Transforming Healthcare in Kashmir: New Schemes and Institutions
kaul.upendra@gmail.com
The healthcare landscape in Kashmir is currently undergoing a structural metamorphosis which has been a long-lasting need. Historically it had a “top-heavy” system where a few tertiary care centres in Srinagar bore the brunt of the entire valley’s medical needs which resulted in overcrowding in these few centres. The region is now pivoting toward a more decentralized, technologically integrated, and education-focused model.
The backbone of any healthcare system is its workforce. For decades, Kashmir relied almost exclusively on Government Medical College (GMC) Srinagar and SKIMS (Sher-i-Kashmir Institute of Medical Sciences). However, the last five years have seen an unprecedented expansion. The establishment of new GMCs in districts like Anantnag, Baramulla, Handwara, and Kupwara has more than doubled the annual intake of medical students. This decentralization ensures that “local doctors for local needs” becomes a reality. With this the necessity for good students having to seek admissions in the neighbouring countries is bound to go down. With the political conditions in Bangladesh, Iran and even in Ukraine becoming very unstable these once popular destinations are getting a hit.
To address the chronic shortage of specialists, the government has aggressively pushed for Diplomate of National Board (DNB) and specialized MD/MS seats in district hospitals. By converting district-level facilities into teaching hospitals, the system ensures a round the clock presence of resident doctors in rural areas, significantly improving patient outcomes. This is especially important for reducing the mortality and morbidity of acute illnesses like heart attacks and strokes.
Healthcare in the outreach areas is always a challenge especially in the geographies of the valley. For a resident of Gurez or Machil, a “minor” complication can become fatal during winter lockdowns.
The solution is emerging through a “Hub and Spoke” model Telemedicine & e-Sanjeevani programs with high-speed internet (where available) now connects remote Primary Health Centres (PHCs) with specialists in Srinagar or even New Delhi. These facilities, however, need many more trained personnel and a functional equipment. The maintenance and availability of an engineer however remain a continuing problem.
Over 2,000 sub-centres have been upgraded to Health & Wellness centres “Ayushman Arogya Mandirs,” have been designated to provide basic diagnostics and non-communicable disease screening at the doorstep. However, the services rendered there are far from satisfactory. My team and I myself see many of these patients and their prescriptions at our outreach centre at village Hawal. After giving acute care like injectable pain killers, pantoprazole or diuretic injection most of them are referred to Srinagar Govt hospitals. These hospitals being already overworked make many such patients go to private hospitals which for many of them are un affordable.
For nomadic populations and high-altitude villages, mobile vans equipped with basic labs and pharmacies are now the primary point of contact but much more needs to be done for this population which is largely uneducated and present at very late stages of their medical problems.
The Economics of Healing:
Medical bankruptcy is a global crisis, but in a region with limited industrial income, it can be particularly devastating. Fortunately, during the last five to 6 years Ayushman Bharat (Golden Card) in Jammu & Kashmir has been one of the few regions to implement Universal Health Coverage, providing ₹5 lakh per family regardless of income status. This has democratized access to private corporate hospitals for the common man. The proliferation of generic medicine outlets through Jan Aushadhi Kendra’s also popularly termed as Modi Ji’s medicines have slashed out-of-pocket expenditure on chronic medications by nearly 70-80%.
Kashmir like most parts of South Asia is witnessing an “epidemiological transition.” While infectious diseases are declining considerably these are being replaced by the “Silent Killers”-the non-communicable diseasesand Cancers which have become the major killers. Stomach and colorectal cancers have alarmingly high rates in the valley, often linked to dietary habits (excessive salt, low fibre food, sun-dried foods) and the continuing tobacco use. Hypertension and Diabetes are rampant. Early screening is no longer a luxury but a necessity to prevent the “heart attack epidemic” currently gripping the younger population.
In the midst of this transition, the Gauri Kaul Foundation, led by the author has emerged as a lighthouse of civil society intervention. The foundation has shifted the focus from “treating a heart attack” to “preventing a heart attack. Their innovative “Heart Clinic on Wheels” brings advanced diagnostics—like ECG, Echo, and point-of-care blood tests—to the most remote hamlets. Through their Gauri Old Age Mission (GOAM) they have addressed a long-neglected demographic, providing specialized care for the elderly who often struggle to navigate crowded government hospitals. Taking a cue from these activities smaller off shoot groups are also making similar efforts for the elderly which is a good and complementary development.
The future of Kashmiri healthcare is inextricably linked to the Central-State relationship. Since the reorganization of the state, there has been a massive influx of “Centrally Sponsored Schemes” (CSS). One of the very important developments have been the “AIIMS Awantipora”. This project is the crown jewel of central investment. Once functional, it will reduce the referral load not only to Srinagar but also to New Delhi and Chandigarh. The direct infusion of funds from the Union Health Ministry has bypassed historical bureaucratic bottlenecks, allowing for rapid infrastructure upgrades (like the new PET-scan facilities and oxygen plants etc). Its introduction represents a tectonic shift in the healthcare landscape of Jammu & Kashmir. For existing private hospitals in Srinagar, this isn’t just “more competition” but it’s a fundamental challenge to their existing business models, which have historically relied on the gaps in the public sector. With its 1000 beds and 300 super-speciality beds it is going to be a boon for the sick.
Private hospitals will lose their “speed-to-care” advantage. Patients who previously paid a premium to avoid long waitlists at public hospitals will now have a high-capacity, world-class public alternative. Private players will likely have to pivot toward personalized boutique care or highly niche sub-specialties that AIIMS may not prioritize initially. For this progress to be sustainable, the local administration must ensure “last-mile delivery,” while the centre must continue to treat Kashmir as a “special priority zone” to bridge decades of infrastructural deficit. The unfortunate closure of the Mata Vaishnav Devi Medical College in Katra made in a tearing rush was a very sad spectacle and should not be allowed to recur.
The future of health care in Kashmir predicts brighter days ahead. By the year 2030, we can expect digital twins for efficiency and precision medicine through artificial intelligence. A medical university which would be a unified body to govern all medical colleges in J&K, streamlining curriculum and research. Digitising of the Health Records - a valley-wide database where a patient’s history would be accessible from any primary health centre or a Tertiary centre will be a part of this process.
The day should not be far when Kashmir with its climate and natural beauty and the upcoming infrastructure should become a hub for medical tourism and wellness and elective surgeries for the rest of South Asia.
Prof Upendra Kaul, Founder Director Gauri Kaul Foundation.
