw waiting to be admitted," said Ms Singhal. "Just like that, I became in charge of my school-going daughter's and my own future."

Ms Singhal has not had a chance to mourn her husband's death - instead she must focus on how to pay rent and where the next meal will come from.

"Whatever savings we had was spent on his treatment, the funeral, paying last month's rent and running around," she said.

India has lifted tens of millions of people out of extreme poverty in the last decade, but the World Bank has said the pandemic has reversed that trend, at least temporarily.

The number of Indians living on US$2 (S$2.72) a day or less has risen by 75 million as a lockdown-induced recession clawed back years of progress, the US-based Pew Research Centre said in a report.

Families have coped with the decline in earnings by eating less, selling belongings and borrowing, it said.

A Reuters survey found that borrowing had risen by three times since the pandemic hit in March 2020 and about half of that was taken out the past six months.

Poverty trap

About 100 million people lost jobs during the nationwide lockdown last year and about 15 million workers remained out of work at the end of 2020, according to the State of Working India study, conducted by the Azim Premji University.

Among those who are still earning, there has been a shift from the stability of employment to the informal sector, which already employed the bulk of India's workforce even before the pandemic.

"Nearly half those (who were) in the formal work sector are now doing informal work, where there are no safety nets," said Mr Amit Basole, director of the Centre for Sustainable Employment at Azim Premji University, who co-authored the study.

"They will have to make tough choices going ahead - from pulling kids out of school to delaying healthcare."

A delayed economic recovery risked creating a "poverty trap"as debts build up and assets are sold, Mr Basole warned.

As India struggles to balance reining in Covid-19 with reopening, campaigners say a shadow pandemic of hunger is taking root.

India ranked 94th of 107 countries in last year's Global Hunger Index, which described its hunger level as "serious".

"The expenditure on healthcare is much more this year. Those who could meet daily expenses last year are unable to manage this time around," said Professor Dipa Sinha from Ambedkar University.

Fear and frustration

Dignity has been a recurring loss during the pandemic in a country with no social safety net. Those who survived the second wave said fear and frustration had stripped their loved ones of a dignified farewell.

Ms Singhal in Agra had not had a proper conversation with her husband for almost a week when he was isolating at home. Her last moments with him were spent trying to resuscitate him as he lay dying outside the hospital.

Mr Meghwal himself wrapped his mother's body in a PPE kit, wheeled her out on a stretcher and put her in an ambulance that charged him 1,000 rupees for the drive to the cemetery 2km away.

"Whatever we had is now gone," he said. "I hear about government helping Covid-affected families. I am trying to figure out how that works."