Lost genius

Super specialist doctors in Kashmir are unable to offer their services properly for lack of proper jobs forcing many others to fend for greener pastures abroad. Hamidullah Dar reports.
Malawi, a small poor African country has more of its doctors practising in Manchester, England, than in all of Malawi. The reason; Malawi produces doctors but is unable to provide them facilities. Like Malawi, Kashmir produces brilliant super specialist doctors but when it comes to utilising their expertise and knowledge for the society with poor health record, the state fails to do so.
For Malawi doctors, pecuniary consideration and prevalent corrupt system are the reasons; their counterparts in Kashmir have many more problems. By and large they want to serve their own people but at the same time allege that the system here is ill devised to meet their genuine needs and demands. It results in brain drain of doctors to green pastures like America, Europe and Middle East.
“I can tell you without any hesitation that Kashmiri doctors are among the best in the world and their capability is recognised at international level. However, back home doctors are not provided adequate facilities like a respectable salary, better working environment etc that distracts them and nation loses them to other countries”, opines Dr Nisar Ahmad Bhat, a paediatric surgeon at SKIMS.
Dr Bhat has served in King Faisal University in Saudi Arabia for three years as Registrar and Consultant. Ask him why he left the valley, he retorts, “After doing my M.Ch from AIIMS New Delhi, I was without a job for two years which left me with no option but to go outside.”
The absence of jobs or jobs incompatible to degrees is one of the major causes for doctors opting to leave Kashmir.  “We produce 60 postgraduate doctors and government fails to provide jobs to most of them. Even those who are engaged are posted at places where they are left to rot and people also do not get benefited,” says noted gastroenterologist and head of Gastroenterology Department SKIMS, Prof Showkat Zargar.
Citing an example he adds, “Two specialist gastroenterologists have been employed as assistant surgeons which manifests the ill devised methods of the government. We will keep on losing talent if government does not remove the illusory curtains from its eyes and come forward with a healthy method to rejuvenate the health sector.”     
The working atmosphere and bad governance in the valley are among the causes for many super specialist doctors to say good bye to Kashmir. “Mediocrity breeds mediocrity. Here mediocrities are at the top so everything is in mess. It is bad governance that has resulted in deteriorating health system in the valley. There should be good working atmosphere available so that specialist doctors can take their professional decisions independently. Then you see no body will leave valley,” blurts Prof Mushtaq Sidiqi, Head Immunology and Molecular Medicine Department SKIMS.
Dr Sidiqi has served in Germany and while asked to draw parallels, he laughs “There is no comparison at all. There you are accorded the respect and paid as you deserve and consulted according to your knowledge that gives immense satisfaction, a pre requisite to deliver the best. Here almost everything is opposite.”  
When asked what will give him greatest satisfaction while serving in Kashmir, Dr Sidiqi instinctively replies, “Independence of thought will give me greatest pleasure as it will satisfy my professional ego.”
Prof Khursheed Iqbal, Head Cardiology department SKIMS is also convinced that salary is not the only reason for doctors to take foreign flights. However, when asked why he stayed put for the last 27 years in Kashmir he replies, “Attachment to the place and above all to serve my people was the sole purpose of holding back.”
Prof Khursheed however, complains of disparity in salaries among the doctors. “I have done my super speciality in cardiology and those who did simple MBBS and got jobs in the field are almost receiving the same salary as do I. Theoretically we are at par with AIIMS but practically there is no resemblance.”
There are many doctors who have served in foreign countries and broadened the horizons of their knowledge. However, when they return their skills were left to blunt for want of their engagement in the health sector. Dr Manzoor Dar is one among them who, prior to leaving for Britain, was a consultant at SKIMS and is now doing a private job. “I was aspiring for better training and exposure so went to London. I spent eight years there and learnt many great things that are of immense help” said Dr Dar.
However, almost all agree that the behaviour of doctors in Kashmir is not encouraging. “Outside the valley there is accountability for everything. There doctor is in trouble as he has to take every care from diagnosis to amicable communication skills while attending a patient. Here, unfortunately most of the times patient is in trouble. Besides, everything you need while discharging your professional duties is available that is not the case here,” said Dr Bhat.
Dr Dar holds similar views. “Doctors have to be very humble to the patients here as they are already in trouble with the disease and any maltreatment can exacerbate their woes.”
But there are some who believe that doctors should not be stopped from going outside the state or country. “If you pay somebody Rs 10,000 and he is baited with one lakh or more at international level, let him go. We will not have fewer brains here. All that is needed is to take care of those who are stuck here and at the same time will have to encourage reverse brain drain. It is simple. If we cannot provide jobs to doctors they have to seek them somewhere. They have their families to feed and also their degrees demand them to serve people, no matter who they are,” said Prof Abdul Hamid Zargar, Director SKIMS.
“If someone wants to come back he must be welcome and government must help them in developing private health sector. It will help us in two ways; we can use their expertise and at the same time it will reduce the rush of influential and well off patients to SKIMS or SMHS where low income people can be treated,” he said.
Prof Showkat also suggests development of private sector in health to reverse brain drain. “Government cannot do everything. It must facilitate return of Non Resident Kashmiri doctors and help them establish their own hospitals by providing land, lending loans and in developing infrastructure. And in return state can demand free health care for say 25 per cent patients and if these hospitals are established at district headquarters, then it really will boost our health system,” he says adding he is content with the salary he receives.
Every government in the state has been claiming to bring health sector on rails but the mess can be gauged from the fact that for smaller ailments people are referred to tertiary hospitals like SKIMS and SMHS from district hospitals for want of facilities or qualified manpower. “We have to treat patients in tertiary hospital that otherwise must be treated at district hospitals. Even people from Gurez and other far flung areas throng SKIMS for ailments that could be tackled at Gurez if manpower available is utilised judiciously,” said Prof Zargar.
Unaware of its human resources the state government recently approached Union Health Ministry for providing super specialists to J&K. “This is crass detachment of government from its own people. We even have a super specialist heart surgeon (Dr Khalid Mohiudin) working as an assistant surgeon at SMHS and a super specialist paediatric surgeon (Dr Rashid) posted at Kulgam hospital. Bad planning and unawareness of bureaucrats is responsible for this non utilisation of human resources and crying of non availability of specialists in the state,” says Dr Majid, a surgeon.
Presently, there are more than two dozen super specialists in Cardiology, Gastroenterology, Neurology, Nephrology, Endocrinology, Urology, Plastic Surgery, Paediatric and Neonatal Surgery, Cardio thoracic and Vascular surgery, Neuro-surgery, Surgical Oncology etc in the valley alone who do not have appropriate jobs. They are working at lower posts like assistant surgeons and contractual lecturers.  And if government turns a blind eye to their presence and plans to import super specialists from outside state, then there is no wonder if Kashmir overtakes Malawi in brain drain.


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