Kashmir’s healthcare faces institutional collapse in harsh winters. But there are solutions

By: Dr. Fiaz Maqbool Fazili 

The harsh winters of Kashmir bring more than just bone-chilling cold; they expose the frailties of an already overstretched and underprepared healthcare system. In a place known for its immense  beauty, the realities of its healthcare infrastructure during the winter months reveal a stark contrast. With snowfall often disrupting road connectivity, electricity supplies faltering under the strain of excessive demand, and inadequate heating facilities in hospitals, healthcare becomes a nightmare for both patients and their attendants. The institutional collapse of healthcare in Jammu and Kashmir is a grave concern, demanding immediate attention and long-term solutions.

The State of Public Welfare: A Grim Reality

Education and healthcare are universally acknowledged as the cornerstones of public welfare in any nation-state. Yet, in Jammu and Kashmir, these sectors have become heavily privatized and commercialized, catering more to the affluent than to the common citizen. The pharmaceutical industry, often monopolized by the wealthy political elite, exemplifies the systemic inequities. Healthcare, despite being bolstered by numerous welfares schemes, suffers from poor implementation. These schemes largely remain confined to paperwork, advertisements, and photo opportunities, failing to translate into tangible benefits on the ground.

Winter Challenges in Healthcare: Road Connectivity and Accessibility

One of the most pressing issues during winters in Kashmir is the disruption of road connectivity. Heavy snowfall often blocks major highways and arterial roads, cutting off access to remote villages and towns. This poses a critical challenge for emergency medical services, including the transportation of patients and supply of essential medicines. The delayed or non-existent snow clearance further exacerbates the problem, turning simple health issues into life-threatening crises.

Electricity Shortages:

Electricity is the lifeline of modern healthcare, but in Kashmir, power cuts are a perennial issue. Hospitals frequently operate on generators, which are neither reliable nor sufficient to meet the demands of critical care units. Neonatal intensive care units (NICUs), operating theatres, and diagnostic equipment suffer from frequent interruptions, jeopardizing patient safety. The lack of a stable power supply is particularly alarming during winters, when heating systems are essential for patient comfort and recovery.

Lack of Heating Facilities:

The absence of adequate or 24×7  heating facilities in hospitals adds another layer of distress for patients and healthcare workers alike. Cold hospital wards not only hinder the recovery of patients but also make it extremely difficult for medical staff to perform their duties efficiently. Patients suffering from chronic illnesses, the elderly, and newborns are especially vulnerable to the freezing temperatures, which often exacerbate their health conditions.

Conditions for Attendants:

A Neglected Aspect; In Kashmir, it is common for family members to stay with hospitalized patients to provide care and support. However, the lack of basic amenities for attendants in hospitals makes this a harrowing experience. There are no proper heating arrangements or sleeping facilities, forcing attendants to endure freezing nights on hospital floors or in their vehicles. Washrooms are often in a deplorable state, with broken fixtures, unhygienic conditions, and an acute shortage of water—making even basic hygiene a challenge. This neglect highlights the systemic apathy towards the holistic needs of patients and their families.

Institutional Collapse: Symptoms and Causes

Poor Infrastructure- The inadequate infrastructure of healthcare facilities in Kashmir is a glaring issue. Most government hospitals are ill-equipped to handle the influx of patients, particularly during winters when respiratory illnesses and accidents due to slippery roads surge. Essential equipment such as ventilators, defibrillators, and diagnostic tools are either outdated or unavailable, forcing patients to seek treatment in private facilities that are prohibitively expensive. Shortage of Skilled Personnel-Another critical problem is the shortage of skilled healthcare professionals. The region suffers from an insufficient number of doctors, nurses, and paramedics, compounded by a lack of specialized training. Many doctors prefer to work in private hospitals or migrate to other states, leaving government facilities understaffed and overburdened.

Policy and Administrative Failures:

The failure of the administration to prioritize healthcare is evident in the poor allocation of resources and lack of contingency planning. Emergency preparedness for winters remains inadequate, with no significant efforts to stockpile essential medicines or ensure the availability of ambulances equipped for snow-covered terrains. The absence of accountability mechanisms further aggravates the situation, allowing systemic inefficiencies to persist unchecked.

Privatization: A Double-Edged Sword

While privatization has brought some modern facilities to the region, it has also created a stark divide between those who can afford quality care and those who cannot. Private hospitals and clinics, driven by profit motives, often charge exorbitant fees, making healthcare inaccessible for the majority. The focus on commercialization undermines the very essence of healthcare as a fundamental right.

The Way Forward: Solutions and Recommendations

Strengthening Infrastructure-Investing in robust healthcare infrastructure is imperative. This includes upgrading existing hospitals with modern equipment, ensuring adequate heating arrangements, and building new facilities in underserved areas. The government must also prioritize the maintenance of hospital premises, including clean and functional washrooms for patients and attendants. Enhancing Road Connectivity; To address the issue of disrupted road connectivity, the administration should establish a dedicated winter task force for snow clearance and maintenance of highways. Advanced technologies such as GPS-enabled snowplows and real-time monitoring systems can be employed to ensure timely action. Additionally, helicopter services for medical emergencies in remote areas should be made more accessible and affordable. Ensuring Reliable Power Supply- The government must invest in alternative energy sources such as solar panels and battery storage systems to supplement the unreliable power grid. Hospitals should be equipped with high-capacity generators and uninterrupted power supply (UPS) systems to safeguard critical medical equipment and heating facilities. Training and Retaining Healthcare Professionals-Addressing the shortage of skilled healthcare workers requires a multi-pronged approach. This includes offering better incentives and working conditions in government hospitals, increasing the intake capacity of medical colleges, and introducing specialized training programs. Collaborative efforts with private sector stakeholders can also help in bridging the skill gap.

Policy Reforms and Accountability:

Healthcare policies must be revisited to align with the unique challenges of the region. This includes setting up independent monitoring bodies to oversee the implementation of welfare schemes and holding officials accountable for lapses. Public-private partnerships can also be explored to improve service delivery without compromising affordability.

Focus on Patient-Centric Care:

Creating a patient-centric healthcare system involves addressing the needs of both patients and their attendants. This includes providing comfortable waiting areas, heating arrangements, and hygienic washrooms. Feedback mechanisms should be established to understand and address the concerns of hospital users effectively.

Community Participation:

Public awareness campaigns can play a crucial role in improving healthcare outcomes. Educating people about preventive measures, first aid, and the importance of timely medical intervention can reduce the burden on hospitals. Community health workers can also be trained to provide basic care in remote areas, bridging the gap between the populace and the healthcare system.

The harsh winters of Kashmir bring to light the systemic failures of the region’s healthcare system, turning what should be a sanctuary of healing into a source of additional suffering. While the challenges are immense, they are not insurmountable. With focused investments, policy reforms, and a commitment to patient-centric care, the healthcare system in Jammu and Kashmir can be revitalized. The administration must rise to the occasion, ensuring that healthcare is not just a privilege for the few but a fundamental right accessible to all, irrespective of the season or socio-economic status. Only then can the people of Kashmir face the harsh winters with resilience and hope, rather than fear and despair.

Dr. Fiaz Maqbool Fazili is a distinguished clinical auditor and an expert in healthcare policy analysis, His insightful analyses and contributions to healthcare policy and practice make him a respected voice in the field can be reached at [email protected].)