Edit & Opinion

What Ails the Healthcare System of Jammu

 

 

With the blessings and divine care of Shri Mata Vaishno Devi Ji, Jammu appears to have survived “Murderous May”, the worst phase of second wave of Corona, as the daily graph has begun to ebb. Jammu is not only the victim of regional discrimination but also of departmental neglect and apathy. But for the close monitoring by the local administration, the Health & Medical Education (H&ME) Department had set the stage for a disaster. Only emergency measures have been taken to tide over the immediate problem, while there is no visible improvement in the functioning of the Department and the much-needed preparation for the likely third wave needs much to be desired. The question on every body’s lip is “why Jammu is suffering”? While the situation prior to 05 August 2019 was different and Jammu became a victim of regional discrimination, why there has been no improvement post that?

Between 1948 and 05 August 2019, the foremost aim of all administrations in J&K, duly backed by New Delhi, had been to “protect the Kashmiri identity.” That is what justifies inclusion of Article 370 and 35A in the Constitution of India and a separate flag and constitution for the erstwhile state. The authorities were so blinded by this single point agenda that their tunnel vision did not permit them to see and think beyond the Kashmir Valley, not even the entire Kashmir region leave alone Jammu and Ladakh regions which comprised 2/3rd of the then state. The entire focus was on Kashmir Valley be it connectivity, tourism, health or education. Jammu & Ladakh were deprived of the basic necessities of education and health infrastructure. For long Jammu remained dependent on the infrastructure created during the Maharaja’s rule.

Defying all logic and rules of provision of Medical facilities Srinagar was chosen to be the hub of healthcare in the State. The only tertiary care hospital was located at Srinagar. The rule says that no patient requiring critical health care should be moving backwards because it hampers shifting to a higher care hospital in case of an emergency. But here patients are expected to move rearwards for treatment in the only tertiary hospital. Logically, Jammu would have been the ideal location since from here the patients could be easily shifted to Ludhiana, Chandigarh or Delhi. The only logic of locating it at Srinagar was to keep it next door for the residents of signature Gupkar Road. If the privileged residents of Gupkar Road would need to move to Jammu, in case tertiary care hospital was located here, it would have been an affront to the Kashmiri pride.

To ensure better quality and well- trained doctors, the Kashmiri doctors were permitted to go to Dubai and other places for professional enhancement. Many of them drew their salaries in Kashmir as they were minting money in the Middle East. Some of them were removed from service but reinstated on return with old seniority and perks, kind courtesy Abdullahs and Muftis. No such largesse was shown for Jammu doctors who struggled to keep themselves professionally updated. No doubt Doctors Association of Kashmir (DAK) is a very professional body. Naturally, Srinagar also got maximum assets and resources.

While Kashmir continues to benefit from the benevolence of the Kashmiri rulers even today, why Jammu is not getting the due it deserves? The answer is simple. While the statutes may have changed, the bureaucratic mindset has yet to change.  In an earlier article, “Lack of Strategic Advice Hampering JK Government Fight against Covid,” the issue of unequal distribution of oxygen generation plants and lack of application of mind has been highlighted. Incidentally, in the month of May, the number of Covid patients requiring ICU beds was 10 times higher yet the bulk of OGPs received from Germany were installed in Kashmir. Take the case of Injection Liposomal, a life -saving drug for Black Fungus, a post-covid disease. Its availability is scarce and H&ME is procuring in batch of hundred. It is being divided equally 50-50 in both the regions, while in Jammu patients are dying due to its shortage and there are nil or hardly any Black Fungus patient in Kashmir.  A clear- cut example of appeasement and lack of application of mind.

The “Chalta Hai” attitude of H&ME Department is the biggest bane of Jammu and its only premier medical institution. “Murderous May” established beyond doubt the glaring lacunae in its functioning and management. A detailed investigation and interaction with certain functionaries, highlighted that most of the problems were self-created either due to lack of vision or purely due to inefficiency and ego-hassles.

Lack of resources was the major complaint of the patients and their attendants. Lack of manpower is clearly a self-created problem. The deficiencies of medicos, nurses and paramedical staff was not done in time, no action was taken to fill-up vacancies of those who failed to join duty despite being appointed. Financial Commissioner H&ME did not take any cognizance of the High Court order of 2017 regarding regularization of 90 employees employed on hire basis by GMC, Jammu. This inaction on part of the FC has put on hold the process of filling up 300 vacancies on different posts under 35 categories that has direct bearing on patient care in the hospital. Four years have passed since the court order but the FC remains indecisive under the belief, “No decision is also a Good decision.” But who suffers?

Similarly, is the shortage of medicos and senior doctors a self-created problem. While the academic arrangement faculty enrolled two years back for the new medical colleges even today, after the regular procedure of enrolling faculty has begun, continue to be paid an incentive pay between 40,000 to 50,000 per month. Moreover, the academic arrangement faculty is not subjected to biometric attendance. The amount is too high and attractive to leave behind and serve in GMC Jammu where there is no such incentive?

To top all this, MOs and qualified Specialists have been employed on administrative duties thus creating their deficiency in the primary and secondary health care centres, where their services are urgently needed in view of the corona pandemic. Since it is a means of sheltering and favouring the blue eyed, no amount of hue and cry affects the concerned authorities.

Another glaring omission and poor planning of H&ME department is in the rules governing the different medical colleges in JK. Usually, all states or UTs have same set of rules governing all medical colleges but in JK the HME department has played a different ball game with different recruitment rules for different medical colleges including the allotted posts of faculty and supporting staff. One set of rules govern GMCs Jammu and Srinagar where faculty positions are four tiers while 5 new medical colleges have three tier faculty by eliminating the post of lecturer. It would have severe ramifications in the future involving litigations leading to further deterioration in patient care. With this system, the chances of inter-college transfers get nullified. Moreover, all new medical college hospitals have no sanctioned posts of Asst and Deputy Medical Superintendents leading to administration deficit in these hospitals which in turn would affect the patient care.

Look at another insensitivity and “Chalta Hai” attitude. Preparing for the third wave, Principal GMC Srinagar has begun the process of recruiting 343 new faculty for 500-bedded Pediatric Hospital, while no such action to beef up or fill up the similar faculty in GMC Jammu has been initiated. While Srinagar benefitting from earlier mindset of “Kashmir First” has been provided a 500-bedded pediatric hospital, Jammu does not have any dedicated pediatric hospital. 200-bedded Maternity and Child Hospital and the SMGS Hospital cater for pediatric care with a meager staff which will prove woefully inadequate in case of third wave. But Principal GMC Jammu has neither displayed any vision or any emergency planning. There is not even a single pediatrician superspecialist post in entire Jammu region.

Jammu lacks even the basic necessities for the third wave. While Srinagar has 120 pediatric ventilators, Jammu has only 14. None available in primary and secondary health care centres at District level. Jammu’s geography and connectivity is much different from Kashmir has already been highlighted. The minimum requirement of Jammu region is 300 oxygen supported beds, 120 ICU or HDU pediatric beds. The Advisory Committee setup by the government has suggested an action plan which one sincerely hopes once again does not become victim of “No Decision” and “Chalta Hai” attitudes of the people at the helm. If it happens Jammu this time will be up in arms.”, A stitch in time saves nine,” should not be lost sight of by the admin.

There has been no dearth of funds. The Central government has been providing adequate funds for upgradation of medical facilities in GMC, Jammu. But there is inertia in spending the allotted amount. At times funds lapse without expenditure while Kashmir does not face any such problem. Skill centre in Jammu funded by GOI to the tune of 3.45 crore has yet to see the light of day while it became functional in Srinagar in December 2019. Funding due from GOI for enhanced PG seats under EWS seats have lapsed twice due to non- timely submission of proposal to GOI by GMC, Jammu and the H&ME department kept sleeping.

30 seats allotted under EWS quota are at the verge of de-recognition, putting at stake the budding career of students belonging to EWS, due to failure of GMC Jammu to create additional infrastructure mandated by MCI. 32 crores stand sanctioned for the purpose but lie unutilized. Not a single work has been started. Welfare of EWS is the major concern of Modi government but the authorities in Jammu seem to be least bothered about it.

As far as lack of resources is concerned, less said the better. The ventilators are lying unused and at some places even unpacked. Only yesterday media reports emerged of critical care equipment lying unpacked in the open and trucks waiting to be unloaded in an office of Health Department in Nagrota. The staff posted at 500-bedded DRDO hospital is not trained in operating BiPAPs and Ventilators and are hesitant to operate them.

Another victim of the high headedness and indecisiveness of HME department is the contract for maintenance of scarce bio-medical equipment. It is learnt that an outside firm hired for management and maintenance of the equipment has quitted due to non-payment of the contracted amount despite the fact that the amount has already been received from the central government. Who will be the ultimate sufferer, the common man?

Two longest serving Union Health Ministers belonged to the Jammu region, at least eight J&K Ministers of Health during the last two decades were from Jammu. What did they do to leave alone improve but at least bring at par with Kashmir, the health infrastructure in Jammu? They owe an answer to the people of Jammu? Was it lack of loyalty for Jammu or overbearing pressure to contribute towards protection of Kashmiri superiority or simple lure of chair? The Jammuites deserve an explanation so that they can understand what ails the healthcare system in Jammu?  Last but not the least. There is a definite need to order an independent audit by external experts of ventilators and unabated deaths in Jammu during “Murderous May” to fix accountability.


The author is a Jammu based veteran, political commentator, columnist, security and strategic analyst.

 

 

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About the author

Brig Anil Gupta

A featured contributor with The Dispatch, Brig Gupta is a security and strategic affairs analyst based in Jammu. One of the well recognized faces on the Indian Television debates, Gupta writes on a range of issues.

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