Murder of Kashmir’s Healthcare System – I

It was summer 2007. I was in Kashmir with my two-year old son. I had decided to get his khatanhaal (‘circumcision’) done in Srinagar (and not in the United States) due to some scheduling issues and the nervousness of dealing with any aftercare on my own, this being my first child. As I had little time for or faith in the government hospitals of Kashmir, I thought I will get the procedure done in a private facility. Somebody recommended a doctor who ran a private clinic at Buchpora. I visited the doctor. The clinic was situated in a corner of a beautiful garden next to a majestic house. It was a dusty, dingy clinic, with marks of blood on the bed sheet spread over the bed on which my son was asked to lie down. I asked the doctor to change the bedding. A hoard of patients was waiting outside, some of them for his gynecologist wife in the room next-door, while a couple pharmacists kept pouring in now and then. The doctor suggested I should bring the child to Shaikh-ul-Alam Hospital, a private medical facility at Karan Nagar.

We went to the hospital on the scheduled date. When the procedure was done, we were shifted to a patient care room on the first floor. Soon afterwards, a sweeper lady came, waiting on us to leave. “But he just had the procedure. We have paid for one night. Why are you in such a hurry?” I protested. “We have to bring another patient”, she said. “How can you bring another patient when the room is reserved for us until tomorrow? We are not moving until I feel we are ready to go”, I added angrily. With utter disregard, the lady left and came back barging into the bathroom with a huge load of laundry. “You cannot do that until we are here”, I said. She ignored me and continued to do her laundry. After she was done, I needed to use the bathroom. As soon as I stepped in, I slipped and tripped over the soapy water that the woman had spilt all over the bathroom floor, hurting myself. Annoyed at this, after a bit of grudging and grumping, we decided to leave the hospital.

I went downstairs to the reception to get the release, requesting documentation for the procedure and for my payment. We got a receipt for Rs. 500 but no other documentation. I looked at it and turned to the guy at the window: “We paid three thousand rupees for the procedure. What is this? And I need documentation with the name of the doctor who conducted my son’s surgery.” The man seemed to be in a dilemma. After a bit of back-n-forth argumentation and messages being sent across to the hospital Director, I was given some documentation but with the name of a different doctor. “I need the name of the right doctor, and I need a receipt for the complete amount ”, I protested. The young man, apparently under obligation to follow a certain protocol, pronounced: “Madam, go and talk to the Director. Why are you yelling at me?”

I asked for the Director’s room and was shown upstairs. My father and uncle were waiting outside impatiently, as my mother held the poor boy in her lap, with all the bandages on his little thing. As I went in the Director’s room, I found the man sitting amidst a bunch of people, perhaps his employees. Quickly, he exploded from his high chair in his sleek western outfit donning an impressive necktie: Tse kath peth chuth shoar lougmut? (‘Why are you making such noise?’). I tried to explain, but who would care to listen to a lowly creature of a young woman dressed in a cheap shalwar-kameez with no signs to signal the standards of my socioeconomic status. In another spurt of disgust, the man threatened me with: tse chey na patah ba kus chus, mye kyah qualification che. (‘Do you not know who I am, and what my qualifications are?’). This arrogance of his, despite being at fault, further infuriated me and I retorted in an equally belligerent tone: Mye che na patah tse kyah qualification chey, magar mye chukh baasaan anpadh sindi khota badtar (‘I don’t know what your qualifications are but to me you are worse than an illiterate’).

It turned out that the concerned doctor who had done the procedure on my son was the head of the Department of Pediatrics at Sher-e-Kashmir Institute of Medical Sciences (SKIMS). ‘Didn’t you know that they are not allowed to indulge in private practice? Why didn’t you figure out before coming here? Why didn’t you go elsewhere?’ he tried to reason with me. “So, it is my fault and my responsibility to do the investigation, and not yours who is allowing illegal practice in your facility? I will make sure you pay the price for this malpractice”, I blurted out, now in English, warning that I would take him to court.

Uhuh! Figuring that his rants were rendered ineffective, the man was considerably deflated, intimidated by a mere foreign language. Nervous, he picked up his phone and called the concerned doctor. In the next half-an-hour or so, both men tried to pacify me, pleading that I “keep quiet”. Keep quiet in more than one way, that is. The Director even tried to bribe me, offering to return my money “in full”. I threw the Rs. 1000 notes as well as the fake documentation they had just prepared for me at the table and banged the door behind me to leave. By this time my father and uncle had come in to put the situation in control while the Director was trying to negotiate with them. On the way home, the duo tried to explain to me how it was a “common practice in Kashmir. The whole system is like that. You are here for only a few days. Just leave the poor guy alone; he will lose his job”.

Leave the poor guy! And so I did. For the next few days, the doctor kept calling me on my phone, trying to make sure that I did not expose him. “I will get you all the documentation you may need, but please do not make a hue-and-cry about this. I beg you. I will loose my job and my reputation”. Under severe pressure from various people I gave in and let go.

A few days later, I was at a wedding; my brother’s friend was getting married. As I was waiting in the living room of the brother’s friend’s house, I caught sight of the doctor. His wife, in a light pink satin “suit” and a beautiful pearl necklace adorning her neck, accompanied him. As soon as he saw me, the doctor smiled hesitantly, passed a greeting, and introduced his wife; perhaps embarrassed, or worried, or grateful, I don’t know. I responded with half a smile. Later, in the “tent” for the womenfolk, when we were about to have our dinner, I found myself sitting next to the wife. As we were still waiting to be served, her cellphone rang. She picked up the phone to answer the call. I overheard her talking to someone about what appeared to be a medical emergency. From the nervousness reflected on her reddened face and her broken vocabulary it seemed that a gynecological procedure that she had carried out that day had most likely failed. The problem wasn’t the failure of the procedure itself, but the fact that it was apparently an unauthorized procedure. The lady doctor, all sweat and perspiration, left the bata-traem (‘platter of food’) without eating a morsel.

As she left, I was reminded of another lady doctor at the private hospital the other day talking to me while my son was being operated upon by her colleague: “You know, our life style has changed. We have to make more money. We want to provide the best for our kids, their education. So, we must do this”.

Yes, indeed! We must do this! 

(Part 1 of 2 concluded)
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(This article was published in the daily Rising Kashmir in Feb., 2015: http://www.risingkashmir.com/murderers-of-kashmirs-healthcare-system-i/ )

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