SHEIKH ABID
WINTERS have already knocked at the doors in the Valley. With foggy mornings & chilly evenings, the temperature is dipping below subzero levels every alternate day.
Winters in Kashmir, besides bringing charm to the mountain-clad Valley, also come up with their unique kind of challenges. One such challenge are the frequent cold-driven diseases like pneumonia, COPD, IPF, bronchitis, chest infections, fever, cold & other similar diseases. And thanks to these infections and illnesses, we witness a huge rush of patients thronging the primary and tertiary public healthcare facilities across the Valley. And for this reason, the availability of adequate facilities in these government run hospitals attains vital importance, especially during winters.
• Public healthcare
In the UT of Jammu and Kashmir, the public healthcare infrastructure functions at three levels: (i) at the primary level consisting of SCs, PHCs, CHCs, HWC-PHCs and CWC-SCs for preventive, promotive, curative, rehabilitative and palliative care such as maternal healthcare, neonatal and infant care, family welfare, chronic communicable diseases, non-communicable diseases; (ii) at secondary, district and tehsil level hospitals for supplying remedial and preventative care to patients; (iii) at the territory level, in which come the district-level public hospitals which provide specialised healthcare facilities for inpatient and outpatient care.
According to official numbers of DHSK, Jammu and Kashmir has a total of 2,102 public healthcare institutions presently functional, including district, sub district hospitals/CHCs, PHCs/MMCs, trauma centres, sub-centres besides tertiary care institutes. Going by the statistics, J&K has a higher number of health institutions in rural and urban areas as compared to the neighbouring Himachal Pradesh (160), Punjab (240), and Haryana (159). Uttar Pradesh, the most populous state, has only 831 hospitals.
• But we are short on doctors…
Various hospitals across J&K are facing an acute shortage of doctors. As per rules, the health sector is the responsibility of respective state governments. However, under the centrally sponsored National Health Mission, financial support is provided to states and union territories to strengthen the public health system, including support for infrastructure, human resource, drugs, equipment, based on the requirement proposed by the states in their programme implementation plan. None of the hospitals in J&K is accredited by the National Accreditation Board of Hospitals. Despite advertisements, doctors are not willing to work in J&K, mostly because of the salary offered and ‘unprofessional’ environment in the state.
“Recently, many specialist doctors have resigned from the Valley’s top tertiary institutes in order to join newly opened high-tech private hospitals. Apart from a better package, the reason they left the top institutes was toxic & unprofessional environment there,” shares a doctor.
• A missing infrastructure
Besides a good professional work culture, there is a clear dearth of adequate hands-on facilities, especially during winters. The gaps in the following facilities are a big concern:
i) An uninterrupted 24X7 electricity supply beyond tertiary care facilities. Usually district and sub district hospitals face this issue of regular power cuts during winters which hamper their smooth functioning.
ii) Absence of adequate heating arrangements among hospitals is another cause for concern. There has to be a proper heating infrastructure installed to ensure that patients and attendants are comfortable.
iii) Engagement of doctors, paramedical staff, nurses and nursing aids to fill the vacant gap of doctor-patient ratio. There has already been much hue and cry over lack of manpower in almost all the hospitals of the Valley.
iv) A centrally controlled command centre for emergency mishappenings like snow avalanche incidents, road accidents in far-off places, delivery cases etc is also missing. There has to be a control room for effective action in those emergency situations.
v) Availability of enough critical medicines and similar life saving facilities like the ICU should be made a priority during winters.
vi) Absence of a good number of doctors, specialists in OPDs to cater to the growing flow of patients amidst winters, is also a big concern.
Besides these issues, aspects like proper road connectivity with far-off villages & cut-off areas of the Valley like Gurez, Tanghdar, Uri are a concern. Also, the immediate availability of enough night shift staff, warm water facilities, clean canteens etc is a problem.
But, assures a health official, “we have already made recruitments for varied paramedical staff in the past month and are also getting newly-appointed junior residents from various necessary disciplines. Besides, the PSC has also made selections of various gazetted posts, including medical officers, recently. We hope more staff will join us to fill the gap”.
• The achievements
Despite the lacunae, there also has been a major improvement in the overall public health facilities in Jammu & Kashmir since it became a UT.
The UT administration has been working with much sensitivity to ensure the common man has access to quality healthcare. It is pertinent to mention that J&K’s performance on ten health parameters is better than the national average, which is a testimony to the administration’s commitment towards upholding quality of life and transformation in the health sector of the Union Territory.
The LG, only a few months ago, noted that more than Rs 7000 crore has been spent on strengthening the health infrastructure and Rs 881 crore to upgrade the dilapidated infrastructure in districts. “With two new AIIMS, seven new medical colleges, five new nursing colleges, upgradation of ten nursing colleges and two bone & joint hospitals, Jammu & Kashmir is redefining healthcare delivery system in the country. Two state-of-the-art cancer institutes are also coming up, one each in Jammu and Srinagar, and an MoU with Tata Cancer Institute has been signed to provide the best care and ensure trained manpower. The work on a bone & joint hospital in Srinagar has been expedited and is expected to be completed by the end of this year,” the LG had said.
Along this, some 98 percent population has access to Ayushman Bharat, which has proved to be a boon to the poor and the marginalised sections of the society as well as the middle class. Earlier there was no facility for critical care ambulances; however, now they are available round-the-clock across the Union Territory.
“Accessible, affordable and quality healthcare for every citizen of J&K UT is our top priority,” the LG is known to have promised.
Well, no doubt the UT is performing relatively well in providing health and medical amenities to its citizens; the level & the pace need to be improved. The government health institutions at the primary, secondary, and tertiary levels miss the mark recommended by the World Health Organisation standards and a lot more needs to be done.
Appropriate maintenance and operation of the health infrastructure are required in addition to supply and provision to achieve a sustainable health status. Upgrading the accessibility of health infrastructure should be taken care of at all levels to advance and strengthen the health of the people of Jammu and Kashmir, especially during these harsh winters.
