Dr. Sadaf Munshi
About a year and a half ago, in August 2013, I was in Srinagar for another yearly visit to Kashmir. During one of those days, an unidentifiable insect bit my mother-in-law in her eye-lid. We thought it was a spider or something but could not say for sure. At night, she had an allergic reaction and was taken to SHMS hospital. Situated in the heart of the city and built in 1948, the Sri Maharaj Hari Singh hospital is perhaps the oldest hospital in the city. With such a long history, one would expect it to have evolved into one of the finest healthcare facilities of the state. Unfortunately, that is far from reality. It turned out that my mother-in-law was grounded in the hospital for about ten days without respite; this besides the number of months it took her to fully recover from the incident and after effects which almost took her eyesight.
I visited the hospital several times before my mother-in-law was checked out, still in pretty bad condition. What I saw in the hospital was not unusual but nothing one would call “normal”. You will find patient wards flooded with visitors round the clock, as if it were a festival of sorts. Except for a few threatening gestures to newcomers, there is hardly anyone checking at the entrance gate. It wasn’t clear if there were any rules or regulations regarding visitor presence, and if there were, they were ruthlessly violated. Like a busy railway station, people were brushing each other’s shoulders in corridors and walkways all the time.
At several occasions, my mother-in-law had to be shifted from Dermatology to a different ward for oxygen. The concerned ward did not have any, and the area meant for the purpose was persistently locked. Because there was no BP machine either, the medical staff on duty relied on the neighboring ward to borrow theirs while patients waited for hours. It was quite an ordeal. “Why don’t you have your own machine in the ward?”, I asked. A staff member responded: “It was stolen a few months ago; so we have had to borrow from the other ward”. “But how much does the machine cost? Why can’t you get your own?” I asked. “It doesn’t cost much, but we need to have the orders and the paperwork approved. It takes time for that. It is a lengthy process”.
Since my mother-in-law’s face and neck had been badly swollen, she needed regular ice packs. But the hospital did not have a functioning refrigerator. We were asked to bring our own, just like the medications. “But this is not something that can be brought from home”, I protested. “You need to have a refrigerator right here”. Our pleas fell to deaf ears. Somehow, we managed a couple packs but these would melt soon. So, every few minutes we had to run to the canteen wallah in the next building, “Could you please keep this in your fridge for some time? They don’t have a fridge in the hospital”. The man obliged. But because of prolonged stay, it was overly embarrassing to continue to ask the guy for the favor. Therefore, we asked visitors to bring ice from home. A lot of ice came in thermos flasks, lunch boxes, and so forth, sometimes all at once, but sometimes none. But when we got it, the damn thing would melt within minutes. Considering the amount of effort it took in arranging such a basic thing like ice, frustration levels were very high.
After a few days, my mother-in-law was still unable to open her eye. So we had to take her to Ophthalmology for a checkup. With droves of people waiting, there was little hope that a doctor would see us anytime soon. People kept cutting into the line, and we had no sufarish. Exhausted, she turned to me sheepishly: karsi English paeth kath, balaay hay lagay. Sakh dag hay chhem (‘Talk to him in English, I beg you. I am in immense pain’). After a little hesitation, I opened the door, “May I come in?” Voila! A few words in good English can work wonders in such a situation. To hell with ethics!
With little improvement in her condition, it seemed the medicines were not working. The hygienic conditions of the hospital were so repulsive we wanted to leave as quickly as possible. Cats and dogs were roaming in the premises and rodents running underneath patient beds. With the sweepers’ half-hearted strokes besides tarnished ground and bloodied toilets, the floor was stinking. Heaps of construction materials and loose cement in the corridors led to dusty stairways. Garbage bins had turned filthy dark with liquids spilt on their surface over time. The sight and the smell were so repugnant that even a healthy person would nauseate. The heavy traffic of visitors was only adding to all this. I wanted to see the superintendent but she was nowhere to be seen. “She will come at 2:00pm”, said someone. “After she is done her private clinic”, a patient added mischievously.
During one of these visits I found a lady on the next bed missing. “They took her to emergency. I wonder if the medications are working….”, somebody said regretfully. I had seen her doing well only a day before. Suddenly we heard a group of women screaming, thumping their chests and wailing at the death of a loved one; this was probably the third one in a row past three days in the hallway. A severely injured young man barged into our ward asking for help. A man – a doctor or an assistant or a patient, no one could tell – pulled the bandage from his wound on the spot, mercilessly, while standing in the middle of the ward, exposing an open gash. It was a horrendous scene. Patients and attendants gasped. I covered my eyes in disgust: “Why here?” It felt like a slaughterhouse.
Every now and then mother-in-law needed oxygen, which meant having to take her over to the other ward. But often no staff or nurse was seen around. And even if there were, it was challenging to identify and find them. Few wore a uniform and no one had a badge on them. Offices were mostly deserted, except for few brief occasional appearances. We were clueless as to what to do in need. At one of these occasions, I wanted to speak to a doctor or a nurse, but it was not clear who was in charge or where to find them. The notice board on the wall was clean, with no updates at all. Eventually a young lady in a bright colored shalwar-qameez came in with a file in her hand accompanied by a couple more people, apparently to examine her. Perhaps she was a nurse or a doctor, or whatever. I asked her name and designation. She got offended and asked why I wanted to know that. I said, “Just for records”. Angered, she turned to me: “Why do you need that?” I said we needed to know so that we could check her status or inform the doctor of any complications if need be. Besides, we had a right to know who was treating (or not treating) her.
The young lady, perhaps a resident trainee, now very upset, scoffed at me. The matter ended up in a bitter confrontation with her refusing to disclose who she was. Frustrated, I took a picture of her. In response, she grabbed my phone and ran away. I tried to follow her but she was able to beat me and vanished into the ocean of people. Consequently, I went looking for the Superintendent. After a bit of running around, I found her in her office. When I explained the situation, the officer turned to me, “She is a young unmarried girl. You took her picture. That was not right”. “Oh? And what you and your staff are doing here all the time is very nice?” After a bit of argumentation, the officer toned down and brought the young lady in. I got my phone back after deleting her picture. But I never got to know her name nor her designation. I hated that.
As I saw my mother-in-law in the ward afterwards, finding me still fuming at the entire ordeal, she pleaded: balaay hay lagay, tsa gatshtay garay; yim hay tshinanam maerith (‘I beg you, please be go home; they will kill me’). With no other venue to go to, she was afraid she might have to pay for the consequences of my behavior. Like anyone else would do in such a situation, I did the same. I left.
First published in Rising Kashmir, Feb. 2015: http://www.risingkashmir.com/murderer-of-kashmirs-healthcare-system-ii/
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