As the civil uprising erupted in valley on crimson note this summer, the entire medical staff got together on war footing to combat the medical emergency. The situation soon turned grave even for medics in the face of raging ire and mounting assaults on streets. But the medics managed to handle the crisis with sense of accomplishment, reports Saima Bhat
Every vehicle driven inside the emergency gate of state-run Shri Maharaja Hari Singh (SMHS) would made volunteers to form a beeline. An obvious guess was: certainly, a bleeding dissenter would be inside. But on July 28, 2016, a private vehicle entered the gate, carrying an injured doctor than a civilian. The assault made it certain that even doctors weren’t out of harm’s way in Kashmir’s seething state of affairs.
At around 4.30pm that day, Dr Altaf (name changed) left for his residence in Old City’s Rajouri Kadal in an ambulance. It was around 5pm and stone pelting was going on. He made his driver to pull over near Kadi Kadal and decided to walk rest of the distance by foot. Teargas shells were being shot in air. Amid panic, he took somewhat safer lane, but just then, ‘something’ hit him on his left eye.
“I could feel a foreign body hitting me, but didn’t know what it was,” the doctor says. “I sped away for home, where I shared the incident with my wife and younger brother.” He was immediately driven to SMHS, where ophthalmologists removed three foreign bodies from his lower eyelid.
“It was a teargas splinter, not pellet,” Dr Altaf thanking his stars for surviving direct eye assault says.
Four days later, he resumed his duty.
“I couldn’t feel like staying home amid the raging crisis in Kashmir,” Dr Altaf, who still has one more splinter, around 1mm, embedded near his lid, says.
In a civilian uprising triggered by Burhan Wani’s killing, already 93 civilians were killed, over 13000 injured and more than thousand persons were partially or completely blinded. The war-like situation and subsequent declaration of Medical Emergency in valley made it departure from usual for medics. Srinagar’s SMHS tackled a huge load — as most of the referrals were from its associated hospitals in peripheries. And till date, the hospitals registered grim statistics.
Only Ophthalmology department of SMHS, 800 patients were registered till 80th day of defiance. Some extra rush was taken care at SKIMS Bemina and outside state hospitals.
But transporting these injured—even in ambulances—was nothing short of nightmare. An ambulance driver of SMHS Ghulam Mohammad Sofi, 32, from Ganderbal was nearly done to death in his line of duty.
On August 18, when Sofi was ferrying two patients to Srinagar from Kangan, he was shot at by CRPF personnel with pellets at Eidgah, Srinagar. “CRPF personnel directly aimed his gun at me and fired pellets,” Sofi says. “Had I not used my arm as shield, around 300 pellets would have perforated my head, my eyes.”
Sofi recalls it malicious assault on him by a lone CRPF trooper stationed on street. After he was shot at, he began bleeding profusely but he continued driving toward SMHS, where he fainted and was taken to operation theatre by volunteers working with many NGOs. Later he was taken to Bone and Joint hospital, where he was operated upon his right arm. He is yet to recuperate from his injuries.
Already, many of Sofi’s colleagues were roughed up on streets for ferrying the injured. The risk still persists. “Ambulance drivers are our unsung heroes,” says Dr Mir Mushtaq, spokesperson Doctors Association Kashmir. “They risked their lives from both sides and worked 24×7 like anything.”
Around 184 ambulances were attacked during last three month of uprising. If ambulances would not have been there, doctors say, then it was not possible to reach hospitals in time or in the peripheries.
But as desperate times demand desperate measures, these ambulance drivers started using the banned symbol—’dark coloured red plus sign’. Patented for International Committee of Red Cross (ICRC), the symbol became saviour for many doctors, paramedics and ambulance drivers.
On September 05, one such ambulance of a NGO, SRO Batamaloo, was asked to halt near Palpora, Noorbagh. Stone pelting was going on in the area. A volunteer Saqib Bashir, 17, having blond hair and blue eyes was accompanying the driver. Once they reached near Pallor ground, Saqib says, police signaled them to stop. But the ambulance didn’t stop. “Had we stopped,” Saqib says, “police would have detained a pellet patient inside the ambulance.”
But on return, the cops stopped the ambulance. “The cop slapped me hard before asking, why didn’t we stop,” the young volunteer says. “I told him we were carrying a patient requiring an emergency treatment. Then he beat me with his stick.” He cued toward his volunteers to go away with patient, annoying a CRPF trooper. Saqib recalls the trooper walked back before “firing pellets directly at my eyes.” Although the boy saved his eyes by using his arm as shield, but pellets perforated his chest, face, neck and abdomen. His colleague drove him to SMHS hospital.
From driving ambulances to carrying patients to operation theatre or helping patients in taking medicines, Saqib, the youngest of all volunteers working at SMHS hospital, does/did it all. Since the July 9 itself, he was stationed in SMHS hospital without missing a single day. “I can’t see people walking helplessly,” Saqib says. “I take their files and get all formalities done. Seeing them relaxed means a lot to me.”
Even doctors weren’t spared. On July 20, Dr Hanif, a senior resident in surgery department at SKIMS, Soura reached his home in Barzulla at 10pm after performing a number of surgeries in emergency ward. He returned home after his assigned 32 hours of duty. But next day, he had a night off. The condition of patients didn’t let him be at ease. He desired to go back to hospital to be assured all of his patients were doing well. No sooner he reached Barzulla bridge, he was cut short by a cop. Curfew was imposed in the area.
“Imagine a constable asking me to show my Id proof—despite repeatedly telling him that I am a doctor,” Dr Hanif says. “Even after showing him Id, he told me that he wouldn’t allow me pass through the barricade because I should have been in hospital at 9 instead of 10. That was disgusting.” The enraged doctor then came out of his vehicle and asked the other cops to call the local officer, who intervened and cleared the way for the doctor. However, the street blues continue for his tribe.
Since July 09, a Peerbagh resident, Dr Sheeba, in-charge medical officer of primary health centre (PHC) Mohadpora Pulwama, could make it to the hospital in ambulance. She used to normally see 3 patients per night—but after the uprising, the PHC started receiving minimum 20 patients from 5pm till morning. “So we changed our rooster,” Dr Sheeba says, “from 24×7 to three nights and then 3 days off.” Having two doctors and 25 paramedics, the PHC was given two additional doctors to treat the growing number of patients.
The kind of injuries and gory images of dissenters would freak her out at times. One injured boy still haunts her. “I don’t remember the date when he was taken in PHC,” the lady doctor says. “We had forgotten calendar—but that boy had a barrel-type hole on his head. I had to put my finger in that hole to check if shell is still inside. We referred that patient to the district hospital, but that incident still gives me goose-bumps.”
Even after coming home, she says, she remains in touch with her PHC staff. “These days I become restless when I am home because our district was the worst hit in present crisis,” she says. In the same crisis, she had a narrow escape when a stone—thrown at ambulance she was travelling in—almost hit her head. “I remember, it was a relaxation time as per the protest calendar,” she says.
At home, Dr Sheeba, a mother of two kids—13-year-old son and 10-year-old daughter—says it was a bit hard for her to manage initially. But then, she made her children understand the emergency nature of her job. Married to a doctor, Dr Sheeba says there were days when her kids would remain alone at home. “I had to shift them to their grandparent’s home.”
What made the doctors’ duty pressing was a circular issued by the directorate of health services on July 09, ordering everybody to be stationed — like in September floods 2014. And the rosters changed from 24 hours to minimum 48 hours up to 72 hours followed by a day off. With the result, referrals were cut down from peripheries. In fact, from July 08 to October 04, 2016 — only 1482 patients were referred to Srinagar’s SHMS hospital.
Only in July, district hospital Pulwama received 463 injured patients, of which only 128 were referred to SMHS, mostly having pellet injuries in eyes. In OPD, they received 46, 000 patients and 1800 in IPD for short stay.
“We did 349 major surgeries including patients from gynea as well. Routine work was suspended, only emergency cases were tackled,” says Dr Mushtaq, an orthopaedician, presently posted at Pulwama hospital. His department received at least 200 fractured and dislocation patients. “Normally it is not possible. Director health kept us on our toes. He used to visit hospitals during midnight, which was very risky those days. But it was an encouragement for us. And then accountability was also there.” But the director couldn’t set foot in down South—the epicenter of the 2016 uprising.
As per the details collected from all ten districts of Kashmir, from July 08 to October 04, 2016, a total of just 1482 patients were referred to Srinagar’s SHMS hospital, while as rest of patients were treated in district hospitals.
But despite the official backing, many doctors and patients were gassed inside the wards of SMHS. “It doesn’t even happen in wars,” says Dr Adil Ashraf, registrar in medicine department at SMHS. Another medic shares his experience, thus: “They [forces] even snatched a number of bodies, took them to PCR for post-mortem. I saw attendants crying, requesting ambulances drivers to help them at PCR — so that they can take their dear ones in shrouds to home.” Mindful of this unfolding conduct further encouraged doctors to be at patient’s side.
When Dr Rashid Maqbool, a consultant at ophthalmology department at SMHS, joined his duty back on July 10, he was literally staring at unthinkable.
With most doctors on Eid ul Adha leave, his department received over 26 patients on that day—with ten backlog patients already waiting for their turn in theatre.
Dr Maqbool along with his colleague Dr Ishfaq, who was on duty for a complete month, started doing ten surgeries in the trauma theatre. But then, more patients started coming. In a single day, the doctor duo operated 56 cases!
“Then we stopped,” Dr Maqbool says, “not because we didn’t had patients—but for the fumigation and sterilization of the theatre.” Still 20 surgeries were to be done. To begin with, the doctor duo did primary eye repair before going for multiple surgeries mandatory for a pellet victim.
Dr Maqbool’s team including eleven consultants and eight resident doctors remember their patients’ numbers than names in presence of sleuths in civvies around. “There was a lot of confusion,” he says. “Fearing police nab, many had even registered patients with wrong names and addresses. So, we preferred to give them proper numbering.”
The latest pellet victim in ophthalmology already surpassed number 800. Dr Maqbool calls it “record-breaking” statistics. “No literature across globe has quoted such a number in any study,” he says. “The existing studies dated back to 1900s have recorded maximum 70 patients.” For him, evenings and Fridays are the worst—normally “sending around 40” patients to hospital.
“We have witnessed such kind of situation every time but the only difference this time around is patient rush,” says Dr Afzal Wani, the senior most doctor at SMHS hospital and founder of Neurosurgery Department at SKIMS Soura in 1982. “We received around 36 patients in first 30 days in our trauma centre and I am glad each one of them are recovering. I fear two or three may are presently having paraparesis, but they too have improvement chances. We didn’t lost a single patient after surgery.” Dr Wani says he and his team, have half a century experience now, who are prepared for 40 years. But they lack equipments and manpower at hospital. More trauma centres are need of hour.
But working in valley’s extreme conditions has given the Kashmiri doctors an apparent edge over their counterparts from any Indian state. Perhaps that’s why Dr Wani says, “If there is war at any place in India, they should call Kashmiri doctors. We have enough of war experience now.”
