As Jammu and Kashmir is mounting its fight to contain the COVID-19 pandemic, health institutions like Sher-i-Kashmir Institute of Medical Sciences (SKIMS) are leading from the front. From expanding testing facilities to the setting up of isolation centres, SKIMS has played a critical role on the front lines of the fight against COVID-19. Tertiary hospital also played a significant role with regard to surveillance, sample collection and testing in Jammu and Kashmir. Rising Kashmir’s Special Correspondent Manzoor-ul-Hassan spoke to the Director of SKIMS, Dr A G Ahangar regarding the Covid-19 pandemic, its preparedness and functioning of the hospital. 

Edited Excerpts:

How is SKIMS responding to the Covid-19 pandemic?

SKIMS took the brunt head-on since March 2020. We received suspected Covid-19 patients, confirmed their viral load from our Viral Diagnostic Laboratory and authenticated them at the National Institute of Virology, Pune. And we continue our services and offer the testing facility for all the samples of Jammu Kashmir, and Ladakh.

SKIMS conducted nearly 12,000 tests in 24 hours on the day of Eid which is the highest record from any such Lab in the country. From contact tracing to treatment of all the levels of Covid-19 infection to begin with, SKIMS offered its services while simultaneously managing the non-Covid patients as well. We continued to run the OPD services in contrast to other premiere institutions that stopped their OPD services. We in-fact enhanced the OPD services through virtual clinics dedicating a number of landlines and cell numbers for this service to the needy patients who accessed the various sites from remotest possible areas of UT of J&K, even also from abroad. This spectrum of service has continued today in the second wave of this Pandemic with apparently highest incidences of infectivity, transmission and morbidity / mortality.

We also constituted an Advisory Committee of all the concerned Heads of Departments, Professors and other divisions to formulate policies and protocols in the management of Covid-19 pandemic that have been revised on real time basis devising its own treatment protocols in the light of WHO and ICMR guidelines and those issued by the Government of India from time to time. SKIMS has exhibited brilliant performance in terms of management level care with lesser mortality in comparison to the data from Wuhan, AIIMS, New Delhi, and almost at par with New York as  evidenced by the published literature.

What’s the USP of SKIMS when it comes to fighting the deadly virus?

SKIMS has the distinction of being a Deemed University imparting post-doctoral, postgraduate, undergraduate, diploma and all other such allied teaching and training programs. The human resources available at the institute makes it different from other health institutions, wherein post-doctoral scholars as well as postgraduate trainees alongside the senior residents and faculty members have contributed immensely in developing these treatment protocols that have unfolded the success story of SKIMS.

When pandemic hit, how rapidly were you able to mobilize resources?   

The pandemic engulfed the entire world, including the advanced health infrastructure in the US, Europe, Far-East, etc. Indian subcontinent was no exception, so was Jammu Kashmir. Many big economies and leading healthcare institutions crumbled but SKIMS took the lead from events across the globe with the help of daily review of the treatment advisories and real time data analysis. We strategized to contain and handle the patient load from Covid-19 pandemic very efficiently while ensuring all the essentials needed in the fight against the pandemic. We ensured that everything needed for the treatment of Covid-19 patients is available be it the space, infrastructure, equipment or medicines.

We were also prepared to take patients on ECMO and Lung Transplant. We also ensured a constant supply chain for the management of Covid-19 pandemic despite all odds, be it lockdowns, restrictions, scarcity and drought in the markets.

Who would you credit for effectively managing the crisis?

Everyone contributed to the success story of SKIMS, be it a colleague from Critical Care Medicine, Internal Medicine or other allied services. The support from lab, engineering services and administration was also encouraging.  

The most crucial and single significant determinant has been constant and close monitoring by the Honorable Lieutenant Governor, Manoj Sinha.

SKIMS also devised a unique strategy and treatment protocols to tackle the coronavirus infection. The institute also organized a different referral system in coordination with other premiere institutions and peripheral hospitals of J&K, in-fact, we deputed a team of experts to help other institutions including GMC Jammu in order to support their efforts in combating corona pandemic. We have also been conducting training sessions for the staff members of the other organizations including security services. Our hallmark remains that we have been sharing our expertise and knowledge with other institutions and organizations beyond SKIMS.

How has Covid impacted the normal functioning of the Institute?

SKIMS has the distinction for having managed Covid-19 pandemic for Level-III illnesses alongside managing Non-COVID patients simultaneously barring a few spectrum of illnesses where the intervention, medical or surgical could either be delayed, avoided or postponed in order to safeguard the patients and their attendants who would otherwise be non-Covid but could get exposed to the Covid-19 viral infection while being in the hospital premises.

For this reason, SKIMS dedicated infectious diseases block, medical Observation, surgical observation, A-Wing of the entire hospital structure consisting of more than 500 beds including the space from Wet Lab, State Cancer Institute etc. for the management of Covid-19  patients while safeguarding the interests of the patients in all the areas of the hospital,    re-organizing / redistribution of all the hospital beds from amongst various Specialties / Subspecialties for Covid-19 and simultaneously non-Covid patient management. At no point of time did patients from comorbidities including cancers, immune-compromised states, stroke, heart attacks, trauma and all other life threatening infectious pathologies suffer for want of management.

With my ‘Futuristic Plans’ for the SKIMS, I have enhanced its bed capacity from 650 in 2016 to 1250 in 2021, ensured its holistic development in all spheres of Academics, Research and Tertiary patient care with a vibrancy of over a thousand in 1982 to about twenty thousand footfall today. With the other projects and plans for a “Vision 2030” I intend to ensure that the Institute caters to the new emerging trends with molecular interventions and nanotechnology and subcellular interfaces. From the admission of a patient to his/her see off from the hospital shall always be a dream come true. 

Do you think turning SKIMS into Covid care hospital would overwhelm the institution?

It’s certainly not, instead it has been in the right direction because SKIMS is the only institute in the entire J&K including adjacent UT of Ladakh where Super-Specialty non-COVID management besides Level-III Covid management has made all the difference in the lives of the people who were otherwise destined to get doomed. This has been one of the wisest decisions in fact to save innumerable lives on account of both Covid and non-Covid pathologies. The fact remains that the patients from all peripheral and central Institutions including other Tertiary Care Institutions have ultimately landed in the SKIMS for the ultimate Care even in extraordinary circumstances. Moreover, SKIMS has been the most often preferred destination for the ultimate treatment for any co-morbidity related to terminally ill patients even from Center’s like Narayana Hospital from Katra, GMC Jammu/ Srinagar and all other Medical Colleges from Leh and Kargil, so on and so forth. Quite a huge number of patients from Rajouri, Pooch, Doda, Chenab Valley across Pir-Panjal had been desperately looking for a slot for treatment at SKIMS that in itself speaks volumes about the Prestige of this Institution. Some of the Patients from outside J&K had the privilege to get treated at SKIMS including some patients who did not have any attendant with, instead were supported in a homely atmosphere besides treatment for their illnesses.

As the head of institution, what were challenges for you?

Be it chaos and crisis, under the most taxing civilian unrest of 2016 or the Covid-19 pandemic with its pandemonium and the disaster with devastation that the valley in particular has gone through, Dr Ahangar in the capacity of the Head of the Institution has always stood the  test of time while leading from the front in the management of traumas of 2016 crisis or Covid-19 Pandemic while going to the front lines in the first instance and motivating all other Human resource who ultimately took the lead in the line of fire from both these worst scenarios which is an open Book for anyone to read, to acknowledge or to ascertain. Infact, from the very first test for RT-PCR, RAT, Interaction with Covid-19 patients in the isolation areas to Vaccination for the first time after e-launch of vaccination campaign by the Hon’ble Prime Minister of India, Narendra Modi on January 16, 2021, Dr Ahangar has been in the lead role and setting the trend for all others to follow while appreciating and supporting one and all in the line of Duty.

What are new projects in pipeline to enhance healthcare in SKIMS?

SKIMS already has many high-end technological support and interventional management for patients of different ailments. With the help of Advanced Human Genetics, Immunology and Molecular Medicine, Biochemistry, Histopathology, advanced Virology, tissue matching with Stem Cell Transplants and Bone Marrow Transplants we  support them at SKIMS. However, there is always a scope for further upgradation and molecular interventions for which the “Futuristic Vision” with fourteen more High-End Projects are in the pipeline that would transform the dreams of millions across the UT of J&K besides the Human Resource and Capacity Building in Jammu & Kashmir.

Finally, what would you say to your critics?

While acknowledging the tremendous contribution by everyone one including HOD’s, Professors, Junior Faculty, Residents, Nurses, Paramedics and other team management, SKIMS has exhibited its brilliance which is quite evident despite the fact that there may be some lapses, after all there is no setup or the system in the World that is perfect enough to claim being the ultimate in an evolving situation where Covid-19 pandemic devastated all modes of management from conservative to interventional, from supportive to life saving, from non-operative to operative modalities of management, yet lapses if at all anywhere are accepted with humility. Unfortunately, the criticism emanating from the Non-performers is the one that hurts but as long as the healthy criticism from ones who matter and the ones who contribute can make the difference while being the source of inspiration for evolving the level of care that this institution is offering because of which SKIMS stands tall today.

Despite these nefarious acts by a few of the mischievous elements who could even sabotage or damage the assets of this Institution, SKIMS has always come up to the expectations of the people at large. My mission for the betterment of patient care at SKIMS or outside shall continue whatever it takes. My “Mission Kashmir'' shall stay very dear to me, I am not scared of anything or anyone. 

“Meri Nazar Qasre Sultani Key Gumbadh Par,

Na Mera Basera Pahadoon Ki Chataano Par,

Mai Woh Uqaab Houn Jo Darta Nahin Baade-Mukhalif Se,

Mere Saamne Aashiyaan Hi Nahi, Aasmaan Aur Bhi Hain!”