It is the duty of every health professional to ensure not only the best health care possible, but a comfortable stay at the hospital
Dr. Mehreen Riyaz Kokiloo
Scottish medical missionaries were the first to establish modern medical health services in Kashmir. The first dispensary for women was started way back in 1864 by Reverend Robert Clark and his wife, which is now the site of the Government College for Women, Nawakadal. Later, a Scottish doctor, William Jackson Elmslie, opened his dispensary on 9 May 1865. Dr Theodore Maxwell succeeded Elmslie and persuaded Maharaja Ranbhir Singh government to give land at the foothills of Solomon’s Hill in Srinagar for the construction of modern hospital.
Dr. Arthur Neve and his brother Dr. Ernest Neve, converted the dispensary at Soloman Hill into an 80-bed Mission Hospital on modern lines in 1888, which in 1893 become 135 beds Mission Hospital. Kashmir Valley had an epidemic of cholera in 1896 and an outbreak of the plague in 1903–1904, which cost thousands of lives. The Mission Hospital team was at the forefront of relief work and helped the local administration in setting up medical facilities in various towns; including the opening of a new well-equipped hospital in Srinagar. At the site of the old Mission Hospital in Srinagar now stands the largest Chest Disease Hospital in the valley, a monument to the great medical missionary pioneers who laid down their lives in the service of the Kashmiri people.
Simultaneously, Dr Edmund Downes and his team built an asylum for mentally sick person in 1881–82, which is now Psychiatry Hospital, Badamwari. This was followed by opening of Leper Hospital in 1891–92 in the same area. On 15 August 1888, a dispensary that later became a hospital exclusively for women (Lalded) was opened by the Church of England Zenana (Ladies) Missionary Society. Likewise, now Jawahar Lal Nehru Memorial Hospital (JLNM), Rainawari was started as Mission Hospital in 1989.
Many years later, a British official in the imperial court of Maharaja of Kashmir, proposed a hospital for poor population near the carpet factory in the outskirts of Srinagar city. There is a folklore associated with this hospital. It is said that the official who proposed the plan for the hospital also donated the land for this pioneer hospital. The name of the official was Sir Heedo. Sir Heedo had a son who had some sort of congenital anomaly. After years of treatment by the best doctors in the world his son could not be saved. This incident moved Sir Heedo. He felt more sympathetic towards the poor people of Kashmir. He then proposed the plan for hospital, donated the land and as well as arranged for the funds and missionary doctors from Europe. After everything was settled, Maharaja then gave money for construction of the hospital. The hospital started functioning in 1948 and was named as Sri Maharaja Hari Singh Hospital. But majority of people of Kashmir still call it Hedwun Hospital (Heedo’s Hospital). After the independence, Government opened many primary health centers at districts and major towns. Subsequently, Government Medical College (GMC) started functioning in 1959 at Hazuribagh on the banks of the Jhelum River. The building was later shifted on the campus of SMHS in 1961. S.M.H.S hospital became a major teaching institution imparting undergraduate and postgraduate medical training in all allied specialties of Medicine, Surgery and Gynecology. The old location now houses the Lal ded hospital for women (Obstetrics and Gynae) associated with GMC Srinagar. It is pertinent to mention here that SMGS (Sri Maharaja Gulab Singh) Hospital at Jammu started functioning from 1940. Both hospitals are called Sadar Hospitals.
The major breakthrough in the modern medical era in Kashmir came in 1970’s when Sheikh Mohammad Abdullah proposed the state of Art, super specialty hospital in his home village Soura. This hospital was named after its founder as Sheri Kashmir Institute of Medical Sciences. During its inception SKIMS was considered one of the best hospital and research Centre in India.
During late 1980’s SKIMS was considered among top 5 government run research Centre’s in India. Also, during this time many national and international seminars, workshops etc. were held at this premier institute.
A semi private medical college called Jhelum Valley College (JVC) was established at Bemina, Bye pass in early 1990’s. After functioning independently for few years it was taken under the wings of SKIMS, which has been upgraded to deemed university at the beginning of political turmoil in Kashmir.
The political turmoil took and is still taking its toll on all the spheres of life in Kashmir including health services. With the inception of conflict in early 1990’s health facilities deteoriated because Government was uncertain and Kashmiri Pandit population left Kashmir. At that time most of the well experienced and qualified doctors belonged to this community. The Muslim counter parts in medical fraternity were less in number and young Muslim medical graduates had less experience. When most of the hospital staff migrated much work had to be undertaken by less experienced doctors as well as paramedical staff.
The migratory appointments which were latter regularized as well as illegal appointments in early 1990’s was very common scenario that also took its toll on health services as less deserving candidates entered government run hospitals.
The Hospitals and allied health services lost their credibility because there was no accountability on the part of doctors or para-medical staff or even other employees working in these hospitals. This scenario is prevalent even today. We can argue that during early 1990’s the condition and the situation in Kashmir was very disturbing as a result nothing constructive could have happened during those times. Hospitals had their own limitations in providing the best health care. But during the present times there can be no such argument regarding the condition of hospitals, health Centre’s and the attitude of staff working there.
Undoubtedly central government is providing money for the development of health care facilities in cities and towns with new schemes but there is not optimization of these funds in the Kashmir valley because of irresponsible and unaccountable governments. It is a well-known fact that most of the machineries in the government run hospitals don’t even function for a year after their installation probably because of mishandling and the patients are forced to seek private facilities. At the same time drug mafia is prevalent in these hospitals. A few years back tragic deaths of more than 100 infants in a couple of months’ span at GB Panth hospital shed some light on this very fact. People were assured that investigations and probes would be done and guilty would be charged but nothing major happened.
An article in the leading newspaper of India a couple of years back, stated that from the year 2007 to 2012 around 12,000 deaths have occurred in SKIMS and most of the causalities have occurred within 48 hours of admission that means on an average 5.5 deaths per day. This is an alarming figure of casualties in the hospitals where leading and experienced physicians and surgeons work and was before turmoil considered being one of the best hospitals in India. In the same article it was referred that there is an improper utilization of funds by the officials at SKIMS.
It is the day-to-day occurrence in Kashmir that people who can afford seek private health care. Most of the educated people don’t even trust the diagnosis in these hospitals specially in cases of life threatening diseases like cancer or any major operative measures like heart surgeries etc. People always tend to ask for the second opinion. Most among them go outside state for better heath services.
But the most important question here is not about the people who are well educated or well exposed or financially well. We as a society have to think about the less fortunate ones. Should they not be given the proper health facilities? Should a qualified doctor not be accountable to them? Should they be forced to seek private care that they can’t afford?
There are no doubts that public health sector has certain limitations not only in the valley but every where in the world, but it is the duty of every health professional to ensure not only the best health care possible by them but a comfortable stay at the hospital. A patient and his/her family are already under a lot of pressure and a least a health professional and allied hospital staff can do is to be accountable to their profession.
