Every fall breaks more than bones in Kashmir’s walnut orchards

Srinagar, Oct 2: Behind the bounty of Kashmir walnuts lies a darker harvest.

Every autumn, as men scale the towering trees with nothing more than bare hands, hospitals across the Valley report a surge of labourers with devastating spinal injuries, many left permanently paralysed.

For 40-year-old Junaid Doyi of Pazngam village in Kokernag, Anantnag, the fall came in autumn 2018.

While harvesting walnuts, he slipped and was rushed first to the District Hospital Anantnag, then referred to the Bone and Joint Hospital at Barzulla in Srinagar.

After a month of treatment, he was discharged but left confined to a wheelchair for life.

“I was working as a labourer to take care of my family, comprising four daughters and two sons,” Doyi said. “Now two of my daughters are married, two are yet to be married. My elder son works as a labourer, and my younger son also suffered an accident and was partially paralysed. We barely manage our expenses.”

Doyi’s plight is far from isolated.

Across Kashmir, hundreds of men have been crippled for life after falling from walnut trees during harvest season, leaving families shattered.

“Our neighbour also fell and has been bedridden since,” said Mushtaq Ahmad of Tral, himself an orchardist. “I know at least a dozen people personally who are paralysed from walnut tree falls.”

Doctors say the crisis is both seasonal and severe.

“We have treated at least six patients this season with spinal injuries from walnut falls,” said a doctor at the Bone and Joint Hospital, Srinagar. “The most severe cases are shifted to super specialty hospitals like SMHS or SKIMS Soura.”

Dr Shabir Dhar , Professor at the Department of Orthopaedics SKIMS Bemina , said walnut tree injuries are unique to Kashmir and place an extraordinary burden on the health system in autumn.

“Most of the research on this injury has been done in Kashmir itself,” Prof Dhar said. “It is probably a knock-on effect as one set of researchers inspires another. But the pattern is clear that these injuries mostly involve young males, the productive section of the population, and they all occur in a short seasonal window, straining medical resources.”

He said that a fall from height is one of the leading causes of fatal and non-fatal injuries among adults, rivaled only by motor accidents.

Medical literature from Kashmir has repeatedly pointed out the devastating impact of walnut tree falls.

A study by Dr Asif Nazir Baba at the Bone and Joint Hospital, Barzulla, found that falls from more than 15 meters typically cause severe injuries due to high impact on hard ground.

“The commonest injuries are calcaneal fractures, wrist fractures from outstretched hands, head and cervical spine injuries, pelvic fractures, and long bone fractures,” Dr Baba mentioned in the study.

“Spine fractures were seen in almost 40 percent of patients, with thoracolumbar fractures being the most common, followed by cervical spine injuries,” he stated. “Cervical spine fracture-dislocations are frequent because the head often hits the ground first. These are high-velocity injuries.”

He also pointed out another distinct pattern: brachial plexus injuries.

“When a person falls, he often tries to catch a branch with his outstretched hand, leading to nerve damage. In our series of 115 patients, two had brachial plexus injuries,” Dr Baba stated.

Earlier research by Dr Tabish and colleagues at SKIMS Soura in 2003 found that 45 percent of patients admitted with walnut tree falls had spinal fractures.

Of these, 20 percent developed quadriparesis and 25 percent died, largely due to associated brain injuries.

A 2009 study at the Bone and Joint Hospital recorded 37 spine fractures among walnut fall victims, with 17 percent suffering neurological deficits.

Another hospital-based series involving 54 patients found that 92.6 percent were male with a mean age of 48.

Spinal injuries accounted for 44.4 percent of cases, particularly wedge compression fractures in the lumbar region.

One large dataset showed spinal injuries at 18.1 percent overall, with thoracic fractures (7.8 percent), lumbosacral fractures (6.3 percent), and cervical fractures (3.9 percent).

The mechanics of falling from a walnut tree make spinal injuries especially common.

“This is because the worker falls through branches and may hit multiple obstacles on the way down,” said Dr Dhar. “The cervical spine is especially vulnerable, being both mobile and fragile. Anything can break on the way down.”

Associate Professor at GMC Anantnag, Dr Younis Kamal, said, “Unlike smaller falls, these accidents often cause burst fractures of the spine and complex fractures of long bones. Many victims land on their heads or shoulders, making the cervical spine highly vulnerable. That’s why we see so many neck fracture-dislocations.”

Dr Kamal said that brachial plexus injuries – leaving arms weak or paralysed - are also common.

“Unfortunately, many spinal cord injuries are complete, meaning permanent loss of movement and sensation below the level of injury. Only a small fraction of patients with complete injuries regain meaningful function,” he said.

In the past two months, Kamal’s department has operated on over 10 walnut fall patients.

“Three of them had complete paraplegia,” he said.

Despite years of data and repeated warnings, the problem persists.

According to official data, at least five people have died this season, dozens more are crippled for life, and hundreds are being treated for broken limbs and fractures.

As the walnut harvest would continue for two more weeks, doctors fear more tragedies.

“Every fall from a walnut tree is a potential spinal cord injury,” Dr Dhar said. “And for each patient, it is not just a broken body, but a broken family.”

So, the price of Kashmir walnuts is often not counted in rupees but in wheelchairs, crutches, and coffins.