J&K’s healthcare sector continued to remain hobbled with incomplete projects, equipment shortage

Srinagar, Dec 3: The year 2024 would be seen as another year in which languishing projects in the healthcare sector in Kashmir continued to remain incomplete while there was also shortage of medical equipment and heavy dues of healthcare insurance bills.

Infrastructure: Progress and Challenges

The most awaited AIIMS Kashmir made progress but seemed far away from the point where it would be ready to be called a hospital. The hollow shells of buildings, claimed to be nearing completion by the authorities, have all eyes set on them for the coming year. The authorities have promised that early 2025 will be the turning point in the life cycle of this project that has the potential to augment the tertiary care health sector.

Like AIIMS Kashmir, many new blocks and vital extensions of hospitals continue to be languishing. The SKIMS Medical College Hospital infrastructure remains utterly poor and the progress on its fresh buildings seems nowhere around completion. This hospital is the prime healthcare stop not just for Srinagar but for entire Kashmir. The apathy towards it has continued for years.

There are innumerable instances like these: Bone and Joint Hospital, Anantnag Maternity Hospital, Kangan Maternity Hospital, the multiple Trauma Hospitals, and the list is exhaustive.

Shortage Of Medical Equipment

Not just the buildings, Kashmir has continued to lag behind in diagnostics and interventional equipment and infrastructure. The GMC Srinagar, which has the highest network of hospitals under it has one MRI facility to bank on. This MRI machine caters to patients at SMHS Hospital, Super Specialty Hospital, Bone and Joint Hospital, Lal Ded Hospital, Children Hospital, Chest Diseases Hospital and those referred from hospitals across Kashmir. The Institute of Mental Health and Neurosciences (IMHANS) of GMC Srinagar has a separate MRI at its Rainawari facility, which is sometimes utilised for other patients as well.

Such gross deficiency only exemplifies the condition of the tertiary care health sector.

The new medical colleges established across Kashmir are yet to come up with facilities that are expected of these. The District Hospitals have been neglected for decades, not just in 2024, in terms of facilities.

Kashmir has just one PET scan equipment, and for patients suspected of having cancer the choice is either wait for months to get a slot, or literally sell something to go outside Kashmir and get a PET scan. Late cancer detection and diagnosis is a grave concern that needs urgent attention.

Lack of Human Resource

Starting from district hospitals, manpower in Kashmir hospitals is under duress.

A recent report has revealed alarming shortages in Jammu and Kashmir's healthcare system, particularly in specialist positions. Despite having 52 Community Health Centers (CHCs) catering to 890 Primary Health Centers, J&K faces a dire shortage of specialists, with 104 out of 220 sanctioned positions remaining unfilled. The vacancies include 25 surgeons, 25 anesthesia specialists, 22 maternity specialists, and 26 pediatricians, forcing patients to seek treatment at higher-level facilities or private hospitals. Additionally, 647 out of 1677 medical officer posts are vacant, resulting in sub-standard care and excessive workload on existing doctors. Addressing these staffing shortages is crucial to improving healthcare delivery in J&K, particularly in rural areas.

The tertiary sector, SKIMS Soura, which has a sanctioned strength of 5000 employees approximately, has just 1900 employees. The effect of this on the patient care at Kashmir's most 'advanced' hospital needs no elaboration. It is like leaving the patients to treat themselves on their own.

All hospitals in Kashmir have a dismal nurse: patient ratio putting a question mark over the quality of care meted out. Paramedic staff of every category is also in gross shortage, and continues like this for decades, each year only exacerbating the deficiency.

Delayed Payment Of Health Insurance Dues

Over the past three years, lakhs of patients have benefitted from the PM-JAY Ayushman Bharat SEHAT Scheme. It has reduced out of pocket expenses on healthcare to a great deal for people across economic strata. People have been able to avail benefits in government and private health sectors and the provision of free procedures, medicines, and investigations have prevented healthcare events from becoming an economic catastrophe. Yet the scheme faces challenges on many fronts. From non-payment of dues to private healthcare facilities to turning a blind eye towards treatment of many chronic illnesses, much needs to be looked into in the coming years.

Changing Health Profile Card

While infectious diseases continue to be a significant reason for hospitalisation, metabolic diseases have taken over the hospital beds to a great extent. A recent study highlights what it means for the health sector.

The ICMR-INDIAB study has revealed alarming health trends in J&K, highlighting the need for urgent attention to the growing burden of non-communicable diseases (NCDs) in the region. The study found that a staggering 18.9% of the population in Jammu and Kashmir suffers from diabetes, with a higher prevalence in urban areas (26.5%) compared to rural areas (14.5%). Furthermore, 10.8% of the population is affected by pre-diabetes, indicating a significant risk of transitioning to diabetes if left unchecked. Hypertension is also a major concern, affecting 27.1% of the population. There is a regional variation in these figures if Jammu and Kashmir is taken separately. These findings have significant implications for the healthcare sector in J&K, emphasising the need for enhanced preventive and control measures, improved access to healthcare services, and increased awareness about the risks and management of NCDs.

It also calls for enhanced awareness and screening measures for the population, given that a majority of people would not know their diabetes and hypertension status till very late in life.

Medical Education and Reservations

With the new Medical Colleges getting operational, J&K now has 1147 MBBS seats, more than double of what it was a few years ago. Specialty intake capacity has also increased proportionately. Although this increase brings about greater opportunities for aspirants in J&K, the development has been marred by controversies. On one hand, J&K in the past two years started participating in the All India Quota, which as per aspirants tends to favour candidates from other states only. On the other hand, the reservation percentages were changed.

The Jammu and Kashmir Reservation Act, 2004, which provides reservations for Scheduled Castes, Scheduled Tribes, and Other Socially and Educationally Backward Classes, was amended last year and again this year. Many candidates have expressed dissatisfaction over the allocation of seats, arguing that less than 30 percent of aspirants belonging to non reserved categories make it to the selection list. The issue has sparked debates about the merits of reservation policies in medical education and their impact on the quality of healthcare services in the region.

Drugs and Destroying Lives

Substance abuse has become a pressing concern in Kashmir, with alarming statistics indicating a significant rise in drug addiction among the youth every passing year. 2024 was no different. The estimates vary, a parliamentary standing committee putting the number at more than 13 lakh in Kashmir. The majority of these individuals are between the ages of 18 and 75, with a significant proportion being heroin users. In fact, a staggering 95% of drug abusers in Kashmir consume heroin, with many spending an average of ₹90,000 every month to sustain their habit. This has led to a surge in related health issues, including Hepatitis C, with 72% of drug abusers in Kashmir testing positive for the infection. The situation is further exacerbated by the lack of adequate treatment facilities and specialist interventions, highlighting the need for urgent attention and action to address this growing crisis.