Govind Sharma
Over the last decade, the Government of India has made significant strides in improving public health infrastructure across the country. Jammu and Kashmir, despite its unique challenges, has seen the establishment of several premier public health institutions such as Super Speciality Hospitals, State Cancer Institutes, All India Institute of Medical Sciences (AIIMS), and numerous Government Medical Colleges. Additionally, the private sector has also contributed to the region’s healthcare landscape, with institutions like Shri Mata Vaishno Devi Narayana Superspeciality Hospital emerging as key players in the local medical field. These developments are particularly notable following the abrogation of Article 370 in 2019, which has led to increased investment in the region.
However, despite these advancements, a significant number of patients from J&K continue to seek medical treatment outside the UT. This trend is especially prevalent among those requiring specialized care, such as orthopaedic surgeries, cardiac treatments, and cancer therapies. Institutions like PGI Chandigarh, AIIMS Delhi, and corporate hospitals such as Apollo, Fortis, Sri Ganga Ram, Max Super Speciality, and Medanta The Medicity remains the preferred destinations for these patients. Understanding the reasons behind this exodus is crucial for identifying and addressing the gaps in the local healthcare system.
Personal Experiences Highlight Healthcare Shortcomings in J&K
The experiences of patients and their families provide a poignant insight into why so many choose to seek medical treatment outside J&K. Naresh Kumar, a bank employee from Jammu, shared the harrowing journey of his son, who was born with a neural tube defect in 2021. Despite spending a month in Shri Maharaja Gulab Singh (SMGS) Hospital in Jammu, and seeking further treatment at various hospitals in the region over the next two years, his son showed no signs of improvement. It was only after they began consulting doctors at PGI Chandigarh that they observed any progress. This case exemplifies the frustration and helplessness that many families face when local healthcare facilities fall short in providing effective treatment.
Similarly, Rajesh from Doda district, whose wife Sushma was diagnosed with blood cancer, initially sought treatment at the State Cancer Institute (SCI) in Jammu. However, they encountered a lack of essential medical facilities and a shortage of expert doctors, which prompted them to seek treatment at Rajiv Gandhi Cancer Institute & Research Centre in New Delhi. Rajesh’s story underscores the critical issue of inadequate resources and trained personnel in local institutions, forcing patients to travel long distances for better care.
Affordability and Trust: Key Factors Driving Medical Migration
Affordability plays a significant role in the decision to seek medical treatment outside J&K. Manish Singh, an engineer, pointed out that those who can afford the expenses of treatment at renowned hospitals in major cities will naturally choose those options over local hospitals. The perception of better quality care, advanced medical technologies, and higher standards of post-operative care in cities like Delhi, Mumbai, and Chennai makes these destinations more appealing to patients who can bear the costs.
Moreover, many patients now have access to cashless health insurance policies, which cover treatments at top-tier hospitals across the country. This financial safety net allows them to opt for institutions with proven track records, such as Medanta The Medicity and Fortis Hospitals, rather than taking risks with local healthcare providers.
Specialized Care and Post-Surgery Follow-ups: A Major Concern
The lack of specialized care and proper post-surgery follow-up facilities in J&K further contributes to the outflow of patients. Harjeet Singh, whose mother was diagnosed with throat cancer, faced this issue firsthand. Although local doctors assured him that the cancer was curable through surgery, they recommended post-operative follow-up at PGI Chandigarh because the necessary medication was not available in Jammu. This scenario is not uncommon, as many patients are advised to seek follow-up care or specific treatments in cities outside the UT due to the unavailability of certain drugs or medical technologies locally. The inconvenience and added stress of managing treatment across multiple locations is a significant burden on patients and their families, leading many to opt for comprehensive care elsewhere.
Public Perception and Trust in Healthcare Institutions
Public perception and trust in local healthcare institutions also play a crucial role in the decision-making process. Despite the availability of public and private healthcare facilities in J&K, there is a pervasive lack of confidence in the quality of care they provide. This distrust is fueled by experiences like those of Mohan Lal, an ex-serviceman, whose son’s severe injury was not adequately addressed by doctors at the Government Medical College and Hospital in Jammu. Instead of attempting to save his son’s arm, they advised him to seek treatment at a hospital in Amritsar, forcing the family to bear the financial and emotional toll of traveling for care.
This case, among others, reveals a concerning trend where even in emergency situations, local hospitals may not be equipped or willing to handle complex cases, leading to patient referrals or self-discharge (LAMA) to better-equipped facilities outside the UT. The irony, as Mohan Lal points out, is that the premier hospital of the region, which should be a beacon of trust and competence, instead becomes a stepping stone to out-of-state treatment.
The Role of Healthcare Infrastructure and Government Initiatives
The situation in J&K is not solely due to the shortcomings of healthcare professionals or individual institutions. It reflects broader systemic issues related to healthcare infrastructure, resource allocation, and the effectiveness of government initiatives. While the establishment of new institutions like AIIMS and Super Speciality Hospitals is a positive step, it is clear that the UT still faces significant challenges in terms of healthcare delivery.
One of the key issues is the distribution and availability of specialized medical equipment and technologies. For instance, the State Cancer Institute in Jammu, despite being a crucial healthcare facility, suffers from a shortage of key medical equipment and trained personnel. This shortage severely limits the quality of care that can be provided, particularly for complex and critical conditions like cancer. The government needs to prioritize the procurement of advanced medical technologies and ensure that these facilities are staffed with adequately trained professionals to operate them.
Furthermore, the training and retention of skilled healthcare professionals is another area that requires urgent attention. Many doctors and specialists prefer to work in larger cities where they have access to better facilities and opportunities for career advancement. This brain drain leaves local institutions in J&K understaffed and unable to provide the level of care that patients expect. The government could consider implementing incentives for healthcare professionals to work in the UT, such as offering competitive salaries, providing opportunities for further training, and improving working conditions.
The Impact of Government Policies and the Road Ahead
The abrogation of Article 370 was expected to bring significant development to J&K, including in the healthcare sector. While there have been some improvements, such as increased investment in healthcare infrastructure and the establishment of new institutions, these changes have not yet translated into a fully functional and trustworthy healthcare system for the residents of the UT.
The Government’s focus should now be on strengthening the existing healthcare infrastructure, ensuring that new facilities are fully operational, and addressing the gaps in medical services that drive patients to seek care outside the region. This includes not only the availability of advanced medical equipment and technologies but also the training and retention of healthcare professionals, the development of specialized care units, and the improvement of post-operative care services.
Moreover, there is a need for better integration of public and private healthcare services to ensure that patients have access to a comprehensive range of treatments within the UT. Public-private partnerships could play a crucial role in this regard, allowing for the sharing of resources, expertise, and technologies between public institutions and private healthcare providers. Additionally, the government could explore telemedicine and other digital health solutions to provide specialized consultations and follow-up care without requiring patients to travel long distances.
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