Jammu and Kashmir's (J&K) healthcare system is a mix of government and private facilities serving over 1.56 crore people. While schemes like "Ayushman Bharat" aim to bring health coverage to millions, particularly in rural areas, significant challenges persist. These include inadequate funding, a shortage of healthcare workers, and insufficient infrastructure. Addressing these issues is critical to ensuring equitable access to quality healthcare for all citizens.
The Healthcare Landscape: A Grim Reality
J&K faces a severe shortage of hospitals, particularly in rural areas, with only 0.9 hospital beds per 1,000 people—and just 30% of these beds are in rural regions. The quality of care varies widely, with inadequate regulation leading to substandard care in some private facilities. Non-communicable diseases (NCDs), responsible for over 60% of deaths, further strain the system, especially among economically vulnerable populations. Mental healthcare remains critically underfunded, with one of the world’s lowest ratios of mental health professionals per capita. Additionally, the doctor-patient ratio is alarmingly low; while the WHO recommends a ratio of 1:1,000, government doctors in India often attend to around 11,000 patients each.
In the Kashmir Division, there are 2,102 health facilities, including 9 District Hospitals, 2 Emergency/Trauma Hospitals, 50 Sub-District Hospitals (SDHs) or Community Health Centres (CHCs), 232 Primary Health Centres (PHCs) or Medical Mobile Units (MMUs), 325 New Type PHCs, and 1,468 Sub-Centres. Similarly, the Jammu Division has 1,955 healthcare institutions, comprising 10 District Hospitals, 31 SDHs/CHCs, 226 PHCs/MMUs, 371 New Type PHCs, and 1,170 Sub-Centres. While this network is extensive, it is grossly inadequate to meet the population's needs, particularly in remote areas.
Lolab Valley: A Case Study in Neglect
The picturesque Lolab Valley, home to over 1.5 lakh people across 45 villages, highlights the healthcare crisis in J&K. The valley is served by a handful of New Type Primary Healthcare Centres (NTPHCs) in Cheerkote, Lalpora, Maidanpora, and Takipora, as well as a Sub-District Hospital in Sogam. Remote areas like Machil have only small health centers, and dispensaries are scattered throughout the region. These facilities lack sufficient staff and resources, with most NTPHCs staffed by a single BUMS, MBBS, or BAMS doctor. Even minor medical cases often require referrals to hospitals in Sogam, Kupwara, Handwara, Baramulla, or Srinagar. The absence of a maternity hospital exacerbates the crisis, forcing pregnant women to undertake long journeys, often resulting in tragic outcomes. Residents of remote areas like Machil must travel over 40 kilometers on foot for basic medical care, sometimes leading to childbirths in the open and fatalities during harsh winters.
On average, more than 2000 patients from different Districts travel to Srinagar daily for treatment at tertiary care facilities like SMHS, SKIMS, LD, Bone and Joints and others. This long journey, which takes nearly hours, is not only physically exhausting but also financially draining. Poor road connectivity further exacerbates the problem, turning what should be a life-saving trip into a perilous ordeal.
Proposed Solutions
Upgrade NTPHCs to Sub-District Hospitals
To revitalize healthcare in JK, the immediate upgradation of existing healthcare facilities is critical. NTPHCs should be upgraded to Sub-District Hospitals (SDHs) and equipped with modern medical technology, including MRI scanners, mammography units, CT scanners, cardiac monitors, laparoscopic surgery setups, neonatal incubators, dialysis machines, physiotherapy centers, and blood bank refrigerators. Similarly, existing Sub-District Hospitals should be strengthened to manage more complex medical cases, ensuring timely and effective treatment for the local population. SDHs should be equipped with round the clock consultant facilities in medicine and surgery to effectively manage emergencies. Ensuring 24/7 availability of specialized care at these hospitals is essentials for timely and efficient treatment, especially in critical situations.
Dedicated Maternity Hospitals
Establish maternity hospitals in North and South Kashmir, as well as the Pir Panjal region, to address women’s healthcare needs and reduce maternal mortality and ensure safer deliveries.
Fully Equipped District Hospitals
Each district hospital should offer specialties such as General Medicine, Surgery, Gynecology, Pediatrics, Orthopedics, Cardiology, Neurology, Oncology, Pulmonology, and Nephrology. This would significantly reduce the dependence on Srinagar’s already overburdened hospitals and bring quality care closer to the people.
Recruitment and Incentives
To attract and retain doctors in rural areas, by offering incentives, accommodation, and bonuses, ensuring that qualified medical professionals are motivated to serve in these underserved regions.
Accountability
In J&K, doctors selected through the Public Service Commission are often posted in rural areas but fail to join due to inadequate healthcare facilities and poor hospital infrastructure. Instead, many seek transfers to urban centers, leaving rural communities struggling without proper care. The government must implement strict laws to hold accountable those who disregard their postings and neglect their duty. This issue isn’t limited to one District of rural Jammu and Kashmir —it’s a widespread challenge across all rural districts in Jammu and Kashmir.
The healthcare workforce needs strengthening, with additional recruitment of doctors, nurses, and paramedics to bridge the delivery gap.
Orientation Programs
Introduce mandatory orientation sessions for interns and house job doctors to improve patient care and communication skills. These sessions should focus on patient care, communication, and counseling skills, ensuring that doctors are equipped to handle patients with empathy and professionalism. By fostering a culture of accountability, ethics, and compassion, we can significantly enhance the quality of healthcare delivery in Kashmir.
Emergency Services
Deploy ambulances equipped with advanced life-support systems in remote areas to handle critical medical cases effectively.
Equipment Utilization
Medical equipment should be installed only where radiologists and technicians are available, otherwise, such investments become a waste of public money and fail to serve their intended purpose.
Telemedicine Services
Uninterrupted power supply and reliable internet connectivity are necessary to enable telemedicine services in these remote areas.
Enhanced road connectivity is equally important for improving access to healthcare services.
A Call to Action
To ensure transparency and accountability in J&K’s healthcare system, private practice by government doctors must be prohibited. Rotational appointments for Heads of Departments and Registrars in top medical institutions such as SKIMS, GMC Srinagar, GMC Jammu, LD Hospital, and the Bones and Joints Hospital should be implemented to prevent monopolization of power. A pressing issue in our healthcare system is the absence of senior medical professionals during critical hours, leaving interns or house job doctors to manage patients. This often leads to mismanagement and, at times, unnecessary conflicts during duty hours. Therefore, senior medical professionals must be present during critical hours to manage patients effectively.
Strengthening the rural health sector is not just about helping villages; it will also ease the burden on urban hospitals by ensuring equitable healthcare access. A well-equipped rural health system means reduced workloads for urban doctors and better healthcare for everyone. It’s time to modernize and invest in rural health for a healthier tomorrow. This is not merely a healthcare issue—it is a matter of dignity, survival, and fundamental rights. The people of JK deserve better. The construction of robust healthcare infrastructure, combined with better connectivity and incentivized staffing, can transform the lives of thousands in this underserved region. This is a call to action for all stakeholders to ensure that no one is left behind. The lives, dignity, and well-being of JK residents depend on it. The government must rise above empty promises and implement concrete measures to bridge this glaring healthcare gap. Only then can the dream of a healthier and more prosperous JK be realized. Let us act now, for the time to make a difference is slipping away.
Email:------------------------------ shahmudasir22@gmail.com
