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(The basic requirement of any healthcare set up is a hospital. Kashmir has many government and private hospitals but these are lacking in many respects)

Before one examines the status of the hospitals in Kashmir, it would be useful to recapitulate how Wikipedia, the online encyclopedia describes a hospital. “A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with a large number of beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children’s hospitals, seniors’ (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment (psychiatric hospital) and certain disease categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received”.

“A teaching hospital combines assistance to people with teaching to medical students and nurses. The medical facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and urgent care) and specialist units such as cardiology. Some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy, pathology, and radiology. Hospitals are usually funded by the public sector, health organisations (for profit or non-profit), health insurance companies, or charities, including direct charitable donations.Hospitals are largely staffed by professional physicians, surgeons, nurses, and allied health practitioners.”

Keeping in view these general criteria, one can say that some of our hospitals both in government side and in private sector lack a number of essential facilities. There are some fully equipped hospitals in government side in the capital city of Srinagar. However, there are no such fully equipped hospitals both in regard to specialised equipment and on manpower side in the districts. This results in extra load on the Srinagar’s main hospitals. For instance there is only one maternity and one paediatric hospital in the entire valley. The most unfortunate part is that the setting up of hospitals and the upgradation of these is not according to some plan. In theory, we have district, sub-district hospitals and the primary health centres all over. In some places, these are very well equipped but lack the essential staff such as consultants and specialists. Invariably a large number of cases get referred to Srinagar which puts tremendous load on the already overstretched facilities and the staff. The main hospital in Srinagar is a teaching hospital being attached to the Srinagar Medical College. The Institute of Medical Sciences which was intended to be a highly specialised hospital for advanced studies and research has turned into a general hospital. The outpatient department of the Institute is so overcrowded that one gets the impression of being in a fish market!The Institute has some of the latest diagnostic and other equipment. However, there are not enough resident doctors and consultants there during night hours. The other problem in Srinagar is dispersal of special treatment facilities with most advanced being in the Medical Institute only. Many times patients needing critical care have to be transported from other hospitals to the Institute. The other controversial part is the private practice by the doctors working in government hospitals. This topic has been under discussion for a long time. Sometimes the practice is allowed and other times it is banned. There has to be a clear policy and its implementation on the subject.

Recently, five new medical colleges have been sanctioned for the State. Two of these are in Kashmir valley at Anantnag and Baramulla. Well that is a good step as there would be more facilities for training new doctors. However, these can work only if these colleges have good teaching hospitals attached to these. It is hoped that this aspect has been kept in view. This may entail upgradation of the two district hospitals which could function as teaching hospitals or two new hospitals too may have to be sanctioned and set up.

Apart from the government side, there are a large number of private hospitals in Srinagar. Except some specialised hospitals like the Khyber Heart Institute, which is fully equipped to deal with cardiac problems and is visited by top cardiologists from within the country and abroad,the others do not even qualify to be called hospitals! These are basically run on commercial lines by the owners. The only thing lacking In Khyber is a dedicated blood bank which is a must for all surgeries. They need to incorporate this facility at the earliest as it is mandatory under the Drugs and Cosmetics Act! Most of the other hospitals do not have 24 hour emergency facilities nor have these the most essential Intensive Care Units! In case of some emergency they have to rush their patients to the Government Hospital or the Medical Institute for life saving!It is reported that a number of private hospitals are being expanded and upgraded. It would be advisable if their owners keep the essential requirements of a real hospital in view and upgrade accordingly. Incidentally, Khyber Heart Institute is probably, the only private hospital which has a critical care Ambulance?

Recently, there is a new trend. A large number of specialists and consultants from outside the state hold their clinics in different private hospitals in Srinagar and then refer most of these to their institutions outside the state. There is no harm in some of the top doctors from outside the state coming here for performing specialised surgeries and other procedures in local hospitals but taking the bulk of patients outside the state at huge costs is not a fair practice.

There is urgent need for the government to examine the entire healthcare set up and ensure all the facilities function according to some global norms so that people all over the valley get the medical attention they deserve and no mal-practices occur. The State’s very first duty is to ensure good health and well-being of its citizens.

Mohammad Ashraf, I.A.S. (Retired), Former Director General Tourism, Jammu & Kashmir

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