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SRINAGAR: To improve and make maternity and child care services much effective and people friendly, Doctors Association Kashmir DAK today demanded for clubbing of specialists doctors under single roof in designated hospitals especially at District and sub-district Hospitals.  It is now time to move forward and reform health policies of state.  What is the fun of having policies and interventions when a woman needs to travel hundreds of kilometres to deliver a baby?

When more than 80 percent deliveries are now conducted in government hospitals, it is high time to start two full fledged single roof maternity and child facilities in south and north Kashmir with 24×7 services, said president DAK Dr Suhail Naik. The birth of any baby is unpredictable life event and can happen any time in last trimester depending on medical or obstetrical conditions. Further a mother can develop complication any time during birth process and may need lower section cesarian section LSCS on emergency basis.  

Therefore to curb the referral to LD hospital and decrease its burden,  the pooling and clubbing of staff, especially gynecologists, pediatricians, Radiologists and anesthesiologists, is a effective short term measure to significantly   reduce rate of referrals and improve healthcare delivery in peripheral hospitals. 

Dr Owais H Dar, General secretary DAK said due to scattering of specialist doctors, comprehensive maternity and child service are compromised and are available only from 10 am to 4 pm, in most district and subdistrict hospitals. The tragedy of Suraya should serve as eye-opener for the policy-makers. With current scenario of posting of doctors, it is the policyless system which forces the hospitals to offer only OPD services for the expecting mothers and carry out caesarean sections between the day hours only.
While the Lalla Ded Hospital incident has generated debate on various fronts, with government issuing guidelines in regard to the referral of the patients from the peripheries, the question that remains unanswered and unaddressed is that are the medicos are over-burdened and stressed beyond limits.

On an average, the doctors in the valley work for 70-80 hours per week, which is against the norms and the Supreme Court directive. Lamenting government vice president DAK, Dr Mohamed Ashraf said that even district hospital Kupwara catering huge population is facing staff crunch and staff crunch problem is not specific to the district hospital Kupwara alone. Due to political interference many specialist doctors were forced to get posted in constituency of politicians to satisfy there voter college Dr Ashraf added.

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JAMMU: Hundreds of employees working under National Health Mission are protesting at Press Club Jammu from 14 jan 2019 and today hundreds of employees having buckets in their hands and cleaning water restored in press club jammu due to rain and showing that despite having good qualifications we are working as labourers. Employees from across Jammu region and many of their counterparts from Kashmir valley reached the venue early in the morning and continued their protests.

Near about 9000 employees from across Jammu & Kashmir have been on strike for last 10 days and held protests in favour of their demands including formulation of a regularization policy. The employees that include doctors, managerial staff and paramedics are also seeking the benefit of Supreme Court guidelines on Equal Pay for Equal work. It may be worth mentioning that the employees had held protests and strike last year as well and had called off the strike after written assurances from then Health Minister Bali Bhagat. However, the employees say that the commitments are yet to see the light of the day despite passage of one year since.

“At this stage of life when we have dedicated 12 years of our service to the department there is no other alternative. We need a secure future as we cannot apply for fresh jobs or think of a career change at this stage”, said All J&K NHM Employees Association President Jammu division Rohit Seth. HE added that Haryana state has already implemented a policy for giving equal pay to NHM employees at par with other employees. “Even contractual employees in J&K state have been given the benefit of minimum of scale pay under SRO 384. We appeal the Governor to provide justice to us”, he added.

The employees said the Governor Satya Pal Malik has assured them that their just demands will be fulfilled and a meeting to consider the same shall be held shortly. “We are extremely hopeful of a positive outcome of the meeting and hope that we shall not have to continue our protests”, said Altaf Ahmad Bhat, Vice President of the Association’s Kashmir province.

At the venue, the employees raised slogans in favour of their demands and resolved to continue their protest till fulfillment of their demands. Meanwhile, protests and strike was also held across Kashmir valley on Monday in favour of demands of the employees. “Due to inclement weather gathering at central place could not be held and as a result it was decided that protests shall be held at district and block headquarters”, said Association spokesperson Abdul Rauoof.

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The two most important factors of public welfare in any nation state could be best judged by its education and healthcare which the state provides to its subjects , but unfortunately these two sectors in India have become highly privatized and commercial in nature. Whereas the Pharma industry is itself controlled by rich political elites of the country, the health care system in India is in shambles despite of hundreds of welfare schemes which are confined to paper work, advertisements and photo oops. The ground reality is far from mere sloganeering and hollow rhetorics.

The recent case of tribal women in Kashmir jolted the whole country wherein the pregnant lady was thrown out of the hospital in sub zero temperature who consequently gave birth to a dead female child in the middle of the road. The irony of the fact is that many districts and voluntary organizations were also holding workshops and awareness camps on Ayushman Bharat and “Beti Bachao Beti Phado” , the flagship programme of government of India to save girl child and female mortality ratio on the dais day as well.

"CAUSES"

The biggest problem of the country and more specifically of Jammu and Kashmir is that of institutional failure and politicisation of health care system. The successive governments does not take the scientific and holistic view of schemes in totality before formulating any policy. The sanctioning of six AIIMS pattern hospitals were taken to ameliorate the sufferings of the people but nothing is being done to equip the existing hospitals and public health centers. The premier institutions like GMCs and other peripheral hospitals doesn’t cater to the huge rush of patients who rush to them despite of district hospitals in every district. The District Hospital and Public Health Centers are just bricks and walls for few employees to draw monthly salary. Thousands of women, new born and accidental patients die on daily basis in these hospitals.

According to World Health Organization there is great disparity in doctor-patient ratio. The WHO recommends 1:1000 whereas its 1:2000 in india and Jammu and Kashmir at the lowest ebb of 1:3864. This disparity directly effects the lives of people which is further aggravated by sluggish system of recruitments and placements in the public sector. The district are themselves running short of doctors and specialized equipments needed for the critical cases.The Public health centers remain mostly close or open with no doctor to look after the patients. Thanks to political machinery and corrupt bureaucracy for devising the plans of attachments and need basis.

The medical colleges in both the divisions doesn’t cater to the thousands of patients who throng them. Even in emerging wards multiple patients are accommodated in the same bed let alone the emergencyand accidental cases. Doctors more specifically junior doctors work at a stretch for more than fourth hours to treat thousands of patients in OPDs. Even the patients with serious ailments of kidney failures, cancer have to wait for months for their respective treatments and therapies. These dysfunctional peripheral and over crowded city hospitals are playing havoc with the health care of the state. 

Moreover the doctors who pass out every year from the medical colleges are not ready to serve in villages and their respective native place because of low career prospects and unprofessional environment which often leads to conflict even between the doctors and patients which is galore with the increasing rate of thrashing of paramedics , damage to hospital properties and scuffles between the patients and doctors. This uneven distribution of patients, ill equipped peripheral hospitals, huge ratio gap of doctors and patients,low career prospects and to the politicization of health department is becoming detrimental to the lives of the people .

"NEED" 

The need of the hour is to streamline the system. The biggest need of the time is equip the district hospitals and public health centers both in human resource and machinery which would eventually give respite to the doctors and patients as well. It must made mandatory for the doctors even at the entry level to serve their native places at-least for a decade both for experience to know the basic requirements and serve the people.The biggest problem which disturbs the whole equilibrium is that the doctors are not ready to serve outside the twin cities of Jammu and Srinagar. They prefer to go to other cities and foreign countries for better future and huge dividends. Even the specialized serving doctors spend decades in gulf in Europe despite on the government roll which itself is the depiction of our legal system and law enforcement mechanism. Let the trade of unethical practices of major chunk of doctors be not discussed in detail here. 

Only infrastructural development won’t set right the track but other corrective measures needs to be taken away from pomp and show with result oriented policy , streamlining the induction and service rules, depoliticization of heath department, better supply of human resource and advanced equipments, strict check on spurious drugs and unethical practices of doctors can help a lot to streamline the healthcare of the state. Besides the doctors must bear in mind that he is next to god for a patient and people must not forget that they are human beings like all of us with their own needs and need and necessities though blots are present in every profession.

{ The author is Freelance Journalist , Columnist and President Global Peace Foundation and can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it. 7006297586 , 9906024843}