Kupwara delivery reveals dark underbelly of Kashmir’s health apparatus

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Keran, Kupwara: The Kalas village was covered under heavy snow when Shahida’s water broke and the labor pain started worsening. Her immediate family rushed the woman to the nearest Primary Health Centre (PHC), in the Keran area of north Kashmir’s Kupwara district. The village is barely two kilometers away from the Line of Control that divides India and Pakistan.

Despite years of resentment among the locals, the far flung areas of the Kashmir valley continue to sulk amid the lack of accessibility to proper medical facilities. The medical centre where Shahida was rushed had no gynaecologist. 

At 11 am, the medicos at the PHC wanted to shift Shahida to a local hospital in Kupwara’s Kralpora area; however, the weather didn’t allow it. The snowfall also ruled out the possibility of the patient being airlifted to another maternity facility. 

The message was clear to Dr. Mir Shafi, Block Medical Officer (BMO), in Kralpora. Shahida’s baby had to be delivered — in that hospital, by the available staff.

“Due to continuous snowfall, the authorities couldn’t arrange an air evacuation for the patient,” Dr. Shafi told The Kashmir Walla.

As per the report 2020-21 of the Union Health Ministry, there is a shortage of 577 doctors at the PHCs of J-K rural areas. The data reveals that 24 posts of obstetricians and gynaecologists are vacant at Community Health Centres (CHCs) in rural areas.

The locals from the district often complain during the winter season regarding the non-clearance of the snow from inner roads, resulting in several hardships. Over the years, several videos have made it to social media platforms wherein locals carry pregnant women on the shoulder to nearby health centres.

Adding to the woes there, the doctor added that the area has weak mobile networks. “We called a gynaecologist at Kralpora SDH (Sub District Hospital) on WhatsApp and followed his directions.”

The time was running out of hands and the BMO and gynecologist encouraged the team to manage the delivery at the PHC only. “He was on the call throughout the process,” Dr. Shafi said. The team included a medical officer and five paramedical staffers.

“There was a risk in waiting for her to be shifted to a better facility. So we took the risk because we had no other choice,” he said. “The wait would have been dangerous for the patient’s condition.”

Fighting the circumstances, the medical staff at the center said they tried to “save the patient’s and her child’s life”. 

And the staff managed that beautifully, Dr. Shafi said.

During the winter season, the Keran village usually remains cut off from the rest of the district. At the hospital, the doctors take similar steps during the emergency but Shahida’s case got highlighted, said Dr. Shafi. “A villager posted a video on social media and soon it went viral online.”

When the news was circulating across the Valley, people called it a “3-idiots” styled delivery. In the Bollywood movie of Rajkumar Hirani’s 3 Idiots, the engineering students deliver a baby by coordinating with a gynaecologists over the phone. 

While the people rejoiced at the efforts of the medical staff at the PHC, the situation was a dark commentary over the state of health facilities in Kashmir’s far flung areas.

For the PHC staff, such situations are not new. “It gets difficult to manage sometimes, mostly during the bad weather. So everything has to be managed with courage and dedication,” he said. “Rest is up to Allah.”

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