The Annual Day, SKIMS and JVC

History.

The SKIMS Soura was envisioned in 1976 and commissioned in 1982. Time has proven that it was one of the most successful major foresight-laden decisions made by the JK administration throughout its history. The whole process was relatively smooth, both in terms of the development of infrastructure and human resource. The SKIMS has been one of the institutions of real quality in Kashmir year after year.

The origins of JVC (I use the term for SKIMS MC Bemina for easy readability), Bemina, were equally noble. A vision for a medical college for women students in Kashmir four decades ago has to be rated highly. However, things did not go as planned. The medical college experienced a series of crises since its commissioning in 1989, until it was taken over by the government of Jammu and Kashmir in 1998. JVC became a part of the SKIMS group.

An overview of the health sector in Kashmir.

Broadly, the health sector in Jammu and Kashmir can be divided into six groups. The SKIMS group, the SMHS group, the private sector, the new medical colleges, the Directorate of Health Services, and the developing AIIMS.

Over the last 16 years, the GoI has made significant strides in terms of infrastructure and manpower development in the health sector across India. A medical college in every district has become a reality. This has nearly ushered in a quantum leap in patient care.

It is worth mentioning that the government health sector in Kashmir was highly rated even two decades ago. A fact attested to by its consistently high ranking in all studies and rankings released by The Outlook and India Today. However, the growth across the country has been mirrored by improvements across the board in Jammu and Kashmir also. The SMHS group has made significant strides and has surpassed the SKIMS group in certain areas and competencies. A very prominent sign of this is that all hospitals in the SMHS group have been rebuilt over the last couple of decades.

The LD hospital, the Psychiatric Diseases Hospital, the Hospital for Bone and Joint Diseases, the Superspecialty Hospital, and the Dental Hospital have been constructed or rebuilt over this time. This has been mirrored by the development and employment of more capable manpower and equipment. The new medical colleges are still in their infancy, but visible growth is felt. The GMC Anantnag and Baramullah are doing quite well already. The private sector has also made significant strides in terms of the quality of procedures at low costs and increased access. The hospitals associated with the Directorate of Health services have improved out of sight, too. The way these hospitals rate highly on the NQAS, laQshya, MUSKAN, NABL, and NBEMS criteria is a moment of pride for both the administrators and the doctors manning them.

The JVC/SKIMS MC as an outlier.

With the incredible improvement in healthcare over the last 15 years, a question arises. Why has the JVC hospital not grown at the same pace as the other hospitals in JK?

There is no doubt that the baggage of its initial controversies has significantly hindered the hospital’s progress. However, nearly three decades after the government takeover, the medical college hospital lags behind in almost all areas of assessment.

The SKIMS shadow

The hospital languishes in the shadow of its larger cousin, the SKIMS Soura. This shadow hampers its administrative recall. It is unlikely that it occupies much mindspace among the administrators of Jammu and Kashmir. This was particularly evident during the first year of the COVID-19 pandemic. The hospital was designated as the valley’s main COVID facility. Admittedly, the hospital and the staff did a good job of handling the situation, especially during the months when COVID was equated with a virtual death sentence. When rounds were like death sentences. The second wave meant that other hospitals had to share the load, but the fear factor had been largely overcome.

A particular point that needs to be emphasized here is that the SKIMS administration has had the opportunity to expand its healthcare footprint in the valley. One feels that it has been a spectacular failure of foresight on the part of successive administrations at that hospital to view the JVC as an opportunity rather than a burden. The SKIMS is an 800-900-bed hospital that has to contend with a nearly 3,000-bed SMHS, the upcoming AIIMS, and the vast Directorate of Health Services infrastructure in the future for resource allocation, mindshare recall, and importance. As the difference in quality of health care between major hospitals is diminishing rapidly, the only way a hospital can maintain its pre-eminence is by expanding. It is quite funny to see that any press note coming out of SKIMS about future development has the last 2-3 lines dedicated to JVC. This has been a recurring theme for years. It is bewildering that this incredible opportunity to maintain importance has been totally lost. This is where one must consider the inherent complexity of human nature.

It was also a rare opportunity to test two different methods of administration under a single roof. As departments of common origin are shared across the two hospitals, a healthy competition between the two lines of thought can be assessed over 5-year periods to provide direction for future health planning. The SKIMS Soura has its own administrative guidelines, and the JVC is largely run by SMHS-type guidelines. Pertinent monitoring mechanisms could provide wonderful evidence for the future.

Why do we need to discuss JVC?

Admittedly, there are enough hospitals in the valley. JVC is just one more hospital. However, I would like to conclude this article by making two totally unrelated points.

The Valley has been wracked with violence of all sorts for decades now. Even though there has been homogenization of medical education following the revocation of Article 370, the JVC had a secular outlook from the beginning. Even at the peak of violence, students from Jammu travelled to Srinagar to study at this medical college. Despite all the challenges, there were no unpleasant incidents all those years. A secular college amidst those conditions deserved a lot of care from administrators across political lines. It is quite instructive that it did not receive the importance that this single fact warranted.

As the trauma epidemic widens, the need for a fast transit hospital in the valley is clearly felt. Transit to SKIMS Soura, SMHS, and the Hospital for Bone and Joint Surgery is hindered by traffic snarls, resulting in slow transit. The JVC is located on a rapid transit route and has land. It is a made-in-heaven solution to the golden hour trauma management system that the administration should prioritise at the earliest.

The JVC annual day celebrations were held in this medical college a few days ago. In an unusually pleasant atmosphere, the bureaucrats, politicians, and doctors seemed to take pleasure in each other’s company. As someone who has been witnessing and analysing healthcare in the valley for a decade, it was quite a wonderful sight. A genuinely happy gathering of these streams is rare. It seems JVC may have just set a new benchmark in this regard. The JVC has always had potential. It is time for a rethink at the administrative level to unlock this genuine goodness through cooperation, evaluation, and listening. Wisdom, as always, belongs to foresight.

By: Dr Saleh Tabib