Our doctors possess the heart, the intellect, and the skill to save lives. What they desperately lack is structural support
SYED NISSAR H GILANI
Healthcare is fundamentally built on a promise: to heal, to comfort, and to protect. Yet, for thousands of families across the Kashmir Valley, falling ill has increasingly transformed from a personal misfortune into an immediate economic and systemic gamble.
While public discourse frequently focuses on the prohibitive costs of private treatment, a quieter crisis is unfolding daily within the walls of our diagnostic laboratories and overloaded referral hospitals. A recent Rising Kashmir editorial highlighted how unregulated diagnostic testing is bleeding patients dry. However, the true reality of our healthcare system is complex—defined simultaneously by deeply dedicated public doctors, crumbling infrastructure, and a system buckling under its own weight. I recently experienced and witnessed both sides of this coin.
A Sudden Crisis in a Far-Off District
In the middle of February this year, while staying with my son in a distant district of Kashmir, a seemingly innocent breakfast altered the course of my week. A slight deviation from my routine tea and traditional bread triggered a severe case of food poisoning. What followed was a total gut failure, resulting in non-stop motions for six continuous, terrible days.
In that remote district hospital, I witnessed the finest virtues of our public healthcare framework. A host of dedicated doctors tried their level best to halt the illness, keeping me hydrated with non-stop intravenous salines. Furthermore, the mandatory diagnostic tests were conducted right there, utilising advanced medical equipment for nominal charges or entirely free of cost.
Throughout those agonising days, I remained fully conscious, rigorously following every prescription. Yet, my body resisted the treatment. Realising that the situation was slipping beyond the scope of local management, the doctors made a critical midnight decision: I had to be shifted immediately to the Sher-i-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar.
Midnight at SKIMS: Emergency Protocols and the Paying Ward
Arriving at SKIMS in the dead of night, I was immediately admitted to the emergency ward. I was relieved to see that despite the hour, all medical protocols were followed in letter and spirit. Seeking a quiet environment for recovery, I opted for a paying ward for the remainder of my stay.
This section of the institute was very well-maintained, and my treatment began without delay. Thanks to the exceptional care of the doctors and paramedical staff, I was successfully treated and discharged within six days.
During my stay, I observed that the paying block was adequately equipped, and the paramedical staff worked tirelessly, monitoring patients day in and day out. However, I also noticed a distinct structural challenge: the senior specialists would usually attend to us at the very last leg of their rounds. This delay was obviously not intentional; rather, it was the logistical result of the paying block’s physical distance from the main blocks of the common designated wards, compounded by the relentless daily rush.
The Weight of Exhaustion on Our Best Minds
This reality inside SKIMS brings us to the core of the crisis. The institute is so overwhelmed by the rush of patients from every corner of the Valley that even the most brilliant, dedicated medical and paramedical staff are visibly drained.
There is no doubt that we have some of the best doctors in the country available at SKIMS. However, due to severe overloading and sheer physical exhaustion, their overall efficiency to treat patients inevitably gets compromised. When human endurance is pushed past its limits, even the most skilled hands face an uphill battle.
This systemic overload is visible across all major institutions in the capital, including SMHS hospital. Just a few days ago, while going for a follow-up ultrasound (USG) at SMHS, I was deeply moved and shocked by a stark contrast. I watched a young doctor—highly trained and educated in the United Kingdom—sitting on a broken chair behind a shabby table. Despite the substandard infrastructure and the chaotic surroundings, this doctor was treating a relentless stream of patients with immense humility, love, and professional grace.
Yes, there are exceptions in every field, and some medical professionals may differ in behavior. But the overarching truth is that our government hospitals are chronically overloaded, and our finest medical minds are being forced to work in conditions beneath their dignity.
The Need to Decentralise and Stop the Srinagar Rush
My own journey highlighted a glaring flaw in our healthcare delivery system: the culture of over-referral. A simple case of food poisoning, severe as it was, should ideally be manageable at the district level. We must actively discourage the practice of automatically referring patients to Srinagar for ailments that can and should be treated locally.
Srinagar’s premier institutes must be preserved for tertiary care—reserved exclusively for patients who require specialised surgeries, advanced interventions, or rare treatments. When peripheral hospitals default to transferring routine cases to the capital, they inadvertently choke the system, exhaust the staff, and compromise care for those who genuinely need the unique expertise of a premier institute.
The “Profit Carnival” and the Mushrooming Private Sector
For those who are pushed out of the public tier due to long waiting lists, exhaustion, or broken machinery, the alternative is financially devastating. Outside the gates of our public hospitals lies a highly lucrative, completely unregulated marketplace of private diagnostic centres and clinics that are mushrooming across the Valley.
As the Rising Kashmir editorial rightly points out, private labs currently operate in an administrative vacuum, leading to wild price disparities for identical tests within the same town. While the growth of private healthcare provides necessary alternatives, these institutes must practice fair play. Patients should be treated with equity and transparency, not “lynched” financially through hidden charges and predatory pricing, as is unfortunately reported all too often.
A Blueprint for Government Action: Eradicating the Menace
To prevent our healthcare system from morphing into a commercial profit carnival and to protect public health, the Jammu & Kashmir UT administration must step in with immediate, sweeping statutory reforms:
Enforce Diagnostic Price Caps: The government must enforce strict, region-specific price ceilings for common tests across all private laboratories.
Decongest Capital Hospitals: Peripheral and district healthcare infrastructure must be strengthened to handle routine emergencies, strictly limiting referrals to Srinagar to complex, specialised cases.
Ban Private Practice for Government Doctors: A major step toward restoring efficiency in public hospitals is to completely stop the private practices of regular doctors working in the government sector. This ensures their undivided time, energy, and focus remain dedicated to the public institutions they serve.
Crack Down on Fake Medical Practitioners: A deeply threatening situation has emerged where unqualified individuals fake their credentials using B.Pharma certificates purchased from outside universities. These impostors are duping the public and playing with patients’ lives. The government must launch a rigorous verification drive to weed them out.
Investigate Illegal Drug Licensing: In both urban and rural areas of the UT, a dangerous menace is thriving where individuals buy or lease drug licenses from the actual certificate holders, who remain silent partners in this illegal trade. The administration must identify and shut down these proxy chemist shops to curb the proliferation of fake and substandard drugs.
A Final Note of Gratitude
Our doctors possess the heart, the intellect, and the skill to save lives. What they desperately lack is structural support. Until firm regulation, transparent oversight, and strategic decentralisation are brought to our healthcare system, the promise of affordable well-being in Kashmir will remain entirely hollow.
Yet, even within a strained system, humanity shines through. I must conclude by expressing my profound gratitude to all the doctors and paramedical staff at SKIMS who treated me with the utmost interest, care, and professionalism during those critical days.
A very special note of thanks goes to the Director of SKIMS, Dr. M. Ashraf Ganayi. Beyond being an exceptional administrator, he is a long-time friend and well-wisher. During my hospitalisation, Dr. Ganayi made personal visits to my room, ensuring that all emergency and ward protocols were being meticulously looked after. It is because of this combined dedication—from the highest office to the bedside nursing staff—that I am here today to share this story, in the fervent hope that our healthcare system can be healed for the sake of every citizen in the Valley.
(The author is a former civil servant from the administrative service and RK Columnist. He can be reached via email at: nisargilani57748@gmail.com)