All is not Well with Kashmir’s Health!

Despite Jammu and Kashmir receiving ‘Best Healthcare Award’ early this year, much needs to be done in basic healthcare especially in rural areas. Sajad, Mansoor and Jahangeer – the student trio of University of Kashmir – write that the government needs to wake up to the rising number of critical ailments in Kashmir

SKIMS-Srinagar

Among all the issues that have plagued the state of Jammu and Kashmir, one of the most crucial and vital issue has been of health. The foundation of any state remains to be on the lines of a welfare state but consistent and continual denial of the sector remains to be the bedrock of various associated and allied issue. This issue is intricately related to poverty, abuse and many other issues that we confront today. Therefore, healthcare must be the prime focus of the policy makers of our state.

If we look at the existing state of healthcare and the way our institutions function, we will find a gulf of differences and huge disparities between health institutions that function at gross root and the apex institutions that we have. The main issue that our apex institutions like SMHS and SKIMS face today is of overcrowd, where people across the valley come to avail the medical care. Most of people come here for health issues which our primary health centers  like sub-district and district hospitals are expected to cater but the overcrowding and rush of people depict the lack of proper healthcare at the basic level.

People across all income levels especially poor face this major issue where in people have to leave their daily livelihood for treatment and come to city hospitals thereby leading to loss in time, money and resources which exasperate further if the disease happens to be a critical one, leaving the families into abject poverty and denial. The scene of people begging with their medical prescriptions and certificates continues to be a routine scene everywhere. This issue is also a major reason for depression as there are cases where people cannot afford the cost of healthcare. This shows how absence of proper healthcare at primary level has affected the foundations of the welfare state.

Sheri-Kashmir Insititute of Medical Sciences (SKIMS) Srinagar
Sheri-Kashmir Institute of Medical Sciences (SKIMS) Srinagar

Recently, government has announced establishment of two AIIMS in our state, which is a welcome step. But government first needs to provide existing institutions particularly rural ones with adequate infrastructure so that people need not to travel miles to get basic and emergency healthcare. Besides this there is need to ensure proper regulations so that hospitals do not remain staff less, a scene particularly evident during winters in rural areas.

Various studies have found that there is rise in major health issues like cancer, tumour among masses. When rich people can afford to fly their patients outside the state, the poor sections have no alternative but to curse their fate because these diseases are very costly and often treatment is not available within the apex institutions of our state thereby forcing them to beg and other ill practices that are prevalent here. So there is dire need for a ‘State Health Insurance’ for such critical illnesses and efforts towards awareness by government and NGOs so that such diseases are treated at the outset and treated well.

Another issue that remains is that of accountability. Since establishment of SMHS in 1948, successive governments have always announced huge chunk of funds to the institute and later SKIMS was commissioned in 1977 but the moot issue remains that despite decades of its formation, almost 67 years since formation of SMHS and 37 years for SKIMS, a time which is enough for an institution to flourish given the political and social support, people are still forced to seek medical care at PGIMER (Post Graduate Institute Of Medical Education And Research)  Chandigarh established in 1962, much later than the establishment of SMHS and  just a decade before SKIMS.

Another aspect of medical care which forms a vital part of it especially in rural areas are the medical dispensaries which serve as first post for majority of emergency and other health issues. But more often, these centers are ill equipped to manage emergencies and people are often to the SDHs, where the same story repeats and finally patients are referred to the city hospitals. So there is need for capacity building and infrastructural augmentation to make them full-fledged to deal emergencies and health issues at community level.

The medical dispensaries are mostly without doctors and supported mainly by medical assistants. Given the constraints that government is facing, it may not be possible to ensure availability of doctors at every dispensary, but government can club some villages and establish a health centre with general physician to begin with.

Besides that there is dire need of critical care ambulances in every district (especially in remote areas)  for which government has earmarked Rupees 5 crore and only 4 critical care ambulances have been made available so far and that too with the help of NGOs.

Therefore, it is dire need of time that these issues are taken into consideration before making any policy decision or any hollow promise.

sajad

Contributors: Sajad-ul-Haq Lone, Mansoor Ahmad Sofi, and Jahangeer Arshad Bhat are Electronics and Communications engineering students at University of Kashmir.

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