Kashmir’s Healthcare Mess

During my college days (outside valley) I used to boast of Kashmir having the world class doctors. Whenever there was an argument with respect to valley not being able to sustain itself on its own, the quality of Kashmir’s doctors, leading to medical tourism, was always one of my key points for rebuttal. I would use the case of Cuba to prove my rebuttal, of how Cuba even being under U.S sponsored embargo (for almost 52 years now), became the world leader in healthcare, biotechnology, Cancer treatment, Drug research & development etc.

The first step towards the continuation of the tradition of producing world class doctors is the selection process. But of late some people have been able to bypass or fox the selection process through money, reach or appropriate connections. The people from this lot magically get transformed into a serial number on the qualified candidates list. All among us personally know at least one of these “Munna Bhai’s” , somehow we all expect the medical education system either to weed them out or make them well trained and educated for the profession they choose. What we can currently see of our healthcare has proved both these assumptions wrong, almost every serial number on the qualifying list sooner or later gets a degree and regarding making them better qualified for the profession I have my reservations.

Regarding the current status of Kashmir’s healthcare, there seems to be no better word to describe it then “Chaos”. Kashmir sans a proper referral system, which leads to overcrowding of the major hospitals or by the time the patient reaches a specialist precious time has been wasted. A patient even with minor ailments wants to visit the major hospital in Srinagar as no or few specialists are available at Sub District Hospitals (SDH).

Due to lack of Grass-root infrastructure couple of hospitals are being forced to coup up with the requirements of the whole state. It is humanly impossible to try to deliver healthcare services for a complete state/region through  couple of hospitals only. Even these highly vital hospitals are not well equipped to help our doctors perform their duties with out any hindrances . SHMS hospital’s CATH lab is ill equipped due to which all the procedure can’t be performed there despite one of the most renowned specialist being available. Recently patients died in SKIMS because oxygen supply was stopped due to some technical snag, the G.B Pant Children Hospital has recently transformed a graveyard for the want of ventilators and what can one say about Lal Ded Maternity Hospital, which happens to be Kashmir’s only Maternity Hospital!

Taking into consideration that every doctor in any major hospital is working extremely hard, at times working for at a stretch for 48 hours or more! We have to commend them for their excellent services. With everyday our doctors challenge the humanly limits, the least they deserve are “better working condition”.

Government needs to keep politics aside and help doctors and other stakeholders in improving Healthcare practices and infrastructure. We all know what happened to Dr. Shawl’s dream project of a super specialty cardiology hospital. If government instead of creating hurdles would had only ignored, not even supported or encouraged the initiative Kashmir would have a Cardiology Hospital by now. Who knows it might have even encouraged some other people to take some other initiatives, but now it is what deters them from making any such efforts.

Only encouraging private sector to invest in healthcare won’t solve the problem here, it is high time that this sector is regulated properly through laws and regulations, which should be implemented with rigorous zeal. The enactment of Drug policy with proper implementation seems to be a good beginning but we have a long way to go. We need to look into our medical education system, try to restore the past glory of Government Medical College, Srinagar, which in near future has too often come too close to de-reorganization from Medical Council of India. Unless we take thing as seriously as they are, a poor man will continue to pay with his blood and the saviors will continue to be enticed to embrace their darker side.

Many  people have been asking for banning of private practice of doctors, well it won’t be possible till there is a demand for it and there will always be demand. So why not try to better regulate private practice. As long as the doctors sincerely deliver their duties in their respective hospitals or places of posting, no one should have a problem with what they do after their duty hours. What needs to be looked into is the undue advantage that some doctors take of their position and reputation. Some well established and reputed doctors in Srinagar (and other towns) in their quest for a complete monopoly have trained their wards in complementary services like radiology or pathology and they don’t accept reports from any labs other than the ones they recommend. So among the family members a patient is sucked till the last drop of blood. May I ask what gives the doctors the right to declare all labs, other than their wards (or the one they recommended) to be pieces of junk. Can government dare to take some action against these affluent doctors? Why is government making any effort in raising the standard of Hospital Labs?

With each passing day healthcare is becoming costlier, every single J&K resident needs to be given access to a Health insurance. Government had started this initiative for its employees but suddenly it has lost all steam, May we ask why?

For this dismal state of Healthcare government is more responsible than doctors. The government’s apathy is such, that it many a times it sends rules and regulations flying through the window. In government hospitals we find Ayurvedic (Unani) doctors practicing homeopathic medicine, which happens to be completely against Supreme Court guide lines.

There is also no proper planning while identification of sites for new hospitals or even when implementing these projects. I would like to ask the government, pardon my language, who was the idiot who approved the construction of Unani (Ayurvedic) Hospital at the HMT chowk (square), didn’t he know that the road widening will happen. Does environment of one of the busiest squares on a national highway qualify for a site for any Hospital? Regarding how efficient our government machinery is in implementation of projects let’s take the example of Sub-district Hospital (SDH) Sopore, the founding stone of this hospital was laid in 1984 and still it has not been completed! Well we can say it confirms another entry for Sopore in Guinness Book of World Records, first one being for it’s yet to be completed by-pass bridge. SDH Sopore is operating through its OPD Block, which itself is not complete!

Coming back to comparison of Cuban Healthcare with that of Kashmir’s, there are many similarities (having large number of qualified, hardworking and intelligent doctors and paramedic staff etc) but there is one major difference that hinders our transformation into one of the leaders of healthcare and that is government will.

Also Appeared in The Kashmir Monitor http://kashmirmonitor.org/kashmonitor/05192012-ND-kashmir%E2%80%99s-healthcare-mess-26697.aspx