Altaf Hussain
Dr Kodali Siva Rama Krishna Prasad

EXPIRED AND SPURIOUS MEDICINES
On 21 July 1999, it emerged that expired medicines were distributed to infants, children and women among poorer sections of the valley under the aegis of Integrated Child Development Scheme (ICDS). Official sources claimed that the medicines were supplied by UNICEF in coordination with ICDS through a pharmaceutical company based in South India. Curiously at the time of release of this report both the Director and Deputy Director of ICDS were out of State and were unavailable for comment. Furthermore, the State Commissioner for Social Welfare also claimed that UNICEF fixed the contract with the relevant firm, which then donated the medicines to the State Government.
On 18 September 2011, Dr G Q Allaqband, a renowned Physician, cautioned the Government unequivocally about the increasing use of fake drugs in Kashmir - “These drugs are taking toll on patients, who not only fail to recover, but develop symptoms detrimental to health.” It appears that spurious drugs are sold in full gaze of the State Health Department and within the knowledge of many doctors. Most of the spurious drugs appear to be dispensed from medical shops in the doctors’ Clinics or Nursing Homes.
It is just the tip of the iceberg. Sadly a seven day old baby died in G B Pant Children Hospital due to negligence of the doctors. The report suggested that he was injected an expired medicine. The death of the infant in the Children Hospital is not the first of its kind. Such deaths are not unusual in Government Hospitals. And majority of deaths go unreported.

POOR HOSPITAL FACILITIES
On 24 July 1999, it emerged that Lal Ded Hospital closed its outpatient department for more than a week due to lack of sufficient number of junior doctors because the State Government was reluctant to advertise job vacancies.
On the same day it was reported that the patients of the only Leprosy Hospital in the valley suffers neglect and is denied even basic amenities such as water, electricity and food. Medical Superintendent of the hospital blamed the crises to lack of State funding.
It is not merely the Government Hospitals that are in shambles. The situation in some private hospitals and Nursing Homes is also disconcerting due to lack of effective supervision by the Government and uniform standard of adequate medical care despite charging the patients exorbitantly. They may have become money spinners for the owners and doctors at the expense of population due to lack of effective control by the State Health Department.

RISKY BLOOD TRANSFUSIONS
On 23 July 1999, it emerged that SMHS Hospital and Lal Ded (Maternity) Hospital had run out of HIV and Hepatitis C blood screening Kits for more than 4 weeks.  364 blood transfusions (104 in SMHS & 260 in Lal Ded) were given without any screening despite increase in the number of HIV cases in the valley. Medical Superintendent of SMHS Hospital was characteristically unavailable for comment.

DRUG ABUSE
Srinagar, 13 November 2011: Government has failed to check the rampant drug abuse among the youth in the Valley. If measures are not taken to root out the menace, it will not only consume the younger generation but engulf the whole society. In addition, people risk addiction to drugs like Diazepam as these drugs are freely available without regulation. 

DOGS, AND DOG BITES
On 30 July 1999, it emerged that the incidence of dog-bites increased dramatically in recent years to a minimum of 5 cases per day. The patients in turn needed a painful course of anti-rabies vaccine for 14 days, which either was not available or if available only few days course was given inadequately, and patient often became septic. It is claimed that disturbingly, hordes of dogs mysteriously stray at night as if by design in many city areas.
On 28 September 2011, it again emerged in ‘Greater Kashmir’ that at least 53,925 people were bitten by dogs in Kashmir in the past 3 and a half years as disclosed by the officials during a seminar on Rabies Free Kashmir in Government Medical College, Srinagar. It is estimated that the dog-human ratio in Kashmir is 1:14 compared to the national ratio of 1:36.  Special awards were presented to the in-charge officials for their services in anti-rabies clinic at SMHS Hospital.
It is estimated that total deaths due to Rabies are 55,000 every year worldwide. 40 % of people bitten are children under 15 years and dogs are the source in 99% human Rabies deaths. Wound cleaning and immunisation within few hours after contact can prevent the onset of Rabies and consequent death. India has the highest rate of human Rabies in the world primarily due to stray dogs. United Kingdom, Ireland, Taiwan, Japan etc have very low rabies among bats. Australia and New Zealand never had Rabies.
Despite the very recent High Court directive that the state government should keep medical treatment for dog bites available in all districts even as it asked the Srinagar Municipal Corporation to file status report on the construction of dog pounds at Shuhama within a week. Effective translation of the directive into practice remains a priority.
Regarding dog population in Kashmir we are not sure if this is representative of the whole of Jammu and Kashmir State or only Kashmir. Vaccination and dealing with stray dogs should be a priority of any government and especially Kashmir State, where proper treatment for dog bites is not prevalent. Striking a balance between animal rights and human rights is vital.

RURAL HEALTH CARE
It is even more difficult to fathom what is happening to health care in rural areas of Kashmir. There are horrendous stories, which should never be heard in modern medical history.

Altaf Hussain is a Consultant Orthopaedic Surgeon based in London,
Feedback: altafhussain_uk@hotmail.com
 Dr Kodali Siva Rama Krishna Prasad is Staff Grade Orthopaedic Surgeon,
Prince Charles Hospital, Merthyr Tydfil, UK. Reach him Feedback: ambakrishna1950@yahoo.co.uk

Lastupdate on : Thu, 17 Nov 2011 21:30:00 Makkah time
Lastupdate on : Thu, 17 Nov 2011 18:30:00 GMT
Lastupdate on : Fri, 18 Nov 2011 00:00:00 IST