Oral health services: ‘Too little’ to smile about in Kashmir

Dearth of manpower, inadequate infrastructure in rural hospital, and dental quackery - government needs to address a host of issues to ensure healthcare delivery in Kashmir

Zehru Nissa
Srinagar, Publish Date: Dec 18 2018 10:39PM | Updated Date: Dec 18 2018 10:39PM
Oral health services: ‘Too little’ to smile about in KashmirFile Photo

Oral health is critical to general health and well-being of a person. Though there is no study to suggest about importance attached with oral health in Kashmir, inadequate manpower and infrastructure in hospitals to provide services amid growing rush of patients seeking better care has not only resulted in “deterioration” of services but is pushing people to quacks, putting their lives at risk. In 2016 the government had “agreed” to clear a proposal for creation of 500 posts of dental surgeons – 300 for Kashmir and 200 for Jammu - and 100 posts of consultants for peripheral hospitals across J&K. Two years on the proposal is yet to see light of the day. “The authorities have failed to get an important health message across - that oral health goes has implications for overall well being of a person,” commented a doctor. The fact that 95 percent of overall patient load in Kashmir is dependent on government sector talks about the need to strengthen dental services as well. But the situation on the ground shows that augmenting the sector is the least priority of the government. There is just one dental surgeon posted in each Community Health Center (CHC) and two surgeons in a district hospital (DH). Data sourced from directorate of health services Kashmir reveals that in most community health centers (CHC)/sub-district hospitals (SDH), the total out patient load exceeded 12,000 between April 2017 and March 2018. In district hospitals (DH), such as Anantnag, over 51,496 patients were seen in OPD during reference period. In DH Baramulla, over 25000 OPD load was registered. These patients included those one also who needed different procedures including extractions, filling and scaling and were numbers in thousands. Specialists in the field have for long rued that due to high load and poor strength of dental surgeons to cater to it, quality of dental procedures was deteriorating. “What kind of quality can we expect when a single dental surgeon has to see 50-100 patients in OPD and also carry out 15-30 dental procedures in a single day,” said a specialist, adding scanty human resource was harming health of people in “more ways than can be imagined”. “The most dangerous consequence of high load is non-adherence to infection control protocol sometimes,” he said. In addition, he said, lack of manpower and growing patient load was also pushing people to seek services outside hospitals. They often end up in hands of quacks. Medical experts have for long warned of impending threat of infections due to unregulated dental sector. A senior faculty member who teaches at Government Dental College (GDC) Srinagar said that a dental procedure requires same attention to infection control as in any other surgery. “An infection such as hepatitis can spread through a dental extraction as in a surgery of gall bladder,” he said. “There is a dearth of modern sterilization even in most equipped of the hospitals. It has also been seen that in most clinics, sterilization process is grossly inadequate.” In addition, lack of regulations and mechanisms to check menace of quackery in Kashmir was allowing quacks and unregistered dental clinics to “easily get away” with risky practices. “Why we still have road side quacks offering to carry out dental procedures?” the faculty member asked. This year, health department initiated a drive against unregistered and illegal clinical establishments. During the drive scores of clinics, including dental clinics were sealed. Many of these clinics were being run by people with no qualification in dentistry. However, these drives, medical experts feel are “far too little” to curb impending dangers of unsafe dental procedures. Doctors feel that patients are forced to visit quacks also owing to high cost of dental procedures. Dental health procedures are costly in private sector and in government hospitals, patients are often not given adequate attention due to patients’ load, a senior dentist working in a peripheral hospital said. He termed it was one of the reasons that led to improper oral healthcare and surge in blood borne diseases in some areas. A study carried out on spread of hepatitis C infection in Takia Magam village of Anantnag published in Bacteriology and Virology Research is an eye opener. The study found that there was “a significantly high prevalence of dental procedures among cases”. The study advocated “sterilized equipment during dental procedures” based on their findings in order to put a halt to spread of such viral infections that have assumed “dangerous proportions” in some parts of Kashmir. “We hope government will understand importance of upgrading oral healthcare in the state and expedite processes to secure health of people,” said President J&K society of dental surgeons Dr Imtiaz Banday. Urging the government to expedite the process for clearing 2016 proposal Dr Banday said there was a need to create more posts. Commissioner secretary health and medical education Atal Dulloo said the proposal was under consideration and a decision was expected “soon”. “We are aware of shortfalls of doctors in the field. Hopefully the proposal will soon be decided upon soon,” he said.

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