Greater Kashmir’s report about the availability of ambulances in Kashmir valley is chilling. A lot of people have written to us and expressed their bewilderment at the unavailability of ambulances in the Valley, given the emergency situation we are confronted with. It is not for the first time that this issue has been highlighted. The imperative for action on this front is urgent. The report that Kashmir has no ambulances with critical care and life-support systems for common citizens and that such ambulances are only available with the state’s Governor and the Chief Minister raise both moral and governance questions. As the report has said, lack of such ambulances in the Valley has resulted in loss of many precious lives. It is now very common for casualties taking place in districts to be shifted to Srinagar. Two questions rise on this: why aren’t our district-level hospitals equipped to handle bullet injury cases? And why isn’t at least one ambulance with critical life support system available in our district hospitals?
Can carrier vehicles, labeled as ambulances, devoid of life saving equipment be expected to meet the challenge?
This debate brings into question the larger state of emergency healthcare in the Valley, which looks primitive given the advances made in this area across the globe. Since the long time experts are calling for developing the infrastructure in District Hospitals to a level which makes them operational for dealing with emergency cases. And it is not for infrastructure alone. The government needs to make appropriate laws that will ensure that doctors belonging to the same areas provide their services within their districts and not centralize in Srinagar. Without expert doctors at these hospitals no amount of physical infrastructure will make them operational. Government also needs to bring in a law barring financial incentives to such medical staff which deserts home districts and operate from Srinagar. The ten district hospitals – which form the backbone of rural health care in Kashmir - are in dire need of specialist doctors, paramedic staff and infrastructure to make them fully functional and thus stop the flow of patients to tertiary care hospitals in Srinagar. Over the years, the district hospitals have turned into referral clinics where doctors dispatch patients, even with ordinary ailments, to Srinagar for treatment. Take, for example, the 100-bed Varmul District Hospital, established in 1932. It has only eight people to run five operation theatres. Three of them have been brought from the field as attaches. The hospital doesn’t even have a CT scan machine. Kashmir’s District and Sub-District Hospitals urgently require latest medical equipment like CT scan machines, ultrasound machines, X-rays etc. The government also needs to address the problem of shortage of doctors, including specialists, in these hospitals. There is also a need to recruit qualified paramedics, technicians, nurses and other staff. Patients should be looked after by qualified nurses and paramedics. At present, due to the shortage of qualified staff, nursing orderlies and pother such staff are doing this job. Most importantly, these hospitals need functional Casualty Wards and also residential facilities to doctors so that they remain available there for 24 hours. There is also a need for upgrading the demographically important CHCs to sub-district hospitals and provide them with better equipment. And of course all this will be possible if proper incentives like rural service allowances are given to the doctors. For many of these things to materialize, Union Minister for Health, Ghulam Nabi Azad, will have a key role to play as a son of the soil. International humanitarian agencies working in Kashmir also need to address this important area of human concern.

Lastupdate on : Fri, 13 Aug 2010 21:30:00 Mecca time
Lastupdate on : Fri, 13 Aug 2010 18:30:00 GMT
Lastupdate on : Sat, 14 Aug 2010 00:00:00 IST