How terminally-ill and poor patients suffer in Kashmir

Refer to Srinagar: Anantnag hospital's lone remedy for maternity patients

For Kashmir’s poor, having meager financial avenues, health emergencies turns into catastrophe, pushing them deeper into abyss of penury, sometimes turning their chances of survival bleaker. The state government’s own data shows that around 93 percent of people in the Valley have no health insurance which in turn adds to the problem of health emergencies for the poor as entire burden of treatment falls on pockets of the family. In case health issue turns serious, families have been often forced to sell their land and house to meet treatment expenses. For such situation the idea of hospital corpus fund could have proven a balm for the poor patients. Many doctors across Kashmir hospitals however believe that most often than not the hospitals have limited financial capacity and are “stingy” when it comes to helping poor. Moreover, there often are complaints of the long procedures that defeat the purpose of timely interventions. Breaking away from the dependence on the Corpus fund, a group of young doctors last year started a cardiac emergency support system which they called “Stent Bank” to provide stents to poor patients free of cost when they land up for treatment at hospitals run by Government Medical College (GMC) Srinagar or Sher-e-Kashmir Institute of Medical Sciences (SKIMS), with a heart block. One of the founders of the initiative, Dr Irfan Ahmed Bhat, a cardiologist at the GMC explained the procedure. He said sometimes they receive a patient who needs a stent and family expresses inability to arrange it. “We then seek patients’ details and all the five founders of the Bank discuss the case and when we are satisfied that the patient needs assistance, we flag the requirement to doctors across the globe, mostly Kashmiris. Someone chips in with the help to the patient and his or her life is saved,” said the doctor.

The financial assistance, Dr Bhat said, is transferred directly to the drug counters of SKIMS and GMC and the cash doesn’t changes hands. “The donor pays for the stent at the sale counter directly. This way, our system stays transparent,” he said. Till date, since its inception, the Bank has helped save lives of many patients. Connected to ‘Save Heart Initiative’, a WhatsApp group of doctors that was started in 2017 to addresses cardiac emergencies, the Bank aims at expanding its ambit of interventions to all cardiac emergencies and fund pacemakers, wires, balloons and drugs for poor patients with heart ailments. “We depend on philanthropists. The more they come forward, the more lives are saved,” Dr Bhat said. However, the ambit of Stent Bank leaves out hundreds of other conditions where patients have to bear huge treatment costs. This includes patients with other heart diseases, various types of cancers, chronic kidney disease, burns, accidents, strokes and other health conditions. For these patients, the dearth of financial resources for treatment has no reprieve. At SKIMS, ‘the SKIMS Endowment Fund’ aims to cover treatment costs of poor patients undergoing treatment for cancer. The Fund however runs on contributions from people, masses and philanthropists and its coverage, an official at SKIMS said, depends on how much contributions are received. Prof Omar Javed Shah, Director SKIMS said that the fund was a small initiative but nevertheless helps the Institute extend help to the needy. “We usually cover life threatening diseases through this fund and we have other schemes also, which we try to help poor patients avail,” Prof Shah said. He however, added that the Institute would have been “better equipped” to help impoverished populations with treatment costs if “more and more people could come forward for the cause”. He said that it was the collective responsibility of society and urged people to donate for healthcare. “When people look around in Ramadhan and at other times to help the needy, we should also think of hundreds of poor bereft with diseases who have no money to bear treatment cost,” he said. At the GMC there is no institutional corpus fund, which many doctors at the hospital feel often forces poor patients to misery. Although costs of diagnostic tests are slashed and sometimes waived off by hospital administrators for poor patients, the costs of medicines, surgeries and other treatment procedures falls entirely on the pockets of the patients. At times however informal small funds are managed by employees, doctors and others to help patients having suffered burns and some other health conditions. The newly appointed GMC Principal Prof Kaiser Ahmed feels that donating for treatment of poor people in hospitals was the best means of charity. “There could be nothing better than helping a fellow human being recover from a disease for which he or she is unable to bear the costs,” he said. He added that in many hospitals across India, people have wards in their names. “These wards are built and run by philanthropists and have helped thousands of people, even many from Kashmir, to recover without any treatment cost to the patient,” he said. He urged that “public participation” in healthcare would help in building participative hospitals. “Healthcare is for all, and all must feel the responsibility towards it,” he said. In peripheral hospitals also, there is no system of funding poor patients’ treatments. A senior hospital administrator of a district hospital said that many patients seek alms when faced with a health emergency. “Some even are pushed to into debts but there is no way we can help them,” he said.

An official in health and medical education department said that the government has a fund to help poor and needy patients but added that the scope of this fund was “too narrow”. Moreover, he said, the procedural delays defeat the purpose. He said that hospitals need to be empowered to create corpus funds to help the needy. “Government needs to come forward and facilitate this rather than create hurdles,” he said.