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India

For A Ventilator In Kashmir, Critical Patients Wait In Queue For Hours

According to reports, the Union Territory has received almost 2,000 units of the ventilators in the past two years but they are inaccessible to the common masses.

A healthcare worker adjusts a ventilator at a COVID-19 Care Center. Image for representation. (ANI Photo)

Even before the pandemic, when 50-year-old Bashir Ahmed Sheikh suffered a brain stroke, he was immediately rushed to the Government Medical College, Anantnag, which then had the status of just a district hospital. Doctors there could not even diagnose what happened to him and as per Suhail, his son, they started making guesses that the patient suffered a heart attack.

As his vitals dropped, Suhail bundled his unconscious father in an ambulance with an oxygen cylinder and reached Sher-e-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar, where an intern doctor said the patient had a brain stroke and “a fountain” of blood had spilled in his head.

Bashir needed a ventilator at this time to survive, but like many, he had to be in the queue and wait either for someone to die or recover enough to leave a ventilator for him and others in that queue. For the whole night, Suhail and his friends took turns mechanically ventilating Bashir and ran all their good offices to arrange a ventilator the next morning. But already brain dead, Bashir could not make it and passed away hours after getting a ventilator.

Three years later, as a pandemic ravaged the world along with Kashmir, which had a minimal health infrastructure, nothing much changed for patients here. Adnan Bhat witnessed the same fate when he saw himself rushing from pillar to post with his dying aunt begging for a ventilator to be arranged in Kashmir’s largest medical facility – SKIMS.

He pleaded with the doctors who gave him no assurance. He took to Twitter demanding help, but got nothing more than consoling. Dawn broke, and his aunt too passed away “without getting a ventilator” as per Bhat.

According to reports, the Union Territory has received almost 2,000 units of the ventilators in the past two years but they are inaccessible to the common masses. An official working in the administrative section of the Kashmir Health Department has said that the department lacks enough skilled staff to operate these life support systems which is why the majority of them remain defunct. “There has been not much of space enhancement in Intensive Care Units (ICU) too to adjust more Life Support Systems,” he said.

Compared to the population, the availability of the ventilators has been very less. The estimates have suggested that SKIMS has over 40 ventilators but when Bhat was at the hospital with his aunt, doctors said only 12 were functional.

He took to Twitter as he tagged the Director of the SKIMS saying, “My aunt had a stroke. She is critical and your doctors are telling us we have only 12 ventilators available, all of which are occupied. These are not COVID times. If anything happens to her, you and your administration will be solely responsible”. But he received no response from the side of the hospital. Instead, people suggested that only those “with good offices” get a ventilator there.

“If you have rasook (connections with higher-ups) then only you get a ventilator. I have faced the same when my grandmother had a stroke,” Amir Ahmed, another local responded.

There is no official data on the availability of the ventilators in Kashmir, however, the official quoted above said, the government was looking at a system to make the availability status of these ventilators available online and in real-time. “But there is nothing credible on that front yet,” he added.

The government has been mulling opening new medical colleges. In the past few years, medical colleges were opened in almost 4 districts – Kathua, Baramulla, Rajouri, and Anantnag – of the UT but the existing infrastructure has been devoid of adequate facilities.

In 2020, the government medical college in Srinagar returned six ventilators worth rupees 39 lac to an NGO which had donated them to the hospital out of goodwill. Hospital had cited unavailability of staff and space to operate these ventilators. The state of infrastructure patients say has not changed much today even.

As per reports, SKIMS had 40 ventilators. SMHS, another major hospital there had 18 ventilators. Srinagar’s Children’s hospital had 10 while Chest Diseases Hospital had 16. Lal Ded Memorial, which is a maternity hospital, and Barzulla Bone and Joint Hospital, both had two ventilators each.

Total active ventilators as per this report have been 100 for the whole valley which has over seven million population. This means one ventilator for over 70,000 people. Two premier hospitals in Kashmir – SMHS, and SKIMS – got more ventilators during the peak of covid but were of no use.

As per an RTI revelation by a Jammu-based activist Balvinder Singh, 165 ventilators that Srinagar’s SMHS received under PM CARES fund were defunct and “not generating the required tidal volume”. In another instance, the Director of the SKIMS had reportedly purchased transport ventilators wrongly when there was actually a need for the ICU ventilators.

Reportedly, this was done without the authorization of the Head of the Department of Anaesthesiology and Critical Care and the deal amounted to rupees 1,28,40,000. Very recently in yet another scandal, three officials of the same hospital have been booked for a fraud amounting to over one crore rupees involving the sale of expired drugs and embezzlement with the sale of unexpired stock.

However, these available ventilator figures which are anyway very less when compared to the actual need do not really reflect on the ground. Even as the pandemic has subsided to a large extent, nothing much as per Bhat has changed. “(Contrary to 40 reported ventilators in SKIMS) the doctors initially told us that there are 14 ventilators. When we went to check inside the hall where patients are put on a ventilator, there were just 12. The one in charge of that hall informed us that there are already seven in line before us waiting for a ventilator. So, getting a ventilator was subject to someone passing away. This a callous situation, one can’t pray for someone to pass away so that his patient can live,” he said.

Bhat added that the worse state of ventilator availability is not only in SKIMS but in hospitals like SMHS where reports say 18 ventilators are available, but only four were functional and occupied. “On the other hand, private hospitals here do not entertain any critical patients,” he added.

He added that as they waited for a ventilator, two people who were rushed in and needed life support died without getting it. “In absence of a ventilator, they give you a pump (to mechanically inflate and deflate the lungs). They (doctors) say that once you start administering this to the patient, you cannot stop and if you do, the patient will die. This is very exhausting for a caregiver who has no experience in using that pump. It puts a lot of mental as well as physical pressure on an inexperienced caregiver. There is no staff to operate that even,” he said adding patients “are left at god’s mercy”.

Director Health Kashmir, Dr Mushtaq Rather’s phone was not reachable for comment.