Established in 1979, District Hospital Pulwama was envisioned as the primary health institution for South Kashmir, designed to cater to the medical needs of Pulwama and adjoining districts including Shopian and parts of Budgam. Located at the heart of Pulwama town, its geographic centrality was meant to ensure easy access for patients from rural as well as urban belts. However, more than four decades later, the hospital now struggles to deliver even basic healthcare services in an efficient, dignified, and transparent manner.
The hospital currently houses five main departments: General Medicine, Surgery, Gynecology, Pediatrics, and Orthopedics. While these departments function daily, the increasing patient inflow—averaging more than 20,000 patients a day—has rendered the infrastructure obsolete and the services overstretched. What was once a modest yet functional health center has now become a hotbed of administrative indifference, outdated technology, manpower shortages, and growing public distrust.
One of the most persistent challenges is access to the hospital itself. The narrow approach roads, unregulated parking, and lack of traffic management make the hospital difficult to reach. Critical patients in ambulances often face delays due to congestion and sharp turns near the entrance. Over the years, there has been no permanent infrastructural solution, despite repeated public outcry. Temporary measures like one-way entry points or police deployment have only provided short-term relief. The location, which should be an advantage, becomes a bottleneck for emergency cases.
Another issue of significant concern is the absence of female staff in departments such as ECG and radiology. In a society where modesty and gender sensitivity are deeply respected, the lack of female technicians creates discomfort and discourages many women from undergoing vital diagnostic procedures. Patients often skip recommended tests due to embarrassment, compromising early detection and treatment. Appeals by civil society and patient attendants have long gone unheard, making this a continuing gap in the hospital’s healthcare delivery.
The ultrasound section is in an equally deplorable condition. The hospital lacks the latest-generation USG machines. The ones that exist are often out of order or insufficient in number. This forces patients to seek ultrasound services from private diagnostic centres outside the hospital. Over time, this has given rise to a thriving commercial ecosystem, where patients are routinely referred to selected private clinics. Allegations of collusion between some hospital staff and these private centres are widespread. The referrals appear more business-driven than medically necessary, and the burden on the poor grows heavier as out-of-pocket expenses mount.
A similar pattern is reported regarding prescribed medicines. Patients often find that drugs recommended by doctors are unavailable at the hospital pharmacy but are easily found in specific private medical stores in the vicinity. There is a growing perception of an informal but well-established nexus between certain doctors and private chemists, where prescriptions are guided not only by patient welfare but by profit-sharing arrangements. This perception has damaged the trust between patients and healthcare providers.
Inside the hospital, another serious problem is the presence of employees who have been posted at the same place for over five years. These long-term postings violate basic transfer norms and lead to the formation of power lobbies within the hospital. These individuals, often called “deadwood” by their colleagues, resist innovation, accountability, and any effort to enforce discipline. Their unchecked presence has become one of the biggest barriers to reform. Freshly appointed staff find it difficult to work under them, and even department heads hesitate to question their non-performance.
In recent times, the hospital has seen a spate of unfortunate incidents, including deaths that led to tensions between doctors and patient families. The absence of any medical audit committee or internal inquiry mechanism means that no transparent investigation follows such events. As a result, public anger intensifies, often culminating in verbal abuse, violence, or even FIRs against medical staff. The lack of an institutional grievance redressal system adds fuel to the fire, and both doctors and patients suffer from rising mistrust.
One cannot ignore the glaring manpower shortage that affects every department. The number of qualified doctors, nurses, paramedics, and support staff is grossly inadequate for the daily patient volume. What makes the situation worse is the heavy reliance on students from para-medical institutes, who are still in training but are asked to run hospital services in casualty, wards, and diagnostics. While the intention may be to offer them hands-on experience, the reality is that these students are unprepared for handling emergencies, and their inexperience could put lives at risk.
Infrastructure within the hospital reflects long-term neglect. Many wards are overcrowded, beds are broken, washrooms lack water or cleanliness, and diagnostic equipment remains outdated. Emergency and operation theatre equipment is often in poor condition, and essential machines like ventilators or defibrillators are either under repair or non-functional. The pharmacy continues to stock outdated medicines, while modern, lifesaving drugs remain out of reach for common patients.
Another contentious issue is the use of hospital space. The current building of the Nursing College is occupying a significant portion of the hospital’s infrastructure. At the same time, the hospital lacks a dedicated maternity and neonatal care unit, forcing expecting mothers to adjust in crowded general wards. Despite proposals for shifting the Nursing College to another location and using the building for maternity services, no action has been taken. The existing space is not enough to meet the demand, and there has been no vertical or lateral expansion of the hospital building in years.
In this entire administrative vacuum, the role of the elected representative—the local MLA—has been disheartening. There is a prevailing sentiment among the public that their representative has shown little interest in the affairs of the district hospital. Despite multiple memorandums, deputations, and media coverage, no major upgradation, funding proposal, or policy intervention has come from the legislator’s office. The public expects leadership that takes ownership of health issues, not silence.
Similarly, the role of local religious leaders, social organizations, and civil society remains underutilized. These community figures, if mobilized, could act as bridges between the administration and the public. They can help in awareness campaigns, crowd control, and act as watchdogs. Their collective voice can push for accountability, but so far, their involvement has been marginal.
The way forward begins with immediate identification of employees who have overstayed and contributed to stagnation. Such individuals must be transferred without exception. Fresh faces and young professionals must be brought in to infuse energy and restore a culture of service. The duties of every staff member should be clearly defined and enforced, with periodic reviews and disciplinary action in case of negligence.
A comprehensive recruitment drive should be launched to bring in doctors and specialists from within Kashmir as well as outside. Local doctors working in metropolitan cities can be offered short-term contracts with incentives. Specialists from outside the Union Territory can also be engaged on a tenure basis. Without enhancing manpower, no meaningful reform is possible.
Immediate attention must be paid to gender sensitivity. At least two female technicians for ECG and radiology must be appointed and posted within the hospital. Makeshift arrangements for privacy during tests must be replaced with dedicated, enclosed diagnostic areas for female patients.
The hospital must acquire a state-of-the-art ultrasound machine and stop over-relying on outside referrals. A ban on unauthorized medical representatives (MRS) inside the hospital must be enforced strictly. Doctors must prescribe medicines available within the hospital pharmacy, and any irregularities should be penalized.
Doctors who have served for more than two years in one post must be systematically shifted, preventing the development of fixed lobbies. This also encourages professional accountability and the exchange of best practices across hospitals.
The Nursing College should be shifted to a nearby educational campus, and its current building converted into a full-fledged maternity and neonatal care block. At the same time, the old hospital building must be expanded vertically, adding at least two more floors to cater to growing departments and emergencies. The model should be modular, allowing each floor to serve one department independently.
\Outdated drugs should be replaced with standard, updated medicines based on WHO and Indian Pharmacopeia guidelines. Machines that are beyond repair must be discarded and replaced. A medical equipment maintenance committee must be constituted with monthly inspection mandates.
An accountability cell should be formed within the hospital to address complaints from patients, attendants, and staff. Every death, serious conflict, or reported case of negligence must be documented and investigated. A weekly public report summarizing patient load, performance, grievances, and resolutions should be published for transparency.
The local MLA must step forward and take responsibility. Their intervention is critical in securing funds, pushing tenders, enabling transfers, and raising issues at the legislative level. In the absence of political support, bureaucracy remains inactive and public anger simmers.
Lastly, local religious leaders, senior citizens, and civil society must form a District Hospital Citizens’ Forum that acts as a pressure group, a support network, and a partner in reform. Community involvement is not a threat to governance; it is a necessary foundation for rebuilding trust.
District Hospital Pulwama does not need a miracle; it needs a mission. It needs urgent action, long-term planning, and above all, human accountability. If the right steps are taken today, this hospital can still live up to the vision of 1979. If not, it will continue to collapse — not because of patients, but because of the system that failed them.

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