Kashmir’s well deserved reputation as paradise on the Earth currently projects as a hell for the people but heaven for the rulers.
We have an overriding obligation and duty to alleviate the human suffering resulting from human violence. The deterioration in medical facilities and services in the state of J&K should be a concern for all Kashmiris, and even more so for those of us in the medical community.  Clearly, the state has been unable or unwilling to provide an adequate and functioning health system, even at a very minimum level.  The result is what we have at present, a health system that continually fails the vast majority of the citizens of our state.
Given the political upheaval of the past 20 years, it would be a mistake to presume that solutions that have worked elsewhere will necessarily work in J&K.  Quite obviously, we have to develop long term projects, particularly in remote worst hit areas alongside communities and health service providers.  The focus should be to help women, children and men - who in many cases are the only earning members of their families - to achieve better health and well-being. Our priority needs to be those people and communities most affected by conflict and political instability. These are the ones who are unable to access routine health care and are dying prematurely through ill-health and disease.
As part of our drive towards self reliance, our people should take their health into their own hands and we should join them in achieving this.  We should ensure that every intervention in the lives of our people develops the strength and well-being of their families and communities, as well as their ability to look after their own health, education, employment, training, language, culture and economy.
We have to develop better communication between patients and health professionals.  This has been a much neglected problem not only in our state but elsewhere in the world.  Much has been achieved in this regard in the leading industrialised nations; consequently, it is no longer possible for us to ignore this vital aspect of the doctor-patient relationship.  However, it is also true that such vital training needs to be provided by the state, especially when poor communication in public services including health is not the exception, but the rule, in our state. Patients have to tolerate bad manners, foul language and in some extreme cases, physical violence.  This kind of inappropriate behaviour has occurred both at the gates of the large public institutions and also in the private clinics of those who run the family health and medical education of our state. 
Access to adequate and proper health facilities should be a most urgent imperative of our society.  A measure of accountability amongst health professionals would be beneficial as it would clearly result in a more efficient health service. These changes need to be implemented so as to facilitate the provision of first-rate health services to all, whether they reside in a border area, town, village or in the capital, and irrespective of whether the provision of health services is through a dispensary, primary health centre, district hospital, city hospital or institution.  Increasingly, these deficiencies highlight the need to improve and develop the curriculum for medical education and training and educating people of their rights.
These goals are a basic and most fundamental necessity in our difficult transition to a just and civil society and we have an overriding obligation and duty to preempt and alleviate these human suffering of our people. 

Altaf Hussain
Consultant Orthopaedic Surgeon
United Kingdom
altafhussain_uk@hotmail.com  

Lastupdate on : Wed, 2 Mar 2011 21:30:00 Makkah time
Lastupdate on : Wed, 2 Mar 2011 18:30:00 GMT
Lastupdate on : Thu, 3 Mar 2011 00:00:00 IST