My Doors Are Always Open

Ikhlaq Qadri caught up with Dr Showkat Ali Zargar, Director SKIMS who claimed the tertiary care medical institute is gearing up to deal with patient woes betterIMG_1887

Kashmir Life: What  major problems did you identify in SKIMS after assuming the charge as the director? What are you doing to address those problems?

SZ: Problems were always in my mind as I am a part of SKIMS from last thirty years. Some problems were in the Out Patient Department (OPD), for instance in OPD, I always felt that facilities there are inadequate. People face hardships in getting appointments. If the patients are advised to get blood investigations done, say CBC (complete blood count), he/she has to come on the second day to deposit the blood sample, on the third day to collect report and finally on the fourth day to see the doctor again. This procedure was too hectic for even patients from Srinagar not to talk of people coming from far-flung areas.

To begin with, the blood collection centres remain open till 4p.m now. Earlier they would  close at 12:30pm. Blood collection, investigation and report delivery in most of the cases takes place on the same day. We are also planning to get all the data in the OPD section online.

Other area of concern was day-care centre for cancer patients. They were getting dates with long gaps. I have made the ward to work in two shifts. Earlier it was 10am to 4pm. Now it is 8am to 8pm. This way we reduced the rush considerably.
Casualty is looking better. We will also be adding 2500 sft to the existing area.  We have installed Ultrasonography (USG) machine and put separate CT scan machine in it.

KL: What are your future plans for the institute?

SZ: Soon you will see every OPD running almost every day. I will ensure that there are consultants everywhere, withdrawing junior residents from OPD, now senior residents will be stationed there. Screening clinics now will be totally managed by senior residents that will result in better interaction with the patients. In casualty there are three theatres. Within seven months there will be three more.

I want to make things comfortable for people living in far flung areas. I am in consultation with director health. We will be having a helpline in district hospitals from where appointments will be sought. The patients need not to come and have unnecessary trouble. Besides, I am planning to make a nearby hospital as a referral and reverse referral centre. We will be sending staff and will upgrade their skills. If this experiment succeeds, in next ten 10 years our district hospitals will function the way they should.
Transparency is my benchmark. Give me some time I will make SKIMS a patient-friendly institution.

KL: Despite having highly qualified and experienced doctors, SKIMS is still struggling to contribute in research. Why?

SZ: This information is the not correct. You see the research done in last year and the impact it is having. More than 100 papers were published in last year in very significant Index journal all over the world. This is the only source in the state producing excellent medical scientific data. Our institute is getting lots of projects to work on. I have framed a clinical research cell.

KL: You have been heading the Gastroenterology Departement since 1998. What are the major problems faced by the people in valley vis-a-vis gastric disorders.

SZ: Gastroenterology is one of the biggest departments at SKIMS. I am happy to say that the department has got recognition of national as well as international level. We have identified all the diseases peculiar to Kashmir. We have defined epidemiology of cancers in the valley. We have also defined Biliary Ascaris (round worm infestation) and showed the world how this disease behaves. While I was in PGI doing DM in gastroenterology, I defined the classification of a disease called corrosive poising and its effects on gastrointestinal tract. It is now followed globally. Prof. M.S. Khuroo who was part of this department has discovered hepatitis E.

KL: What is your take on private practice by doctors?

SZ: It is totally banned as per the law. It is a criminal act. Tertiary care cannot go hand in hand with private practice. If doctors have decided to work here they have to be content with their salaries. I understand the times have changed and doctors also need more money to live a good life. So I want to develop a system that can give more benefits to them.

KL: SKIMS was conceived and created as a super-speciality hospital. Do you think it is losing that purpose?

SZ:You are right. The staff is well-trained to deliver the tertiary care. Infrastructure is certainly a problem. We have only 12 ICU beds but at the end of this year, hopefully, we will be having 50. We won’t let patients die for want of ventilators. I want to make the institute self-sufficient economically as well. We have skills to do the investigations which are otherwise sent to outside labs.  Though we would charge for these investigations, the rates would be far less than what is usually charged outside the state. For instance, hepatitis B-virus DNA test is done there for Rs. 5500-6000. We will not charge more than 1500 for the same test. This will benefit both the patients and the hospital. I have also identified eighteen areas of specialities and which will be added to the institute in next 4 years.

KL: The bio-medical waste from the hospital is found in a nearby compound in Bahloachipora. The liquid waste is reportedly flowing into the Aanchar lake. Why does the problem persist?

SZ:This institution has best facilities to dispose off wastes in the most scientific way. Whenever there is a problem, the controlling body reports it to us. We have two incinerators and huge sewerage treatment plant in the institute. We don’t have major problems with pollution department and LAWDA. We test the lake water regularly so that it does not cross toxic levels. We follow the Supreme Court guidelines.

KL: SKIMS is considered one of the best hospitals in the country but still patients complain about the way they are treated. What are the reasons?

SZ:I think after all you have patient and staff both from Kashmir. We behave violently at times. I always tell my staff to develop good behaviour. Our religion also teaches us to behave properly. People should know that they too have a certain degree of responsibility. At times, they make it difficult for staff to work.

KL: A large number of people are going outside the state for treatment  available at SKIMS. Is there any trust deficit or the facilities outside are genuinely better?

SZ:I think there is no trust deficit. Last year I saw a patient with stomach cancer. I told him I will operate upon him in SKIMS. But instead he chose to go to Delhi for treatment. Only yesterday he came back with recurrence of the disease. I don’t say doctors outside are not good but we aren’t bad either. Lakhs of people come here and are cured. Sixty thousand patients come every year for getting their surgeries done. Around six lakh people visit our Out Patient’s Department. Believe me, many of those who go outside the state to get themselves treated repent after coming back.

KL: Better researchers and doctors leave the valley and usually don’t come back. Are you doing anything, both as person and as the director, to get them back?

SZ:This is a wrong notion. The perception that good doctors leave the  valley is not right. Ninety per cent of the good doctors stay back. The other 10 per cent want to have a better life. Many doctors have contributed to the field here while staying in Kashmir than they would have done anywhere in the world.

KL: Tell us something about your good and bad experiences since you assumed charge as the director of SKIMS?

SZ:Best experience is to be with my employees. I love them. My bitter and sad experience is with behaviour of people. I request them to cooperate. Everything is being done to improve the patient care. I love people of my land. I am here because of them.  SKIMS is not our personal property. It is the legacy that we have inherited and we should take care of it.

KL: As the director SKIMS what is your message to the common people?

SZ:Please cooperate. Don’t overcrowd the hospital. Come to me when there is any grievance. My doors are always open.

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