A foggy start to winter should already have set the alarm bells ringing in Kashmir. Most part of the day these days is clouded by fog and the night temperatures are sliding below freezing levels. Yet, there is no sense of alarm found in Kashmir’s healthcare system.
The winter is the harshest period to live in Kashmir. It impacts physical as well as mental health of the people. The shorter, gloomy days are known to worsen the already fragile mental health of many, while the freezing days and nights harm the respiratory health.
While it is still the beginning of the winter and the core period is yet to begin as it traditionally begins with the solstice on December 21 which in the local parlance is referred to as chilai kalan, the indicators for the coming days are not good. If the weather pattern continues the way it is, we may be faced with a severely troubling winter.
In such a scenario, the administration should have worked preemptively to announce a medical emergency across Kashmir as the number of cases of the patients from susceptible groups – like children and elderly – will drastically grow in the region.
A medical emergency would have meant a heightened state of alertness and preparedness. The four hospitals that are likely to register a significant patient inflow in the coming days and weeks include SKIMS, SMHS, Pediatric Hospital and the CD Hospital.
These four major hospitals are likely to record a significant patient turnout as the situation of those with heart ailments, respiratory illnesses and weak immunity – mainly children and elderly but also young people – may worsen due to the harshly inclement weather.
However, the unpreparedness in these hospitals is for everyone to see. Take, for example, the Chest Disease Hospital where, as recently as December 1, the internal heating system that would keep the wards warm was shut during the night and restarted in the morning. During the coldest hours of the night, the patients most susceptible to cold can’t be put through a more harsh treatment.
The newly constructed pediatric hospital on Srinagar’s outskirts at Bemina is another example of gross mismanagement. The number of people waiting in the queue at the OPDs is horrifying while there are two doctors attending to ill children. The scenes at the pediatric hospital look more like a famine-hit region where people queue up for packets of food.
While it is a known fact that hospitals in Kashmir are badly understaffed and there is a need for more doctors, there have been little remedial measures put in place. Almost all hospitals in Kashmir lack an appropriate strength of doctors. The World Health Organisation has recommended the doctor-patient ratio at one doctor for every thousand patients while Kashmir struggles at 1:2000.
The other immediate need is involving senior doctors on night duty. At night, all major hospitals are staffed by internees, who are still studying their masters. While they may be competent within their age group and may be able to administer the first-aid medicines, they usually shift the patients to daytime hours which further increases the rush at the hospitals and burdens the already overburdened system.
There is another catch to young doctors tasked with the long nighttime duty hours. With a lack of experience, they are also ill-prepared to handle tense and panicky attendants. As recently as last week, a group of MD students attending night shift duties at the Emergency ward of SMHS hospital refused to treat a patient after one of the young doctors accused her attendant of misbehaving with him.
The angry young doctor flung her card away and refused to give her the treatment. Other young and angry doctors, at least two of them, joined the ruckus and forced the female patient to leave without being treated. This is where the senior, experienced doctors could have come in. The absence of senior and experienced doctors at nights is severely hampering the healthcare services in Kashmir.
With the winter becoming increasingly severe each passing day, the administration should have geared up by now. Instead there seems to be no urgency or initiative – neither from the bureaucracy nor from the hospital administration – to streamline the healthcare system and gear up for the winter.
There is a need to think innovatively and go the extra mile. The construction of concrete coliseums does not mean the healthcare system has been upgraded. The healthcare system means trained and experienced doctors and paramedics.
It is also incumbent upon the hospital administration to train the young and inexperienced doctors in such a way that they are able to handle unpleasant situations without turning into rowdies. A doctor refusing to treat a patient isn’t a good.
Also, leaving such young and angry doctors to attend the emergency wards by themselves without the presence and oversight of senior and experienced doctors is gross negligence.
There is a need to change and evolve. Unfortunately, Kashmir’s healthcare system lacks both – a will to change and a will to evolve. And that, needless to say, isn’t a good prognosis.