Poor healthcare facilities in 5 districts

Ranjit Parihar
In Jammu and Kashmir, people of majority of districts are complaining of poor healthcare facilities, even after74 years of independence but health care facilities is on crèches in five bordering districts comprising 15,790 square kilometer area with 20 lakhs population as per 2011 census and people term hospitals in these districts as referral hospitals as they have no medical facilities. Health facilities in Udhampur, Reasi, Ramban, Doda and Kishtwar districts are very poor and people are feeling helpless and in emergency cases they are forced to move summer or winter capital of state or even outside the state for specialized treatment .
It is very distressing and painful to note that the condition prevailing, earlier in these Civil Hospital of these districts was pathetic but after the corona pandemic it has further worsened as patients suffering with other serious ailments other than corona have been left at the mercy of God as doctors have only plea of taking care of Corona and directs patients of other disease not to visit hospitals
.As the Civil Hospital is meant to treat the patients but the shortage of doctors ,staff and health care facilities in these Hospitals particularly in rural far flung areas are leading to loss of human lives in emergency.
Situation in all these districts is near about same. If in some district there is medical infrastructure like CT Scan , Diylasis , Ultra sound machines but in some districts there is no one to handle equipment due to shortage of specialist and staff and these equipment are gathering dust and in some district some services are working partially as existing staff has been given one month special training to deal with Dialysis like machine in absence of Nephrologists doctors.
Besides patients have even no option to avail private facility as it is not available there which force them to think where we are living even after 74 years of independence . J&K received massive Central funds under the Prime Minister’s Reconstruction Programme, time to time , crores of rupees had been spent on the construction of new hospital buildings across the state, but not much was invested in training manpower, rendering buildings idle and useless. “For decades, narrow political aims have led to construction of hospitals in an unplanned manner. How will these be run was never given a thought. The only functional health institutions are big hospitals in the capital cities of Jammu and Srinagar and they act as sponges to the influx of patients.
Various hospitals in five hilly district in J&K are facing an acute shortage of doctors and staff . Lakhs of population living in far flung areas of these district who suffer with Cardic , Diabetes, Kidney, Neuro and skin problem are forced to visit Summer and winter capital Jammu and Srinagar as there is no specialist like Cardiologist , Dermatologist , Nephrologists , Neurologist, Dialectologist in entire area and majority patients were reffered to state capital hospitals and many succumbs on the way during travel which is sad state of affair .
In a major initiative by the Central Government, as many as 35 “Made in India” ventilators have been provided to District Hospital Udhampur and other hospitals under the Prime Minister’s Citizens Assistance and Relief in Emergency Situation (PM CARES) fund in the fight against COVID-19.but they too are gathering dust as they were not put to use till date due to non availability of oxygen plants and staff to handle them . It is also quite amazing that out of all these five districts the district hospital Udhampur has become the first Government-run health facility in Jammu and Kashmir to get the National Quality Assurance Standards (NQAS) certification in recognition of its high standards in 2019 . The hospital scored an overall rating of 85 per cent and met the criteria required for achieving the NQAS recognition. The Union Ministry of Health and Family Welfare (MoHFW) has accorded the NQAS certification to the District hospital, Udhampur, in recognition of its high standards of quality and performance maintained by it, but ground situation is that hospital is facing acute shortage doctors and technical staff in district and most of the medical equipment available with hospital are gathering dust for want of manpower and experts to run them .
Notwithstanding claims of government to open new Medical colleges and Hospitals , the existing hospitals in the state and in all five bordering hilly districts are confronted with shortage of Doctors and Para medical staff putting patients to a lot of trouble and problems. Sources said prevailing doctor patient ratio in the state is over 1: 2000 with the result of the doctors in hospitals are over burdened, with the result they fail to provide proper attention to the patients who visit there for treatment and often result into public resentment or clash with doctors and para medical staff.
Majority of hospital in five district are running with shortage of thirty to forty percent of sanctioned strength and in some cases hospital has appointed health staff on daily rated ,adhoc basis and paying them salary from hospital development fund to run the day to day affair .The shortage of doctors as well as Para medical staff also creates difficulties for the hospital administration especially in rural areas in running the emergencies in the event like accidents or natural calamities .
Majority of these Hospitals facing shortage of staff and Medicare facilities in emergency hours refer patients to Jammu Medical college for treatment and people have now termed them as referral hospitals as doctors do not even deal with pregnancy cases due to non availability of blood banks and ultra sounds facilities . Kishtwar , Doda, Ramban and Reasi district remain militancy infested from last three decades and during militancy operation when security forces and local people were injured during militants attack they had no option than to seek other medicare centres.
In Udhampur hospital thirty percent posts of doctors and staff are lying vacant from past some time . Due to shortage of manpower and trained staff CT scan unit, Diyalisis unit, TMT , Audiometery, Panch Karma are partially working are non functional due to non availability of trained staff . In absence of Nephrologists Dialysis unit of hospital is being run by medical Assistant . CT scan unit is also not working from past some time . 07 posts of specialist , 04 medical officer and posts of Doctors under NHM and 13 posts of para medical staff are lying vacant presently at district hospital . Situation in other hospitals in all rural bordering five district is near about same at district head quarter . One can better access condition of rural health centers if hospital at district head quarter are facing such situations .
The Union Territory has witnessed a sharp increase in fatal road mishaps particularly in Kishtwar , Doda , Ramban , Reasi and Udhampur districts during past few years. To cater with need of people all theses hilly districts Government has established trauma centres along major highways in hilly areas in 2009 -10 but still they continue to be dysfunctional due to the “insensitive and casual approach” of the authorities. Union Health Ministry had sanctioned 10 trauma centers for both the provinces — six for Kashmir and four for Jammu. in view of a spurt in the fatal road accidents, particularly in the hilly areas. In the Jammu region, one trauma centre each was established at Mahanpur in Kathua, Udhampur District Hospital, Ramban district hospital and Thathri.
The trauma centre, Udhampur, has been lying non-functional for the last four years due to non-availability of doctors and paramedics. All modern equipment, ventilators and CT scan have been lying unused in the absence of staff. Despite requisition sent to higher authorities regarding staff requirement but till date nothing has been done and presently these centers are functioning partially. The Ramban trauma centre and Thathri are virtually defunct due to shortage of specialists and other staff.