How Citizens Are Saving The District Hospital in Shopian

A citizens’ initiative in Shopian in South Kashmir has come forward to save the crumbling District Hospital from government apathy.

The campaign to save Shopian District Hospital (SDH) has been undertaken by Shopian Health Aid, a group comprising mainly of local youth who first came together during the 2014 Kashmir floods to facilitate relief work in nearby affected areas.

The district hospital Shopian is in deep coma. First the number of doctors here is too low. We have no specialty for ENT, no specialty for psychiatry and no speciality for geriatric services.

Habeel Iqbal, lawyer and one of the key members at Shopian Health Aid to The Quint

Shopian Health Aid Group Could Help Others

Since Shopian was one of the least affected districts during the floods, we were in a better position to help families from other areas where water had entered homes. Many doctors, who are residents of Shopian but were posted in other districts and could not attend duty due to the floods, had volunteered to serve at the district hospital during those days free of cost but were not allowed to do so. It was during this period that we got to know the real extent of damage; the Shopian district hospital was completely in shambles.

Habeel Iqbal, lawyer and one of the key members at Shopian Health Aid to The Quint

The group now comprises of representatives from the Shopian Fruit Growers’ Association, the Shopian Bar Association and the Students’ Association among others.

Established in 1977 as a sub-district hospital, the facility was upgraded as a District Hospital in 2008 when Shopian was carved out of Pulwama as a separate district.

At present, the hospital, which caters to a population of over 2.5 lakh, has just 30 beds – way below the minimum standard of 100 as per the revised guidelines issued in 2012 by the Indian Public Health Standards.

Shopian District Hospital – One Doctor in Each Department

It also falls short of having enough doctors and paramedic staff. The guidelines require each district hospital to have two specialists each in medicine, surgery, obstetrics and gynaecology, paediatrics and anaesthesia; one specialist each in ophthalmology, orthopaedics, radiology, pathology, ENT and dental and 11 medical officers apart from at least 76 paramedic staff including 45 staff nurses.

Shopian District Hospital, however, has only one doctor each available in the gynaecology, anaesthetics, surgery, medicine and paediatrics department. There are two dental surgeons, seven medical officers and only six nurses.

Till date, the staff strength of the hospital has not been increased. They should have sanctioned more posts for doctors but manpower infrastructure has not been upgraded. Most doctors, including the paediatrician, are working as attachments in the hospital.

Residents also claimed that basic necessary equipments were either not available at the hospital or were not being utilised optimally.

In an RTI response, the hospital has stated that it possesses one set of Boyle’s Apparatus machine used for giving general anaesthesia in surgeries.

But the Medical Superintendent has himself accepted that the machine has not been working for the last three to four months.

The RTI response does not list CT scan machines or basic cardiac monitors as available in the hospital.

Echoing Iqbal, a government doctor from Shopian, who worked at the District Hospital some time ago but is now posted outside the district, said that “ideally”, it is mandatory for all district hospitals to possess such equipment.

But everywhere in India and particularly in Kashmir, CT scan machines and other such ‘sophisticated’ equipments take a backseat.

Government doctor from Shopian

Only One Operating Table

Owing to the lack of Boyle’s Apparatus in the hospital, the doctor said no major surgeries have been taking place in the hospital for the last thee to four months.

They are performing only minor procedures using local anaesthesia or referring cases to other hospitals. There is only one operating table and the theatre lights are not working, which is a matter of serious concern.

The RTI response further revealed that the hospital did not have any digital x-ray machines or biochemical analysers. All samples including blood and urine were tested manually.

Since Shopian is located on the busy Mughal Road, cases of accidents and trauma are reportedly quite high.

But the minor OT section and Emergency department look like cowsheds. If a patient goes there for dressing of a wound, he or she comes back with a sepsis as sterilization is not properly available there.

Government doctor from Shopian

Main Concern is the Babies Ward

In the last three years, Shopian District Hospital has referred 1734 cases to other hospitals – most of them to Srinagar, 1.5 hours away. Iqbal, who had filed the RTI on behalf of the citizens’ group, asked why the hospital did not specify the reasons for the referrals even though the questions clearly sought a response.

“They haven’t answered that because it nails them. It shows either they are not having the necessary equipment or it is in dilapidated condition.”

When Iqbal’s 65-year old mother, a bipolar disorder patient, had to be rushed to hospital and undergo abdominal flushing following a drug overdose, Shopian District Hospital referred her to a Srinagar hospital for observation, only because they did not have even basic cardiac monitors available, he explained.

The doctor also expressed concern for the babies ward. In the RTI, hospital authorities had claimed they possessed 12 Baby Warmer machines. “But where are these machines? Baby warmers are gathering dust in stores,” he stated. 594 babies were managed in the neonatal ward of the hospital in 2015 alone.

Similarly, the hospital claimed to have five oxygen concentrators which both Iqbal and the doctor claimed were “never visible” or used for patients. They also alleged that the blood bank at the hospital was non-functional.

The citizen’s body is now planning to file a public interest litigation in the matter. The court, Iqbal explained, is expected to order an inspection of the hospital to “bring the truth out” behind the claims made by the hospital in the RTI.