They are stopped, harassed, beaten up, but they turn up for duty day after day. Doctors and hospital staff kept the healthcare sector running during summer unrest, despite much adversity, saving precious lives. Ibrahim Wani reports.
In the morning he stepped on to the empty street. His mother was watching him from the window with broken glass panes. Stones thrown by men in uniform had broken them. Dr Rashid heard his cellphone ringing. An ambulance was on its way to pick him up, but it had been stopped short of the pickup point. The driver asked him to walk. He waved to his mother.
After walking for around half a mile, he saw the vehicle surrounded by a crowd of uniformed men. There would soon be a round of identity card checks, questions, and even insults, “So you are going to treat a stone pelter. Why would we let you pass?”
The doctor faced this daily, so he had got sort of used to it. He knew he would manage. For him, the more difficult part was to cross layers of concertina wire laid by the paramilitaries to block the road. Even though he could operate, with finesse, with the sharpest instruments while performing a surgery, this “damn” wire always gave him trouble.
“More humiliating is that you have to put it back in place after crossing over,” says Dr Rashid. The first stage of reaching the ambulance is over, now they have to reach the hospital.
The driver starts the engine to head towards more pickup points where other doctors and hospital staff are waiting. Many have to be picked up from their homes, since they live in areas, where on most days even peeking out of windows is not allowed.
The journey to the hospital is slow – interrupted by frequent checking – an average of six every day from his home to hospital. At many places he sees men in uniform firing bullets, tear gas shells, running after people with canes in their hands. “Another hectic day,” he sighs.
After reaching the hospital he thanks the ambulance driver and calls home to inform his mother that he has reached the hospital.
The hospital is a stark contrast to the outside where there is hardly any sign of normal life. It is abuzz with activity, as if everything was normal. “This is what we do. We make saving lives possible. This is the only place where human life is still precious now,” he says.
Dr Javed, a doctor at SMHS hospital was also waiting at his pick up point at Lal Bazaar. A few men had ventured out to buy bread. He noticed an approaching group of CRPF personnel. As other men disappeared into the lane, he stayed put. He thought they wouldn’t harm him as he was going to his workplace. He was wrong. They pounced on him, and beat him. It was only after his repeated insistence that he was a doctor that he was spared. He was lucky to suffer only bruises.
Even then, the bruised Dr Javed headed to his hospital. “The thought of going back home never crossed my mind,” he says. After his colleagues treated him, he was back to treating patients.
A number of times even doctors’ identity cards are not honoured. Dr Basharat, senior resident at SKIMS, was turned back on two occasions. “They saw my card but did not allow me to go. I tried to argue but to no avail,” he says, “I had to return home.”
Besides the men in uniform, the medicos and other hospitals staff have to face the wrath of the protestors. In the initial days of the protest, even ambulances and the cars of doctors were not spared. Dr Faheem was returning to his home in Bag-e-Mahtab from SKIMS, when his car was attacked. Though he escaped unhurt, the windscreen of his car was smashed.
This did not deter Dr Faheem from reaching the hospital the next day. “This is one of those times when people need doctors the most. If we stay back, then many innocent lives would be lost,” he says. But the attacks on doctors from stone pelters ceased after appeals from the Hurriyat. As curfew was clamped the hospitals used ambulances to transport the hospital staff.
“We are not safe even in the ambulances,” says Dr Nazia, a Senior Resident in SKIMS. “Being females the conditions are even more difficult. The police and the CRPF stop the ambulances and the hospital vehicles and then the frisking starts. Even our bags are not spared. They check everything even after they are sure that we are doctors,” she says. She adds that there have been times when they were made to wait 20 minutes for checking.
“There is an air of insecurity and uncertainty,” she says. “When everyone else decides to stay back at home, not even venture into the immediate vicinity they also have a reason. We face what others chose to stay away from. We face the humiliation of being asked the same questions again and again at every consecutive check point, we have to argue, we have to appeal, sometimes even plead,” she says. “Then there is the insecurity. When we come out of the homes, we don’t know whether we will come back.”
She recounts an episode of 2009, when she was a resident in JVC. “Our bus was attacked by stone pelters. Three doctors were injured. Blood was gushing out of the head of one of the injured doctors,” she says.
Dr Shazia Hamdani, an intern at SMHS hospital also cannot forget one morning in the early days of the protest. She was posted in GB Pant hospital at that time and was travelling to the hospital with other doctors in an ambulance. “One of my colleagues was hit with a stone on the head, and she was bleeding. None of us could control our emotions. Even the driver of the ambulance wept.”
Anybody would like to stay home than face such grave danger and humiliation, but a sense of duty and dedication towards their profession does not let the doctors in Kashmir have that privilege. The sense of responsibility of Valley doctors (towards patients) keeps the healthcare sector going. However, the doctors credit the ambulance drivers for keeping the hospitals functional. “It (the credit) goes to the ambulance drivers, who put their lives at risk, every day and every hour,” they said.
Twenty years ago, a patient in critical condition in SMHS hospital needed a life saving injection which was available only in the army hospital at Badamibagh. The duty to get the injection fell on Ghulam Nabi, an ambulance driver. Along with two attendants he left to acquire the injection. He never came back. His bullet-ridden body was put to rest in a grave in the hospital.
“The situation is no different today. Everday, on every trip, we put our lives on the line. We don’t know whether we will be alive by the evening,” says Mohammad Ashraf Bakshi – a colleague of slain Ghulam Nabi.
These three months have been particularly tough. The ambulance drivers have not only had to carry patients, dead bodies, but staff and medicines as well. They have a 36 hour long shift after which they get a night off. Sometimes they do not even get time to eat.
“The work has increased five-fold,” says Ashraf. Every driver plies a distance of more than 300 kilometres everyday. Most of the times, the only contact they have with their families is through the telephone.
“It is a myth that ambulances are not stopped by the police or the CRPF,” says Mohammad Shaban who was put in the lock up in Shergari police station along with a doctor after being detained near Magarmal Bagh.
“I was on way to drop the doctor home. An officer of SP rank detained us. We were released only when the SSP intervened after being contacted by the hospital authorities.”
All the drivers have similar stories to narrate. The biggest problem is when they are put to rigorous questions about the attendants. “Many a times the attendants are asked to alight and walk home, while questions are asked to us as to why we were carrying them,” says Fayaz Ahmad, another ambulance driver.
According to Mohammad Ashraf, most of the ambulances are damaged. “Two ambulances don’t even have the front windscreen,” he says.
But it is more problematic during night, they say. “We are not allowed to turn on the head lights at night. We have to drive in dark,” say the drivers.
Fayaz says three ambulance drivers have suffered serious injuries during the last three months.
“These four months we have carried everyone from a sweeper to the highest officials of the hospital administration. If we don’t do it the hospital won’t function,” adds Ashraf. They do it at no extra remuneration. “We do not even get a risk allowance, no benefit for the extra duty,” says Fayyaz who has made 15 trips in the past 30 hours, trips to places as far as Magam and Pantha chowk.
The SMHS has 17 vehicles including ambulances to pick up thousands of employees, doctors, patients and carry medicines. The SKIMS has 50 for 4500 employees. This adds to more than 200 trips for these two hospitals only.
An ambulance stops outside the SMHS hospital and a 14 year old is wheeled into the operation theatre. He has an injury to the eye, shot at close range with a marble by CRPF. As he is being operated upon, anxious relatives wait outside. After two hours, he is brought out. He has lost an eye.
One of the surgeons who operated on him is moved. “Even doctors have emotions,” he says. The doctor says that in the past three months they have had to operate on more than 60 patients, out of which around 20 have lost at least an eye permanently. According to him, there have been cases that had more than 15 pellets in the face. Many have been referred to hospitals outside the valley.
“Most of them were youngsters below 23 years of age…I have a brother of that age,” he says.
There have been instances when doctors have to work round the clock. They have even coined names for the days. One they remember the most is ‘Black Sunday’ (August 1, 2010).
Resident Surgeon, Dr Munir recalls that 14 surgeons were working at the same time in the trauma theatre. “The trauma centre has four (operation) tables and two minor (surgeries) tables. Everything was occupied,” he says. Doctors from other departments were also called in to help.
The surgeons could not believe their eyes when tear gas shells landed in the trauma theatre, where injured where being operated upon. “It seemed as if we were working in a war,” says Dr Munir.
In all this mayhem, Dr Munir saw a patient who had no attendant. He had died on the table after all efforts to save him had failed and the surgeons had moved to other patients. Dr Munir saw that he had a wallet which he opened to see if he could find a phone number. When he opened the wallet he saw a blood stained chit, which had a mobile phone number and an identity card which listed the slain’s name and age.
Dr Munir called the number, and asked the receiver if he knew the deceased. It turned out to be the father. “I instantly regretted, I will never forget the call.”
According to Dr Basharat in SKIMS most of the injuries were to the upper part of the body. “The intention in most cases was to kill.”
While the doctors put their lines on the line to reach hospitals and keep the valley’s healthcare centers up and running, the hospital administration (comprising mostly of doctors) put in extraneous efforts to ensure supply of drugs and other life saving equipment.
Dr Amin Tabish, Medical Superintendant SKIMS, Soura, says that managing medicine supplies during this period was a challenge. “Most of the supplies come from outside the valley, and there was an uncertainty among the suppliers. There was also the problem of transportation. Because of the conditions no transport company was willing to deliver the supplies to the hospital,” he said.
The hospital authorities either airlifted the supplies or used ambulances to ferry medicines from Qazigund, as truckers coming from Jammu refused to move beyond Qazigund.
The unrest and curfews shutdown everything including the valley’s only oxygen factory in Khanmoh, endangering the lives of patients. “We sent our own hospital vehicles to ferry the employees to the factory, and then only could the factory function again,” says Dr Tabish.
Such efforts helped in keeping life saving drugs available in hospitals. “More than 90 percent of the supplies were always available in the hospital,” states Dr Tabish. He adds that all the essential and vital drugs were always available in the hospital, and 80 percent of the hospital staff was able to make it to the hospital on any given day.
The medicines, he says, were provided to the injured free of cost.
Essential medicines were also kept available in the SMHS hospital, where the authorities added many medicines to the supplies list which usually are not provided in the hospital, in view of the closure of the pharmaceutical shops.
Even with these efforts the doctors could not have saved so many lives if the volunteers from the civil society had not come forward to donate blood, generously. As cases of firearm injuries started to rise the blood banks were drained. The doctors at the two main hospitals appealed for immediate blood donations and people responded positively, making sure that there was no dearth of blood for transfusion in these hospitals.
“Many people, mostly young men, showed up after hospital authorities made public appeals for blood donations,” said a Senior Resident doctor at SKIMS.
Many blood donors gave their phone numbers and other contact details to the hospital authorities, so that they could be called in case of an emergency. As the government enhanced restrictions on people’s movement, the hospital authorities would contact the blood donors and in cases send an ambulance to bring them to hospital as they could not come on their own.
Blood for transfusion is much needed as patients with firearm injuries bleed drastically until attended by medics. When some patients need more than 15 pints of blood, the reserves were depleted fast.
The injuries, doctors in the main tertiary care hospitals say, constituted 20 percent of the patients. Most of the patients visiting the hospitals were unrelated to the violence.
Hospital sources say that there has been a 60 percent decline in the number of patients visiting the hospitals.
When every wing of the civil administration was defunct, the healthcare sector remained open, though purely due to the efforts of the doctors and other healthcare staff.
The unsurpassed efforts put in by the doctors and the hospital staff and administration made sure that any patient making it to the hospital received medical care.
Dr Irfan along with his colleagues works for 48 hours on a stretch in SMHS. “We did not even get tea for this period,” he says.
Putting their lives in great danger, the medical fraternity of Kashmir makes saving lives possible.
(Some names have been changed on request)
