Health care facilities in Jammu and Kashmir are insufficient to meet the crisis which has unsettled the countries with world class medical infrastructure
Article 21 of Indian constitution guarantees not only the right to life and liberty, but also the right to health, right to a safe environment, right to live a life with human dignity, etc. The Supreme Court has read the right to health as a part of the Fundamental Rights chapter in the Constitution and has relied on the Universal Declaration of Human Rights, the failure of a government to provide timely medical intervention to a person in need of treatment results in violation of fundamental rights .But the health care system in Jammu and Kashmir is creaking , further burdened by this pandemic for which we were never prepared. Health care had long been the victim of politics ,it had suffered because it was a low priority sector in the eyes of our rulers. Health care system in this region especially in Kashmir has acute shortage of doctors, health care staff ,hospitals ,beds and critical care infrastructure like ventilators ,ICU beds etc. The main issues of health care system in Jammu and Kashmir are:
Poor doctor ratio
According to standards set by the World Health Organisation, the doctor patient ratio should be 1:500.In many western countries, the ratio is a little generous being 1:1000.But in our Jammu & Kashmir, the ratio is even greater than 1:3000.J&K has one allopathic doctor for 3866 people according to Central bureau of intelligence .In many of our district and sub-district hospitals, there is a deadly lack of doctors .Due to this deficiency of doctors, the Health Department has abandoned the practice of running health centres 24 hours .Maternal care in rural a the brunt of shortage of shortage of doctors. This can be assessed by the fact there are only 44 Gynaecologists for 60 health institutions in entire rural Kashmir.14,mostly sub district hospitals are without gynaecologists this reflects the sad state of affairs in rural Kashmir .if we look at the number of health care professionals available the situation is worrisome. The Jammu and Kashmir currently had 12650 MBBS doctors against 927000 total MBBS doctors in india , that is just 1.3 % of MBBS doctors of india. There is also dearth in other medical staffs in jammu&Kashmir this can be assessed by the fact that india has 1748363 nurses working in different hospitals, but jammu&Kashmir had just 1520 nurses that is J&K shares 0.08 % of nursing staff of india .Also there are 217000 dentists working in india in which 3159 dentists are in Jammu and Kashmir. Even if the infrastructure is upgraded Kashmir lacks real manpower which is trained to run ICU and high dependency units.
Hospitals and Beds
Jammu and Kashmir with a population of 1.48 million (2019) has very less hospital to meet any adverse calamity like coronavirus. The condition is that our major hospitals had been designated as covid-19 hospital where other OPD Services had been barred even when there are just less than 600 confirmed cases of coronavirus .when we look at the national health infrastructure J&K shares very less amount of it.India has 69265 hospitals in both public sector(25,778) and private sector(43487) .Jammu & Kashmir has just 157 hospitals available in both public and private sector .india has 535 medical colleges and Jammu and Kashmir has just 4 medical colleges. There are 156231 sub centres, 25650 PHCs,5624 CHCs in india. In Jammu and Kashmir there are 2967 sub centres ,710 PHCs and just 84 CHCs .This is also a shame that Kashmir with population of more than 70 lakh has lone maternity hospital (Lal Ded) with bed capacity of 500-700.Daily 130-150 patients are being admitted, the OPD bears the huge rush 800-1000 on daily basis. The patients are mainly from rural areas due to dearth of maternity care in rural Kashmir. The situation is such that patients of share beds even after the surgery. Lack of infrastructure and huge rush may be the reason that more 60% deliveries occur through caesarean operations.
Another important factors of determining quality of health care infrastructure is the number of hospital beds available. India has 18,99,228 hospital beds in both public sector (713986) and private sector(185242).Unfortunately J&K shares just 0.61% of beds total hospital beds available in india . J&K has just 11651 beds in public sector and 704 beds in private sector.
CRITICAL CARE SYSTEM
To reduce the number of deaths of severely ill patients especially in times of crisis like coronavirus pandemic it is important to have number of beds in intensive care and access to such machines and well trained staff to run them .In india there 95961 ICU beds in both in public and private sector,j&k has just 400 ICU beds in both the sectors. If we look at the number of ventilators available in the country india has 47481 ventilators in available in both the sectors and in Jammu and Kashmir there are just 180 ventilators in public sector and 20 in private and only 97 ventilators in the valley. The government has to purchase (ventilators). But there is a limiting factor, which is that if you purchase one lakh ventilators, then you need to have two lakh doctors to utilise those ventilators.
Now the time has come to make the Health care system as top most priority sector. There is an immediate need of upgrading of our health care infrastructure to meet any crisis and to overcome acute shortage of doctors and paramedics.
Author: M.sc Geography, University of Kashmir