On any given day, a walk through any of the Government hospitals exposes the gross shortcoming in our healthcare delivery system. Distraught, confused, miserable patients and their attendants wait in endless queues, get tossed from room to room and get lost in the spirals of procedures they have no idea about.
Before lamenting about these issues, it is important to put on record that 97 percent of the healthcare needs in J&K are met by the Government hospitals. This is not a guess but findings of the Manpower Audit Report of J&K Government carried out a couple of years ago. That means Kashmir’s hospitals cater to over nearly 70 lakh individuals, including their needs for pediatric health, geriatrics, maternity, accidents, emergencies, non communicable diseases and infectious diseases. The Government Hospitals are the mainstay for consultations, admissions, diagnostics and even referrals from private hospitals. The three percent share of private hospitals in the healthcare delivery is limited to consultations by specialists in evenings mostly, and maternity services for a few of those who can afford.
“There are 3972 health institutions consisting of 115 District/sub district hospitals, 259 Allopathic and 457 Unani dispensaries and Ayurvedic dispensaries, 412 public health centers, 460 medical AIDS and mobile units, 11 TB centers, 2081 family planning centers and sub centers and 55 leprosy sub centers and leprosy control units in 2010-11,” states and article titled Health Status and Access to Health Care Services in Jammu and Kashmir State published in Asian Review of Social Sciences. “As on 31-03-2011, 14165 beds were reported to be available in the health institution showing an increase of 3727 beds from 1999-2000 to 2010-11,” it says. Post this period, a Super Specialty Hospital and five medical colleges were added to the infrastructure, and much manpower and many more machines were pooled in to improve the delivery of services.
Despite this, the beelines of patients in the dilapidated hospitals lament and shout about insufficiencies on every front. The insufficiency inevitably leads to inefficiency, patient care getting compromised on every step.
Just as an example, lets look at SMHS Hospital. It is perhaps the most frequented hospital in Kashmir. The OPD registration counters and the OPD rooms are a source of untold distress and miseries to patients. While a queuing system has been established for OPD registration counters and the number of windows increased, the rush is still over capacity. The desperation and dependence can be gauged from the fact that at this 850 bedded hospital, which was till late designated a COVID19 hospital during the pandemic and its routine patient services suspended, 7 lakh patients were seen between March 2020 and March 2021.
The waiting areas of the hospital are always full during OPD hours, the benches all occupied, and tired, frail patients and elderly sit on the pavements and corridors waiting to hear their names being called in the ocean of people. In the doctors’ rooms, a group of patients is seen simultaneously, quickly. An extra question or a query from the patient can invite trouble from the doctor on duty, who has the crowd in mind while he or she is checking up the individual. The patients are rushed in and rushed out as hundreds are waiting outside and scenes of impatience, unruliness and indiscipline are the order of the day for the person manning the entries.
At SKIMS Soura, the spaces for registration are even narrower. Inside the hospital, the sheer number of people in a small confined space looks like a disaster. The Lal Ded Hospital, the GB Pant Hospital, the district hospitals, the sub-district hospitals, all have the same appearances and same issues. The diagnostic areas, labs, drug counters, payment counters are all inadequate or inadequately manned. The signage in hospitals has never been worked upon and patients are often lost about where to go for a particular purpose.
The condition of the civic facilities, the washrooms, the dining areas is hidden from nobody. Broken latches of toilets, blocked hoses of washrooms, broken taps, leaking pipes, overflowing sewers, clogged sinks and stinking atmosphere speaks about the success of the infection control measures put in place.
Much is being done to increase the bed capacity, the intensive care and the diagnostic paraphernalia in hospitals here. But first of all, the hospitals in Kashmir need decongestion. The hospitals need repair and restoration. The hospitals need benches, wheelchairs and signage. The hospitals need more manpower to improve the healthcare delivery. The patients definitely deserve better than what they get. They deserve a comfortable and dignified experience in the healthcare sector of Kashmir.
J&K needs a committed committee and a policy to improve how patients are treated in hospitals, not just their diseases, but themselves. The healthcare sector of J&K has won many awards at the national level; it can win the hearts of poor and desperate patients too.