Gauri Healthy Heart Project | A Tale of Woes

The township though not strictly a Kashmiri Pandit colony, is largely inhabited by them. Kashmiri Pandits, Brahmins of the Shaivite Saraswat community, have been the original inhabitants of the valley. They are the only remaining Kashmiri Hindu community native to Kashmir before very large numbers got converted to Islam under the influence of Sufi preachers from Central Asia and Persia in 14th century.

Their population in the valley has been declining steadily.  In 1947 they formed only 6% of the population of the valley and by 1950 it declined further to 5% mainly because of the uncompensated land reforms policy, unsettled nature of the accession, and economic decline. Their population in the 1981 census was around 1, 25, 000 and by 1990 it had gone up to around 1,65,000. The militancy of 1989 forced a large number of them to migrate out of their havens in the valley to Jammu or the NCR. All of them had houses of their own with some land for cultivation before leaving their beautiful abode.  Their numbers in the valley have become abysmally small with only around 3,500 without any seeming increase.

Around 60,000 Kashmiri families are today still registered as migrants. They are predominantly Pandits but also include Sikhs and Muslims. In the initial years these unfortunate families had a harrowing time in makeshift camps in Muthi, Purkhoo, Butta Nagar and near Jagti village on outskirts of Jammu. Ultimately in 2012 the J & K government allotted 4,224 two-room flats to them in Jagti Township, near Nagrota in Jammu.  At present it has around 20,000 residents living there. Additionally, they get a cash relief of Rs 2,500 per member (Rs 10,000 maximum for a family) and 9 kgs of ration per month.

The team of GHHP went to the township after informing the residents with high BP or diabetes mellitus with or without pre-existent diabetes to register with our representatives for the Healthy Heart Camp on 29th and 30th January 2021. The venue was Govt Middle School and it was done in collaboration with Aman Movement and Helpline Humanity, NGO based in Jagti.

As you enter the township, one is struck by the facial and body language of the people walking up and down. Majority of the people are elderly with sadness and isolation looming large on their faces. They come mostly from villages of different districts of the valley and only small numbers from the Srinagar city.

We examined 210 subjects but got complete data of 143 individuals which has been analysed. Eighty percent patients were in the age groups of 40 to 79 years with 51% females. Almost all were Kashmiri speaking, with one third of them un-employed. Thirty-eight percent of the persons were below the poverty line with incomes less than Rs 15,000 per month. Their physical activity levels in general were moderate with 60% spending more than 30 minutes on walks. Consequently 73% were overweight and one third being obese based upon the body mass index (BMI). Majority of persons seen by us were non-smokers (81%)

Uncontrolled BP – A striking observation:

More than half of the population seen by us had history of high BP and were on drug treatment. It was very concerning to note that around 55% of these had un controlled BP’s (>140/90 mms Hg) with half of them more than 160/100 mms Hg predisposing them to strokes, heart attacks and kidney failure. A very alarming finding was that 40% of those with uncontrolled BP had additional diabetes, making them sitting ducks for complications.

Diabetes with Poor Control despite treatment:

More than one third patients (48/143), who presented to us had known diabetes. There were 15% patients with both uncontrolled BP and sugar levels >180 mgs/dl, a very high-risk population. Since all patients examined had blood sugar done, we detected 6 new patients with diabetes, who were un aware of it. They were advised further evaluation and started on treatment.

Adverse Lipid patterns:

The population seen had a high prevalence of post meal triglycerides > 200 mgs/dl in 55% patients and one quarter of them had high levels of bad cholesterol (LDLc) also. Of these patients with high triglycerides, 42% had diabetes and 30 % had additional diabetes and high BP. This combination is particularly vulnerable to vascular events and needs aggressive management.

Psycho-Social Issues:

Another important issue seen in a large number of the patients examined was depression, feeling isolated, behavioural disorders, ranging from a state of fearfulness, crying, irritability, and refusal to be left alone. Many of them were carrying prescriptions of anti-depressants and sleeping pills. These issues are also known to aggravate diabetes and high BP. Apparently drug abuse was not being talked about but it is a perfect milieu of getting into it especially for the younger population.

In the 2 days of the camp every patient was seen and investigated and prescribed cost-effective medications and counselled for healthy life style as a part of our mission. They will be followed up periodically by our team in months to come.

Lessons Learnt:

The population living in the township is a sick population with uncontrolled BP diabetes, poor fitness and bad lipid profiles. It is several folds more than the districts of valley we visited. Neglect and psycho-social factors could be playing a very important role for these alarming findings. This has important implications and challenges not only for the administrators but also for the people of the valley, who have been a part and parcel of these unfortunate souls. These families had to leave their homes for no fault of theirs.

GHHP is committed to work on the lines of facilitating health heart care with an aim of “No Heart Attacks” for the residents. The township will be receiving a Telemedicine facility shortly to take care of the issues of high BP, diabetes and proper diagnosis in time for people in and around the township, with video conferencing with experts.  However, there is a crying need for providing them psychological support by specialists visiting the township periodically. Cultural rejuvenation of Kashmiri music and giving them assurance and moral courage to return back to their land. This is a dream of most of them who feel caged there.

Acknowledgements: The staff and team of Aman Movement, Team Helpline humanity NGO Jagti Township, Research Team of Batra Hospital, New Delhi (Ms Priyadarshani Arambam, Nomita Thounaojam and Siddhi Maheshwari), Dr V K Misri and Mr Mushtaq Ahmad Chaya.