In the feeble and hesitant light of dawn, my mother sent me to the chemist in the nearby market to purchase medicine for my little brother. The moment I was out in the open air, I covered my whole face with a muffler and put gloves over my hands and stuck my feet into some foam shoes. As soon as I walked out the season's sharp bitterly cold wind got into my breaths and was shredding my throat and making my eyes full of tears. Somehow, step by step, I made it to the chemist shop and joined the queue of people, waiting to buy medication for my little brother's viral infection. I felt this pain when my own body became counted among the victims of antibiotic resistance. Back then, there was still no awareness about antibiotic resistance and even today in Kashmir there is a painfully absent awareness about the same. The morning fog lifts over Kashmir to reveal a familiar winter tableau: families huddled around portable heaters, children coughing in poorly ventilated rooms, and pharmacies doing brisk business in antibiotics. What most Kashmiris don't realize is that they are witnessing the opening act of a health crisis that could turn their valley into a breeding ground for superbugs.

Kashmir's extreme winter conditions have prevailed, which worked out to be perfect for the spread of respiratory infections at an alarming rate. With temperatures regularly dipping below 0degree Celsius touching to minus The cold air gives viruses a longer life and a longer range to travel, while dry winter weather sucks up the protective mucus barrier protecting the nasal passages that normally holds pathogens according to a report by the Kashmir Observer. The situation is exacerbated by temperature inversion a meteorological phenomenon where a layer of warm air traps cold air and pollutants near the ground creating thick smog that chokes the valley throughout December.
In an interview by Dr. Murtaza Ahmad Ganaie, a general physician in DHSK, says that viruses such as rhinoviruses and influenza flourish in cold and dry conditions. "Winter air is often dry which leads to drying out of the nasal passages, compromising the mucus barrier that normally traps and flushes out pathogens Traditional heating systems, such as kangris (portable clay firepots), create confined, warm spaces which increases viral transmission amongst family members crowding together for warmth."
The scale of the winter health crisis in Kashmir can be realized by a look at the hospital data. SMHS Hospital in Srinagar has registered a huge 30-35% rise in the number of cases of fever, cold and cough in December 2024 as compared to November, which shows how dramatically the winter conditions are contributing towards the spread of respiratory illnesses According to a report by the Greater Kashmir. Hospitals throughout the valley are reporting that more than 10% of their patient load is now associated with flu-like symptoms, overstretching already scarce healthcare resources.
The disconnect between medical science and public behaviour is striking. Antibiotics such as Azithromycin, Co Amoxclav 625 have been made part of the everyday treatment for the common cold, which is mainly caused by viruses which are not affected by antibiotics. Doctors have noted that "a very common practice we see in our homes is the urge of usage of antibiotics like Co-Amoxyclav 625 and Azithromycin, which have become household remedies for the treatment of common cold which more often than not is attributed to a viral infection expected to be self-resolving " according to a report by the (Greater Kashmir.)
Walk into any chemist shop in Kashmir, and the scenario plays out repeatedly: customers requesting specific antibiotics by name, pharmacists dispensing Schedule H1 controlled drugs without prescriptions, and no questions asked about symptoms or medical history. This unrestricted access to antibiotics has transformed Kashmir's pharmacies into unregulated dispensaries of potential superbug accelerators.
Research reveals the top three antibiotics dispensed without prescription are metronidazole (75%), ciprofloxacin (15%), and amoxicillin (10%) . The problem is so severe that the Drug and Food Control Organisation in Jammu and Kashmir has been forced to take action, cancelling eight pharmacy licenses and sealing 75 shops for violating drug control norms
The ease of access to antibiotics in Kashmir is very disturbing. Patients are able to receive powerful broad-spectrum drugs just by describing their symptoms or requesting them by name, with little to no clinical evaluation. As Doctors note, in Kashmir "the majority of pharmacies sell medicines to customers without a proper prescription, as is the case in many other states of India" and this normalizes unsafe self-medication and undermines rational drug use.
This free access has led to the misuse of antibiotics as a consumer commodity, which no longer enjoys the protective measures that should be in place for their proper use. What seems to be convenient in the short-term lays the foundation of a much larger and more dangerous problem: the steady, upward progression of antimicrobial resistance.
The ramifications of this antibiotic free-for-all go way beyond the individual patient. Every wrong prescription, every extra course and every viral infection treated with anti-bacterial medication contributes to a global health emergency: antimicrobial resistance (AMR). Doctors at GMC Srinagar already report cases in which "trusted antibiotics fail to work" and infections that were once easy to cure have become stubborn and difficult to treat, signalling a dangerous shift in the region's microbial landscape.
This is not just a local crisis, but a warning of what might occur across the world if current trends persist. The World Health Organization now counts antibiotic resistance among the top ten global threats to human health, and makes the point about how misuse in any one region can have far-reaching implications. Resistant infections already kill an estimated 1.3 million people every year worldwide and projections are that the toll could increase to 10 million by 2050 if the trajectory is not reversed.
A landmark analysis published by The Lancet estimated that bacterial antimicrobial resistance contributed to almost 4.95 million deaths in 2019 alone. These figures show how drug-resistant infections are changing the face of modern medicine in ways that threaten to make once-routine treatments obsolete and push health systems toward a post-antibiotic world.
Compounding the problem is the phenomenon referred to by many physicians as "Dr. Google." Or "Dr. ChatGpt" In a world where medical information is only a search away, many people in Kashmir now self-diagnose and self-prescribe on the basis of internet searches than seeking professional medical advice. Patients, who have limited time or do not want to visit a clinic, may just search symptoms on the internet, suspect a certain diagnosis, and then get antibiotics from a pharmacy.
Many people in Kashmir take their diseases lightly, consult the internet instead of doctors and antibiotics are easily available without prescriptions. Family and community advice is often substituted for medical advice, thus leading to inappropriate, incomplete and unnecessary antibiotic use. Kashmir's severe winter, shoddy air, insufficiency of Vitamin D and indoor crowded spaces with poor ventilation only add to the burden of respiratory infections and antibiotic dependence.
Reducing misuse involves stringent enforcement of prescription rules, improved enforcement of pharmacies, education of the public on the distinction between viral and bacterial infections, and greater access to diagnostic tests and primary care. Hospitals need robust antimicrobial stewardship programmes, while communities need ongoing education to foster a culture of cautious, evidence-based antibiotic use. Environmental measures cleaner heating, better ventilation, air quality alerts and vitamin D awareness have to underpin the medical efforts.
Kashmir is at a turning point: unless self-medication and overuse of antibiotics is controlled, the day will come when common infections will become fatal. Protecting antibiotics for when they are needed to treat genuine bacterial infections, strengthening health systems, and altering everyday behaviours are vital to ensuring that the valley, and the rest of the world, doesn't enter a post-antibiotic era.

Email:------------------------------------kamranbhatt029@gmail.com