‘What has crept deep in our healthcare system is no fear of accountability. Death can happen, but we have to fix the responsibility, just to see what went wrong; we learn, and in future try not to let the same thing happen again.’
In an exclusive conversation with Kashmir Vision’s Health correspondent Irfan Tramboo, President Doctor’s Association of Kashmir (DAK) Dr. Nisar Ul Hassan talks about issues of varied nature faced by the ‘disorganized’ healthcare system of Kashmir
KV: How do you see the overall healthcare scenario in Kashmir, where do we stand?
Dr. Nisar-ul-Hassan: The overall healthcare scenario is abysmal, rather it is dismal. When there is a total absence of comprehensive healthcare policy, how can we expect it to be vibrant and effective? In terms of infrastructure, we may be ahead, but it is all disorganized and thus leading us to nowhere.
KV: Why is there a high referral rate of patients from peripheral hospitals to Srinagar, what is going wrong?
Dr. Nisar-ul-Hassan: At district level, the healthcare system is even more pathetic, the cases that can be treated—should be treated at localized level—are referred to Srinagar hospitals, adding to the already high patient inflow. The thing is that we are here to give a specialized and advanced treatment to the patients, and more importantly to invest more time in quality research. We are treating almost 99 per cent of patients here who can be easily treated at the peripheral level. Even after having a satisfactory number of doctors and infrastructure at the peripheries, we see huge number of patients who are referred after 4 PM, even during the day. The tertiary care is there to give out protocols and primary healthcare is supposed to take care of such patients at their level. The system has been formed in such a way that the patients even don’t go the primary level healthcare, because they know, at the end of the day they will be referred to the tertiary care hospital, thus burdening the already choked system that we have. Because of bad policies there is the chaos that you see.
KV: What is the condition of maternity and infant healthcare in the state?
Dr. Nisar-ul-Hassan: One of the indicators of good health care is Maternal and Infant care, but here too, we are lagging behind. There should be no infectious diseases, but if you see our wards, majority of the cases are about infectious diseases, which somehow indicate towards the bad healthcare prevalent in the state. Due to the lack of preventive aspect of the healthcare system, we are having high mortality rate in maternity and infant health care sector. The specialized people have been concentrated here in Srinagar, because there has been non-implementation of transfer policy. In peripheries, the maternity cases are still being carried out by midwives and that is due to the non availability of specialists in peripheries. There are many specialists coming out, and they should have been placed in such places, but nothing of that sort is happening. The solution is to de-centralise the maternity healthcare system, you are keeping it all for Srinagar, turning a blind eye to the needs of people living in far off places.
KV: Recently, there have been many infant deaths at GB Panth Hospital, how do you see the functioning of lone childcare hospital in Kashmir?
Dr. Nisar-ul-Hassan: I see every hospital unaccountable, it is all mess. There is no audit. I write a thing, there is no audit, I do a thing, and I am not being audited. I am not asked whether the thing that I have done is correct, or there have been any shortcomings. Every death should be audited to see why this did this happen, because ultimately a human life is lost. Here they die and they die; there is no one to raise questions. What has crept deep in our healthcare system is that there no fear of accountability. Death can happen, but we have to fix the responsibility just to see what went wrong; we learn and in future try not to let the same thing happen again. Deaths caused due to negligence are usually covered up, even if there is a gross negligence. Interestingly, I am yet to find a doctor being punished for any negligence.
KV: In some cases of medical negligence inquiry panels were formed while some were hushed up, do you see any way that the victims can get justice?
Dr. Nisar-ul-Hassan: From last 60 years, there were numerous cases of medical negligence, but as I said, I am yet to see any doctor being punished for negligence. Even if somebody is raising their voice, nothing happens, nothing and that is why nobody goes to consumer courts or other forums for justice, because ultimately the doctor will be saved by the system. At the end of the day I don’t find any ray of hope in such cases who are craving for justice.
KV: How do you see the recent circular issued by Principal GMC, banning media persons from visiting hospitals?
Dr. Nisar-ul-Hassan: If we are not accountable to anyone, we are accountable to the media on every issue. It was because of media that fake drug racket was busted, otherwise people were dying every day. It was because of media that so many issues were highlighted. And if you are banning media from entering hospital premises, you are surely hiding something, otherwise, if there would have been something extraordinary, you would have invited people to freely have a look at the facilities available at the institution. This really means that you are covering up something.