Thursday, March 26, 2009

History

From tertiary care to JK biggest dispensary  

Naseer A Ganai 

Srinagar, Mar 25: In 1970s, when the former chief minister, Sheikh Muhammad Abdullah, used to visit PGI, Chandigarh, or the All India Institute of Medical Sciences, New Delhi, for treatment, he would be moved by the sight of long queues of patients from Jammu and Kashmir waiting for their turn. He felt the need for a medical institution at par with AIIMS and the PGI in the state itself. 

 Back home, he discussed the plan with leading doctors of Kashmir. Dr Ali Jan, Dr Allaqaband and Dr Jehan Ara Naqashbandi were among them. Sheikh traveled to different states across the country to meet with leading doctors. The outcome of these efforts was the Sher-i-Kashmir Medical Trust for which he sought donations from anyone and everyone. 
 Since a lot of money and time was required to build and commission an Institute of Medical Sciences, small beginnings were made to provide improved healthcare facilities at Soura. The Sher-i-Kashmir National Medical Institute Trust was established to collect funds for the purpose. Its Trust deed was signed on May 19, 1973, and a 30-bedded Trust hospital was commissioned. In 1975, the state government decided to establish an Institute of Medical Sciences at Soura. In pursuance of this decision, the Trust offered 292 kanal eight marla land, then worth Rs 1,66,96,000, for construction of the Institute. The government of Jammu and Kashmir transferred 214 kanals and six marlas to the Institute.   
 The funds for constructing and equipping the Institute were provided by the state government under 5th and 6th plan grants earmarked for the Institute and the Planning Commission approved it as a plan project. The construction of the Institute building commenced in 1976 and though it was incomplete in many respects, the Sher-i-Kashmir Institute of Medical Sciences was commissioned on December 5, 1982. 
 Sheikh got Dr Nagpal from the PGI Chandigarh to head the prestigious Institute. The then director of the AIIMS had asked the Sheikh that Dr Nagpal would be a great asset to the Trust. Young Dr Nagpal was then the deputy medical superintendent at the PGI, Chandigarh. And, he lived upto the Sheikh’s expectations. 
 Those who have worked with him describe Dr Nagpal a bright doctor with great administrative abilities. He held hundreds of meetings with the young faculty in Kashmir and discussed each and every plan about the Institute. Not a single brick was laid without a plan. In every ward, there is a fire exit, not used now. For in-patients, there was system in place near the bed to call the nurse. The international and the national experts in different fields were called to give final touches to every plan. Then started the struggle to mobilize resources for the Institute.
 Dr Nagpal and his team held scores of meetings with the Finance Department, government of India. The present governor, N.N Vohra, was in the Finance department. Instead of portraying the SKIMS as a Trust, Dr Nagpal convinced the authorities that be that it was an Institute. “He would always present larger than life image of the Trust,” says a former director. 
 The central government asked the state whether it wanted the SKIMS to be a national institute directly under the government of India like AIIMS and PGI. Sheikh put his foot down. He said it would come up as a state institute but with the central funding. This settled, the governing body of the SKIMS was formed. The director of the Institute was designated as the ex-officio secretary to government with unlimited administrative and financial powers. There were in-house purchase committees to facilitate procurement, apical selection committee to find and choose best faculty, material management department to pursue and streamline local, national and foreign purchases, a number of committees to search, employ and promote staff and a governing body headed by the chief minister to define policies and pursue SKIMS growth. 
 This reduced the red tape and facilitated expeditious decisions. And, Dr Nagpal ensured that the SKIMS remained free from red-tape. He had proposed the idea of committees for purchasing, recruitment, constructions and other fields. The SKIMS was planned to have four major specialties. These were neurology/neurosurgery; cardiology/cardiovascular surgery; nephrology/urology and cancer therapy (oncology, radiotherapy and surgical oncology). All other clinical departments were made as supportive services. There was no place for general physicians and surgeons as secondary level medical care was not envisaged in SKIMS. Emergency department to cater to 24 hour casualties was never conceived in SKIMS, as all patients whether elective or emergency would be referred to SKIMS and received accordingly.
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