Sitting in the hostel room of my medical college in Srinagar one afternoon, I noticed that my phone had no signal. As I went outside to enquire about the situation I saw that there were army personnel and police forces on the roads.
There had been a protest in a part of the city that had caused a communication shutdown across Srinagar. When I went to the hospital, I noticed that very few ambulances and patients were coming in due to the road blockades.
In this way, healthcare became inaccessible to the people of the valley during the ongoing pandemic, when it should have been the primary focus. Kashmiris suffer immensely due to a critical shortage of healthcare staff, hospital beds, drugs, and oxygen and the doctor-patient ratio of Kashmir is one of the lowest in India.
While the World Health Organisation (WHO) recommends one doctor for a thousand patients, Kashmir has a ratio of 1:2000. Out of these doctors, most of the specialists are located in the city of Srinagar, which makes them inaccessible to patients from far-off areas.
Very often, to access these specialists, people with critical or chronic illnesses have to travel hundreds of kilometers for basic checkups and treatment which becomes extremely challenging during curfews and lockdowns.
Moreover, security forces on the ground are notorious for preventing ambulances with patients from reaching hospitals. All of this makes healthcare one of the first services to be affected by military actions in Kashmir.
Fellow medical student, Sheikh Jahanzeb, shared his personal experiences of accompanying his father to dialysis treatments during curfews:
“My father, who is suffering from chronic kidney failure, requires dialysis for which we have to undertake a journey of 120 kms from Kupwara to Srinagar, twice a week. On one such journey that had to be undertaken during yet another curfew, we were made to repeatedly stop at several military checkpoints on our way to the hospital.”
Checkpoints in Kashmir are infamous for their unpredictability: there is no saying as to when the military personnel will let you pass or send you back.
Despite these checkpoints, Jahanzeb and his father somehow managed to reach the dialysis center in Srinagar on time.
However, due to a communication blockade that was enforced as a part of the curfew, they were unable to make an appointment at the hospital due to which they were forced to wait until late in the evening in order to receive critical treatment, which, if not offered on time, could be fatal.
Of Curfews And Lockdowns
In August 2019, the Indian government scrapped Article 370 of the Indian Constitution which offered the state of Jammu and Kashmir (J&K) a semi-autonomous status and placed the people of this region under an intense curfew.
Over 9 lakh Indian army personnel were deployed to ensure the strict enforcement of the curfew and to suppress any dissent from the Kashmiri people whatsoever, thus making Kashmir the world’s most militarised zone.
The lockdowns, road blockages, and travel restrictions that were enforced as part of the curfew made healthcare inaccessible for Kashmiri people, especially for those with chronic illnesses and for those who do not have access to private transport.
Talking about receiving critical dialysis treatment for his chronically ill father, Jahanzeb says, “During the 120-km-journey we regularly have to undertake to reach the hospital, we are very often sent back by the military personnel at checkpoints after the first 20-50 kms.”
Similar misconduct by the military personnel has been seen around the valley, with personnel regularly stopping patients at military checkpoints, and in some cases, even attacking them.
This misconduct even extends to healthcare providers of the valley, as Dr Afshan Atta, senior resident at Sher-E-Kashmir Institute of Medical Sciences, Srinagar, described:
“As healthcare providers, we put our lives at risk to reach the hospital. But, we are stopped by military personnel at checkpoints because they are ordered by the government to prevent everyone from passing. It severely impacts our mental health when we don’t have the freedom to travel in our homeland.”
The enforcement of the curfew was also followed by a six-month-long suspension of communication and internet services in the valley which meant that emergency helplines, online medicine, and government-funded schemes became unavailable for both patients and healthcare providers.
As a medical student, I also observed that several healthcare providers were forced to delay treatments as they could neither consult their senior counterparts due to the communication blockade, nor log onto health websites for guidance.
Staff members also often had to be sent from one department to another in search of senior doctors, which led to confusion and delayed surgeries and treatments.
Additionally, during these communication blackouts, hospitals can’t place orders with suppliers—which led to a shortage of vital medication and equipment.
The Urgent Need for Reform
In April 2020, several medical professionals voiced concerns about the capacity of the valley’s infrastructure to handle the COVID-19 pandemic. The J&K directorate of health services was quick in publishing a circular threatening prosecution against these outspoken doctors.
This decision by the administration portrays how little attention is paid to Kashmiri people’s right to healthcare.
The current healthcare issues in Kashmir are deeply rooted in the socio-political problems that the valley has long endured. Kashmiris need to be involved in the decision-making of the region.
There is an urgent need to address the issue of human rights violations in Kashmir both nationally and internationally to bring in reforms for the healthcare issues that Kashmiris currently face.
Speaking about what can be done on the local level Dr Atta suggested, “An administrative body should be formed within the hospitals and their prime focus should be to work on issues of dire need, like lack of equipment and infrastructure. They need to make this process of change quick because ultimately it is we, the people of Kashmir, who are suffering.”
Featured image is for representational purposes only. Photo credit: Wikimedia Commons.
Note: The author is part of the current batch of the Writer’s Training Program.