Heartbeats among Ruins

It wasn't the first time I had traveled this road, the road that winds through Pulwama to Shopian—nor the first time I had been jolted out of the lulling rhythm of the journey by the haunting sight of charred houses standing starkly amidst the blazing red of the Chinar trees.

This time, however, what caught my attention were the clusters of vehicles—public and private—gathered outside a newly constructed building. A modest, single-story structure, it bore a sign that read Prasad Joo Khan Heart Center. The scene was lively, with people of all ages moving in and out. Some stood by a small tea stall outside, sipping their tea. An ambulance sped up the road and parked at the entrance, adding to the sense of urgency and life that pulsed through the place. It was a stark contrast to the somber image that the village of Haal had carried for decades.

Haal, located at the brink of Pulwama and Shopian, had long been a living testament to loss and grief, a village marked by the absence of those who once called it home. In the early 1990s, when the conflict in Kashmir took a violent turn, around 80 Pandit families who lived here began to leave. Over the years, almost all homes were abandoned, and scores were burnt down, leaving behind empty shells and memories of lives that once thrived. The newly opened Heart Center, brimming with activity and hope, seemed to reclaim a space long defined by sorrow.

Prasad Joo Khan Heart Center 

Established by the Gauri Kaul Foundation, the Prasad Joo Khan Heart Center Haal is the first and only cardiac facility situated outside the capital city of Kashmir. This center provides essential cardiac care and diagnostic services to neighboring districts, where such facilities are otherwise scarce. It is a fully equipped diagnostic and treatment center addressing not only heart conditions but also other non-communicable diseases (NCDs). The Center’s facilities include ECG, echocardiography, ultrasound, treadmill testing, long-term ECG monitoring, and head-up tilt testing. Critical blood biochemistry tests are available, including rapid point-of-care diagnostics that provide results in just 10 minutes, aiding in the detection of heart failure, heart attacks, and blood clotting disorders. Additionally, the Center has a well-stocked pharmacy managed by a certified pharmacist, ensuring that patients have immediate access to necessary medications. Patients can complete their assessments, receive diagnostic results, and start treatment all in a single visit. If advanced care is required, patients are transported by ambulance to larger hospitals.

The Center was established between 2020 and 2021, with funding from the Corporate Social Responsibility (CSR) initiative of the Oil and Natural Gas Corporation (ONGC). It was formally inaugurated in September 2022 by Dr. Alka Mittal, then CEO of ONGC. The facility is located on land that has personal significance; it is an ancestral property of Prof Upendra Kaul, a renowned cardiologist who spent his early years in Haal village. Prof Kaul’s career has been distinguished: he served as a Prof of cardiology at the All India Institute of Medical Sciences (AIIMS), along with several other esteemed institutions including the Post Graduate Institute of Medical Education and Research, G. B. Pant Hospital, Batra Hospital, and Fortis Health Care. He also held prominent roles as Executive Director and Dean at Fortis Health Care in New Delhi. A former president of the Cardiological Society of India and the SAARC Cardiac Society, Prof Kaul is a Fellow of both the American College of Cardiology and the National Academy of Medical Sciences (NAMS). With over 450 published medical papers, he was honored with the Medtronic Award for Best Scientific Paper in 1983. In recognition of his contributions, he was awarded the Dr. B. C. Roy Award in 1999 and the Padma Shri, India’s fourth highest civilian honor, in 2006.

Prof Kaul considers the Heart Center as his way of giving back to the community. “It’s incredibly fulfilling to return here,” he reflects. “I’m present every Thursday, and with God’s grace, we have treated many severe cases of heart failure—patients who were misdiagnosed as having pneumonia or post-pregnancy breathing issues. Thanks to the correct diagnosis and appropriate treatment, these patients recovered dramatically. We have point-of-care tests available, which allow us to make quick and accurate diagnoses. This not only reduces the need for multiple visits but also minimizes the travel burden for patients. We use heart failure markers, HbA1C for diabetes management, and a variety of other diagnostic tools to ensure comprehensive care.”

Although the Center’s services are not free, there are provisions to assist those who cannot afford the costs. “The goal isn’t to deny care based on financial constraints, but to offer specialized services that are otherwise unavailable in rural Kashmir,” Prof Kaul explains. “Without this center, cardiovascular diseases, diabetes, and other NCDs would often be diagnosed too late or treated improperly. Our patient base comes from all over—Shopian, Kulgam, Pulwama, Anantnag, Rajouri, and even Poonch. One thing I’ve noticed is that patients in this area tend to be very diligent about following treatment plans.”

He envisions transforming the Heart Center into a full-fledged heart hospital, capable of performing procedures like angioplasty, but acknowledges that current financial limitations are a barrier. “If funding materializes, it’s certainly within reach,” he says. “At present, we have a dedicated team, including a cardiologist, a general physician, and a nephrologist, and many other doctors.”

Heart on Wheels

An additional grant of ₹80 lakh from Indian Oil Corporation Limited (IOCL) is set to fund a mobile "Cardiac Clinic on Wheels" by the end of the year or early next year. This mobile unit will be equipped with diagnostic facilities such as ECG, a portable echocardiography machine, and on-site blood sampling equipment, enabling tests that yield results within a few hours. This mobile service will visit villages across South Kashmir, following a pre-announced schedule. The first installment of ₹20 lakh has already been received, and the clinic is expected to be operational early next year. Patients requiring advanced care will be transferred to the Heart Center, and if necessary, to larger hospitals like SKIMS Soura or SMHS Hospital.

All in a Day

As Prof Kaul shares these plans, the waiting area of the Center continues to fill with patients. Some are visiting for the first time, others are regular attendees, for follow-ups. He returns to his desk, beginning with an elderly man in his late 60s who anxiously hands over medical documents. “Is my heart alright?” the man asks urgently. Prof Kaul checks his blood pressure, carefully jots down from his investigations, asks a few questions about his medication. The man answers impatiently, and repeats his question: Is my heart alright? Prof Kaul looks at him and answers: It is alright for now, the stent has set the things right. But if you don’t stop smoking, it is not going to be alright.  The man’s stern look gives way to a shy smile. “I have stopped,” he answers unconvincingly.

The next patient is a woman in 50s, accompanied by two female family members. She has had heart failure, but has dramatically improved ‘in just one week’ as she puts it. She has adhered to medication and wants to know if she can go about her daily routine of household chores. “Not yet. Let others take care of the house and of you for sometime. We need to perform a procedure on you,” Prof Kaul says, while explaining to her family members where and how to approach the Cardiology department at SKIMS, Soura. “We don’t have everything possible in this center. They will take care,” he says while jotting down names of a few doctors on the prescription.

The group of women leave the room heavy hearted, when a young female walks in with her father. She shows her ECG reports and a few blood tests. She has been to a few nearby Government hospitals in the recent past. “I have pain in chest and it recurs very frequently,” she complains. After examination, Prof Kaul tells her to get a few more blood tests done. The girl is preparing for a competitive exam. Prof Kaul tells her to relax and take less stress. “Let us rule out there is nothing else, but it seems your pain and fast heart rate is due to stress,” he tells her, and reassures her father.

The beeline of patients continues. “I will be here the whole day, these people wait for me the entire week,” he says.

In the waiting hall, patients exchange stories about other healthcare facilities they’ve visited, often discussing common issues like uncontrolled diabetes and hypertension.

Addressing Non-Communicable Diseases

Kashmir and Ladakh face a significant public health challenge: nearly one-third of adults in these regions have hypertension. According to the Indian Council of Medical Research (ICMR), 30 percent of adults in these areas are hypertensive. Prof Kaul’s camps in south Kashmir, extending up to Banihal, have revealed that hypertension, often due to non-compliance with treatment, sedentary lifestyles, and inadequate follow-ups, is a widespread issue. “There’s a knowledge gap concerning proper treatment and lifestyle modifications,” he points out. The Gauri Kaul Foundation has worked with local physicians, advocating for combination drugs to enhance compliance, reducing the chance of missed doses.

In a study published in the Indian Heart Journal titled Uncontrolled Hypertension in Rural Kashmir, Prof Kaul and his team reported that 63 percent of known hypertensive patients in rural Kashmir had uncontrolled blood pressure. The study highlighted a particularly high prevalence among individuals aged 40 to 60 : 49 percent, followed by those over 60: 40 percent. Prof Kaul emphasizes that “hypertension is a global problem, but accurate diagnosis and consistent, correct treatment are critical.” To address this, the GKF’s SUPPORT program has empowered communities to take charge of their health. In collaboration with St. John’s Medical College Bangalore, they’ve initiated educational programs on blood pressure monitoring and when to seek medical help.

Expanding Services and Honoring Roots

Beyond J&K, the Gauri Kaul Foundation has expanded its outreach by organizing health camps in Manipur and Maharashtra, and it has run cervical cancer screening programs in Kashmir. One of the most impactful projects is the Telemedicine and Critical Care Ambulance initiative, funded by the CSR of IOCL. This program brings specialized healthcare to remote and difficult-to-access areas, such as Kupwara’s Machil sector near the Line of Control. In partnership with the Rashtriya Rifles, the Foundation operates a tele-unit that can perform ECGs, conduct crucial blood tests, and connect patients to distant physicians for immediate guidance. Essential medicines are also stocked in the unit. A similar telemedicine unit has been set up at Jagati migrant township near Katra, Jammu, serving displaced Pandit communities who left the Valley in the 1990s.

In addition to these efforts, the Foundation has collaborated with local healthcare workers to organize cervical cancer screening initiatives. These camps, held periodically, have raised awareness about preventive health measures and provided vital screenings for women in rural areas. In regions like Manipur and Maharashtra, the Foundation's outreach has focused on broader health concerns, including NCDs, maternal health, and basic preventive care.

Prof Kaul believes in the importance of giving back to one’s roots. “I returned because this is where I grew up—my family’s home was in Haal village,” he says. “Our home is just memories and an abandoned house in Haal, but my connection to this place is strong. People in these rural regions need specialized care. We can save more lives if we expand access to advanced cardiac care. It’s essential for more healthcare professionals to support this mission. Doctors from rural areas have a unique responsibility to their communities.”

WHAT’S IN THE NAME: PRASAD JOO KHAN

The grandfather of Prof Upendra Kaul, Prasad Joo, worked with the Afghans and was given the title of Khan. The revenue records have their family name as Joo Khan. When Prof Kaul’s father pursued higher studies outside Kashmir, he found people amused by his name – Prem Nath Khan. Prem Nath, out of urge to avoid attention, changed his surname to Kaul, the common surname of Kashmiri pandits. “Thus, I became a Kaul, while my grandfather was Joo-Khan,” Prof Kaul shares with a smile.