On 18 February 2021, a protest took place in the district hospital of Poonch, where the locals from Arai village expressed their anger over the death of a pregnant woman, Naseem Akhter.
Protestors termed the incident as a case of negligence, wherein there was a delay in offering her the right treatment while she was ready for delivering her child.
Surrounded by Line of Control (LoC) on various sides, district Poonch is 250 kilometers away from Jammu and around 170 kilometers from Srinagar.
The district hospital, which caters to more than four lakh people, holds a rather controversial reputation. Known for its dilapidated condition, the place has left the locals dissatisfied with numerous cases of negligence every year.
With inadequate medical support, various cases get referred to Jammu or Srinagar sometimes even for basic laboratory tests and scans.
“Most of the slightly complicated cases are referred to Jammu and Srinagar because our district and sub-district hospitals lack adequate medical facilities like CT-MRI scans. How does one hope for a patient’s survival when sent off on a journey of 7 or 8 hours,” said Sourabh, a 25-year-old resident of Poonch town.
There are three community health centres, a single visit to each one of them unveils the poor sanitary situation there. Along with this there are 17 primary healthcare centres, which are in a crumbling state. Many like PHC Lathoong do not even have proper electricity.
“Healthcare infrastructure is not sufficient and systematic here, which is an administrative failure. Regardless of this we as a community have failed as well by remaining silent,” said Khushnood Hussain Shah, a social activist from Surankote area of Poonch and also one of the founding members of The Helping Hands – a non-for-profit organization based in Poonch.
Talking with The Kashmir Walla, the Deputy Commissioner (DC) of Poonch, Inder Jeet, said that they are in a process of streamlining the functioning of the hospital for better health service.
“Before any doctor on duty could refer a case to other hospitals, but recently we have formed a committee of medical officers who look into referral cases and approve it. This has systematised the process,” said Inder Jeet, the DC Poonch.
Covid-19 crisis and response of civil society
The second wave of Covid-19 also created havoc in the Poonch district when the increasing cases and the lack of health infrastructure put pressure on doctors.
The total number of Covid-19 cases reported in Poonch district is about 6285, which is a large number for a district where there are numerous vacancies for medical officers and consulting doctors.
“There are 15 vacancies for medical officers in our district, we are looking into it.” said the DC Poonch.
Members of Muhammad (PBUH) The Merciful Trust, a local non-for-profit organization, said that the second wave of Covid-19 led to a widespread oxygen shortage in Jammu and Kashmir.
“We were aware of the deficient medical support in our region,” said a trust member. “This made us take immediate action and we raised funds to purchase oxygen concentrators. People’s fears were resounding due to the horrid realities of health infrastructure here.”
The Trust said that owing to the poor health infrastructure, people were reluctant to shift to hospitals. But “our team had students and doctors as well, this eased our functioning.”
Another member of the Trust added that “people here called us almost everyday asking for concentrators and were reluctant to shift to hospitals given their lack of faith in the system.”
The Trust provided concentrators based on prescriptions by doctors. “The Helping Hands” has been at the forefront of the fight against Covid-19.
“People here had more faith in organisations like ours than in the medical department. The doctors in our region were helpless as well with a shortage of necessary equipment and machines,” said Shah from The Helping Hands.
According to the local residents, there were ventilators but no technicians to operate them, and even for basic tests and scans patients were referred to other cities during the lockdown.
The oxygen plant that was supposed to start months ago became active recently on 7 October 2021. However, the Chief Medical Officer of Poonch, Ghulam Ahmed Malik, said that in the beginning of the second wave they were sending oxygen cylinders to Jammu.
“Eventually one unit of the oxygen plant (here) under DRDO started functioning. The oxygen plant inaugurated on 7 October was the one sanctioned under PM Care,” said Malik, the CMO.
Concerns of younger generation
Ammar Hyder, a 26-year-old resident from Poonch, lost his close friend in the absence of the specialised doctors in the district hospital Poonch.
“It was last year when my friend Zahid (name changed) was taken to the hospital in the middle of the night. There were no specialists present at that time and after a long delay the specialists arrived and announced that his lungs were not functioning due to double pneumonia. He was referred to Jammu but before he could leave the district he died,” said Hyder.
“Now the important question that arises is, why don’t we have specialist centres and specialised doctors that can cater to these cases,” he asked.
The district hospital Poonch has four specialist centres; there are no centres for endocrinology, nephrology, or neurology.
“In the recent past, a Government Medical College was established in Rajouri but practically Poonch needed it more as we are seven hours away from Jammu,” noted Hyder.
Limitations posed due to the de-facto border
A lot of villages in Poonch are near the de-facto border with Pakistan – the LoC, where high surveillance creates new problems for the village locals.
“Sometimes when we have a medical emergency post dusk it becomes difficult for us to reach the hospital in time. Due to the security setups like checkpoints etc,” said Tahir (name changed), a resident of Degwar village, one of the last villages near the LoC.
Local residents believe that the severe ceasefire violations and the casualties due to it required better medical emergency services especially in the villages near LoC.
There have been various reports and incidents of cross border fire victims dying even before reaching the hospitals.
“The condition of Primary Health Care centres here is extremely poor, they are unfit to provide emergency services, a lot of them are not even properly functioning,” said Shah. “Given the border realities of our district, PHCs need to be highly functioning and air ambulance services should be provided for all sections of the society, this can save lives.”