Coronavirus: Doctors Without Protective Gear in Kashmir

SRINAGAR: Every morning Dr Imtiyaz Ahmad travels in his vehicle and reaches the health facility located in the Khan Sahib area of Budgam district in central Kashmir, but he says he is risking his life.

“While the novel coronavirus is causing havoc across the globe we are being advised to take precautionary measures, but here in this Primary Health Centre we do not have masks, sanitisers and not even hand wash,” Ahmad rues.

He says both doctors here, as well as paramedical staff, are working without proper arrangements. “Since duty in the health department is considered as emergency, we are treating patients without applying the safety measures. We have requested officials to procure the medical supplies and equipment for health facilities, but our demands have fallen flat.”

Long after COVID-19 was declared a pandemic by the World Health Organisation, there is still no safety gear for doctors.

On Saturday two female resident doctors were put under observation after they complained of respiratory problems. While one of them works at the Sri Maharaja Hari Singh (SMHS) Hospital, the other is at Sher-i-Kashmir Institute of Medical Sciences (SKIMS).

During the prevailing situation, doctors across different hospitals in the Kashmir Valley grieved the lack of adequate medical arrangements. Doctors and nurses across valley said that shortages of masks and other safety gear are putting them and their co-workers at risk.

A doctor from Srinagar city said there is a shortage of medical supplies, mainly N95 masks, PVC coated gowns and goggles. “Now, hospitals are days away from exhausting their stores, and many doctors have resorted to crafting their own protective equipment with supplies they can access, such as clear vinyl, tape, foam and elastic bands.”

With medical staff already getting sick and dying from the disease worldwide, doctors in Kashmir said they are terrified for themselves and their patients.

“We are treating patients without proper masks, tissue papers, soaps or sanitisers. The government took us for a ride. If something happens to our lives they will be responsible,” said a doctor posted in a district hospital in Pulwama who claims to be consulting dozens of patients every day.

The situation is such that nurses and doctors are not the only ones at risk.

A gynecologist posted at the Sub District Hospital in Tral said: “It’s the scariest thing, going to work every day without safety gear. I’m worried about myself and my colleagues, and that we’re not doing nearly enough to prevent transmission from infected patients to staff, to other patients who may be immuno-compromised.”

A senior orthopedic surgeon in the Government Medical College, Baramulla said that hospital cleaning staff have been directed to clean rooms that held coronavirus suspected patients without a mask. The unprotected cleaners are expected to turn over the rooms for new patients much more quickly now.

As per sources, doctors across district and subdistrict hospitals are performing invasive procedures on coronavirus suspected patients with loose fitting surgical masks, rather than the tight respirator masks recommended by health agencies.

In various peripheries, doctors were given expired masks, and when they tried to put them on, the elastic bands snapped.

With the scare spreading after Srinagar declared its first positive case, doctors, nurses and other frontline medical workers are confronting a dire shortage of masks, surgical gowns and eye gear to protect them from the highly contagious virus.

A nurse at the Lala Ded maternity hospital here in Srinagar said, “Without those masks, we would be immediately out of work. We can‘t work without masks.”

Asked about the shortage of masks and other equipment, a senior health official said there was a short delay in the distribution of personal protective equipment and masks, but these were later provided to the doctors concerned.

“We have provided the masks to the doctors. There was a slight delay but we have provided the essential gear,” he said.

Many doctors did not speak about the problems they are undergoing in the hospitals. On March 8 a doctor in Jammu faced government ire and was transferred for demanding adequate protective measures for medical staff.

As per reports, Dr Balwinder Singh of Jammu appealed to the government to arrange for proper masks and hand sanitisers for those working in the government hospitals of J&K in view of the rising coronavirus threat.

“Most of the hospitals are not providing masks and hand sanitisers to doctors. If the doctors get infected while treating patients, the infection can be then spread to other patients too,” Singh, who is president of the Doctors Association, Jammu, said in a statement.

Barely two days later, he was transferred to a remote hospital in the Batote area of Jammu.

In similar vein, president of the Doctors Association Kashmir (DAK) Dr Suhail Naik stated: “It is doctors and other healthcare providers who are at the forefront in dealing with the coronavirus threat. They can save the patients only when they are first themselves protected from the same.”

He advised the government to focus on screening travellers at airports and railway stations rather than “political transfers” of doctors.

On Saturday the DAK also sent a letter to Baseer Ahmad Khan, newly appointed advisor to J&K Lieutenant Governor Girish Chander Murmu, pointing out that hospitals in Kashmir lacked “proper and adequate personnel protection gear especially N95 Masks, PVC coated gowns, goggles and other equipments.”

“We appeal your good self to kindly make arrangements to supply protective gear for the doctors, nurses and other paramedical and supportive staff, so that they work without any apprehensions in health facilities,” the letter states.

The doctors’ body also requested the government to procure adequate ventilators to augment the capacity of district hospitals and new medical colleges in the Valley.

According to reports in local dailies, to help critical coronavirus patients, who require invasive mechanical ventilation to survive, there are approximately 76 ventilators in Kashmir, which has a population of nearly 70 lakh.

Sources said there are less than 200 ventilators available in Jammu and Kashmir hospitals for a population of 1.20 crore.

“All these ventilators are at presently occupied by patients. If there is requirement of more ventilators, we will be in crisis situation,” a source said.

When contacted a top official said the J&K administration has placed orders for 100 more ventilators. “It will take a few weeks to procure them,” the official added.

Meanwhile, the J&K administration in an order issued Friday asked government employees to attend office on alternate weeks except those associated with coronavirus control.

The government also said that Baseer Khan, adviser to the LG, will be overall in-charge of coronavirus-related efforts in Kashmir.

Kashmir on Thursday reported it’s first Coronavirus death as  65-year-old man died at Chest Disease (CD) hospital Dalgate, Srinagar.

Taking to Twitter, J&K govt spokesman, Rohit Kansal wrote: "Sad News : First death due to Coronavirus- 65 years old Male from Hyderpora Srinagar.  Four of his contacts also  tested positive yesterday."

So far, eleven people - eight in Kashmir and three in Jammu - have tested positive for the new disease, prompting authorities to impose prohibitory orders on the movement of people in the newly carved union territory.  

Authorities in Kashmir have expressed apprehensions that the cases could be more than reported in the Valley as a significant number of people appeared to have concealed their travel history. As per a government bulletin on Wednesday in Jammu and Kashmir, as many as 5,124 travelers and people who came in contact with suspected and positive cases have been put under surveillance. Among them 3,061 are in home quarantine (including facilities operated by the government), 80 in hospital quarantine and 1,477 in home surveillance.

National Health Mission director Bhupinder Kumar told a local news portal that the J&K administration is purchasing 120 ventilators and the orders have been placed.

“Ventilators are a key element in the battle against the Coronavirus. It is the only remedy that is put to use in serious cases. The other basic flu medicine. Masks are a key protection for everybody. Right now ventilators are in short supply because the entire world is witnessed an appetite for these machines,” said Kumar.

“We had a detailed meeting with MoS Jitendra Singh to discuss our preparedness against Coronavirus,” said Dr Saima Rashid, who heads the Government Medical College in Srinagar and is the top decision-maker of the chain of associated hospitals in the city, according to a report in Outlook magazine. “We highlighted the issue of the shortage of ventilators and Director NHM. We have been promised 40 high-end ventilators by the end of this month.”

Rashid also said the GMC has received 1,00,000 triple-layer masks from the J&K Medical Supplies Corporation Limited which will be distributed among associated hospitals judiciously.

Irfan Amin Malik is an online editor with Rising Kashmir

Cover photo: Isolation ward set up for coronavirus in Srinagar. Photo by BASIT ZARGAR.