Monday, October 5, 2009

TIME TO INTERVENE

There is a rot within the hospital that needs to be addressed seriously. It is only a few individuals that are running the Institute, the rest is all trade unionism. 

By Naseer A Ganai

IT was in October 2007 when I had to spend a night in the Emergency Ward of the Sher-I-Kashmir Institute of Medical Sciences Soura as an attendant of a patient. The Ward was as chaotic as it is today. It was crammed, patients were lying everywhere and their attendants were after doctors. The doctors were finding it hard to cope up with the pressure. They were attending one patient, and attendants of another patient were complaining of neglect. There were only two nurses in the whole Emergency and they too were running from one patient to another. There was total chaos. All of sudden a young boy was brought in who had met with a serious accident. He had at least 20 attendants. .

 The doctors immediately started attending the patient. But soon, a senior resident on the duty realized that the patient needs to be kept on a ventilator. But in all ventilators there were critical patients. The resident doctor, Dr Sabu Jenhagir, I still remember his name, tried hard to arrange the ventilator but failed. He then called the army hospital from his mobile phone and pleaded to accept the patient who would die if not put on the ventilator. After some time the army hospital agreed and asked him to send the patient. And, when the attendants started shifting the patients, there was a tragic drama.
 The patient was breathing through ambo-bag and nurse on the duty wanted it back. The argument started. First, between the attendant and the nurse and then between the senior resident and the nurse. The good doctor tried to convince her that the patient would die if the bag is removed but she said she would lose the job if it was not returned.
 Over 15 minutes were lost in this madness. Exasperated, the doctor said if they fail to return he would pay the amount and asked the nurse to let to the patient go. She let the patient go but 15 minutes were already lost. No one from the Control Room of the hospital came to see what is going on. This is one example of hospital mal-administration.
 In August 2009, I was again there as an attendant of a patient, but this time in the Surgical Intensive Critical Care Unit for about eight days. Unfortunately, the day after the patient was shifted to the Ward, the Resident Doctors went on strike. And, for next eight days, it seemed everyone is on strike in the hospital. It seemed everyone wanted to raise slogans against genuine or perceived injustice. Everyone wanted to shout at each other. The attendants at doctors, nurses at attendants, doctors at administration and so on…

The security staff too was on strike. Then the paramedical staff was preparing for strike against the order of the administration for planning to introduce triple shift system. Meanwhile, the OPD was closed. The attendants of the admitted patients realized something wrong is going on. They too lodged protest. From one corridor to another, there were only slogans of zindabad and murdabad. The hospital had turned into trade union conference.

I was worried about my patient and the madness around terrified me. I was worried whether anyone would come to take care of the patients or not. I rushed back to the ward and surprisingly found a doctor there. He was going from one bed to another and assuring the attendants that he would be on duty from 10 a.m to 6 p.m as long as the strike of resident doctors continues. I doubted this. But he was true. For the next eight days, Dr Abdul Qayoom Dar would come at 10 a.m and leave at 6 p.m. he would be in the ward all the time. I was shocked to see a consultant working like this. Then I heard he has worked in England. And it seems while returning from England he has not washed his hands in the river Thames to wash English traits. His presence in the ward was reassuring for the attendants who were not sure what next would fall on the critically ill patients. But, when he would leave in the evening there was always an apprehension about the doctor who would replace him for the night duty. And rightly so. They would seldom turn up for duty. Only one night saw a consultant on the duty. Rest they would come in the evening and then show their face in the morning.
 On one night, I saw a person in green clothes resuscitating a patient who had consumed poisonous substance. The case was strange. One of his attendants told me he had an affair, and a girl had told him she has consumed poison and is dying. He too consumed and was in critical care unit. The girl had lied to him. He died despite hectic efforts of the man in green. I thought he is doctor. But, he turned out to be technician. Resident doctors were on strike and the young man Yasir was working like anything along with nurse Shahida on that night.
 The stay in hospital made me realize that the hospital is not functioning because of its Director, Joint Director, Head of the Departments and trade union leaders. It is functioning because of individuals like Dr Sabu Jehangirs, Dr Qayoom Dars, Yasirs and Shahidas.

Such individuals might be scores in SKIMS. It these individuals who have taken upon themselves to work and work, whether it is appreciated or not, whether it is liked or not, whether the Director sees it or not. the day the dedicated lot in the hospital would get dejected by the system, the day they would feel exasperated by the witch hunting, the day they would feel tormented and started leaving for greener pastures and many have already started doing so, the hospital would crumble under its own weight. Time has come to rescue the Institute.
 Time has come, when the working of faculty must be questioned. They must be forced to work. It indicated that the hospital is run by the PGs, not by the faculty. The administration must be asked why it closed down the OPD? The answers must be sought. People should be made accountable. Time has come to ask questions to the faculty members who have brought indiscipline in the hospital by indulging in the private practice. They have made fun of the Institute. This lot must be asked to adhere to the rules of the hospital or leave for the good of the hospital. When seniors break the rules and don’t get any punishment, they lose the respect of the juniors and it reflects on over all functioning of the Institute. The rules, even if considered as unrealistic, are rules. Time has come that the unionism should end in the hospital. The clear instructions should go that the union leaders to abolish their little kingdoms through which they hold people of Kashmir at ransom. The unions have no place in hospitals. Biggest rot has brought to the hospital by the unions. The government must end this disease of unionism in hospitals.
 Time has come when the hospital should end to practice of bringing the staff to hospital in its vehicles. This happens no where. They are duty bound to reach hospital and they should reach on their own. The SKIMS is the only hospital where the medical records are not available. It takes months for PGs to collect data for research. And no one is bothered. In the surgical ICU, you have only two nurses for 12 critical patients. Bathrooms stink, the Birla House constructed for the attendants has been occupied by the employees, but no one cares. One of the excellent buildings, which is equivalent 15 emergencies, is under the illegal control of troopers for the past two decades and no effort is made to vacate it. The weed around the hospital is growing, the residents of the adjoining area have dismantled compound wall of the hospital and have made path through it, but no one seems to bother. The laboratory tests of the hospital astonish even patients. At times in the tests, they declare blood sugar level of patients only 10 and he gets away with it. Here is no counter where one gets information where one should go. The public administration relation is at its nadir.  The SKIMS is the hospital, which looks like a hospital. It caters every section and every area of JK state particularly of Kashmir valley. The health sector has crumbled at district level. And everyone rushes to the SKIMS. It is the hope and the day it crumbles down, whole health system would crumble down in the valley. The government must understand this and it must understand it now.

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