The events of last four weeks have rendered the psyche of Kashmiris tormented and bruised. All this is a natural consequence of brutal killing of teenagers and adolescents mostly ranging from 9 – 25 years by indiscriminate use of force by men in uniform. These ghastly episodes have struck us leaving a lasting impression on our minds. No amount of sympathy can alleviate the pain and heal the wounds of the dearest and closest of those 49 innocent souls who perished in otherwise preventable causalities. Though we can't bring back the dead,  but we can make a sincere introspection of our suffering during these two months of turmoil.  During this period, hundreds of other innocent souls from all age groups lost their lives because of want of medical treatment in view of crippling unannounced curfews, shutdowns and security restrictions in almost the entire valley. We, the doctors, have been witness to such unprecedented, and most unfortunate events for the last two decades, but seeing the miseries and pain of numerous patients and their kith and kin who could sneak through the strictest restrictions to reach the Accident and Emergency Department of SKIMS during last two months prompted me to plead and cry for those who died or became critically sick for want of medical help and shortage of life-saving drugs.

Here I quote a few examples which will make my readers understand the whole situation in the right perspective and encourage them to share the unspeakable agony of these patients.

Shortage of life-saving drugs exposes patients to big risk. About 0.1% population (one in thousand) suffers from Seizure disorder, commonly called epilepsy – a disorder which requires regular administration of drugs and this disease is essentially treatable if patient is compliant to drug therapy. Missing even a single dose can lead to disastrous consequences of Status epilepticus (characterized by repeated seizures with loss of consciousness) which can result in sudden death. During the present turmoil, dozens of patients who missed drugs due to this chaos were admitted on emergency basis because of status epilepticus. No one knows how many more must have been engulfed by this disease and were not as lucky as the few who managed to reach the hospital. Likewise, scores of unfortunate patients with heart failures and chronic lung diseases were hospitalized in emergency services – the reason again was patients failed to procure drugs. Same has been fate of many other patients suffering from diabetes, liver disease and many other diseases. One can know the plight of such patients only by contacting their family members. The situation is yet worse for cancer patients who missed their scheduled chemotherapy and radiotherapy which is bound to cause problems for them in terms of response, complications and outcome of the disease.

Now let us talk of those patients who require surgery for potentially treatable diseases and by delaying surgery in such patients for months, we are denying them definitive treatment with consequences of significant morbidity and mortality. The situation is quite worse for cancer patients in whom postponing surgery even by weeks will render their surgically curable disease into an incurable stage. In other words, it simply means a red signal for their early death. Furthermore, this scenario will overload the already crowded surgical waiting lists in public hospitals and consequently will add to the miseries of those who cannot afford to undergo surgery in private hospitals.

Although all the hospitals, regardless of their status – Sub-District and District Hospitals, Bone & Joint, GB Pant Children’s  Hospitals, SMHS and SKIMS rendered exemplary services to our ailing people during this period. Despite Himalayan odds, yet the hospital staff tried their level best to help the patients. During these 60 days, although, the casualty department was flooded with patients, most of whom were youth who had sustained bullet injuries but the Out-patient services of all these hospitals wore a deserted look for weeks. Compared to three thousands patients who regularly attend OPD services of SKIMS on normal days, only a few hundred mostly from nearby areas could manage to attend OPDs. Lakhs of patients from Srinagar and other districts have missed their appointments for consultations and outpatient procedures  since 11th June 2010 after the killing of an innocent boy Tufail Mattoo whose death triggered a fresh spurt of violence in Kashmir.

Recent research in conflict zones such as Iraq, Sudan, Bosnia and Burma have demonstrated high mortality rates in general populations as a result of indirect consequences. Apart from direct-conflict deaths (violence, teargases, bullets, landmines), there is ample evidence to support that higher death rates in protracted conflict zones are caused by preventable diseases, comorbid illnesses, inaccessible medical care, and shortage of drugs   among neonates, children and adults, and pregnancy-related deaths.  Health strategies need to be developed with international aid agencies to provide medical relief to the needy in conflict zones and we should ourselves gear up to help our needy patients especially for their transportation to hospitals. The efforts of a few NGOs like Help Poor, Yateem Foundation and some others in the present turmoil were commendable; however, a lot more is required in this direction.

Thousands of Kashmiris have died as a direct result of violence because of bullets, teargas canisters, torture, but many more have died from indirect consequences of conflict – as a result of disruption  in health services, food and water supplies, and sanitation. For every conflict related direct death, many more people die as a result of shortage of life saving drugs and inability of needy patients to reach hospitals for treatment.   People, especially children, who grow up in such an atmosphere, may suffer from a variety of emotional and psychological problems which can have a devastating effect on their development and personality   and will eventually lead to post-traumatic stress disorders. Such people suffer from sleep problems including nightmares and waking early, flashbacks and replays, impaired memory, forgetfulness, irritability, panic attacks, obsessiveness and low self-esteem.

 The need of the hour is to have rehabilitation centers where our demoralized youth can vent their feelings and sentiments. We need to have psychiatrists and counselors who can help our youth whose lives have been scarred because of these twenty years of turmoil. Our young generation has been brought up in violence. There must be hardly anyone who has not lost a dear one directly or indirectly because of this violence. There is lot of pessimism and hopelessness among our youth. We as senior citizens need to take concrete steps to safeguard the interest of our young children and restore their self esteem. I didn’t deliberate on adverse affect of the conflict on quality of education for our children. The remedy lies in the legitimate, honest and permanent solution to the vexing problem of Kashmir conflict according to the aspirations of its people. It is needless to emphasize the honest role, not the rhetoric, of mainstream political parties in this regard.

(Dr Showkat Ali Zargar is Prof  & Head Gastroenterology, SKIMS and Chairman Cancer Society of Kashmir. Feedback at Showkatzargar6@gmail.com)

Lastupdate on : Sat, 7 Aug 2010 21:30:00 Makkah time
Lastupdate on : Sat, 7 Aug 2010 18:30:00 GMT
Lastupdate on : Sun, 8 Aug 2010 00:00:00 IST