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Indian doctors’ leaders demand national law to reduce violence in hospitals

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4303 (Published 19 June 2019) Cite this as: BMJ 2019;365:l4303

Concern regarding access to health care in Jammu and Kashmir, India.

We wish to bring to your attention the current situation in Jammu and Kashmir which is leading to a violation of the right to life and to health care. The Government of India on the 5th of August, abrogated Article 370 and Article 35A of the Constitution of India through the provisions of which the state acceded to India and which give the state certain special provisions.

Anticipating widespread protests, the Government of India, from the night of 4th August 2019, put the state under lockdown and arrested nearly 500 political leaders and activists in the state, including two former Chief Ministers. All means of communication – landline telephones, mobiles, internet and cable television - have all been shut down and remain so at the time of writing.

The lockdown and snapping of all modes of communication has made it very difficult for people in the Kashmir valley to access health care. From various news reports that are available from Srinagar the capital city, the picture that emerges is grim. People are unable to call an ambulance to take a sick person to hospital – they need to be taken a private vehicle if they have access to one. These vehicles are stopped every few metres by security forces standing at concertina wire barricades to check identity and ask questions. Several patients have been admitted with pellet gun injuries, and some have been seriously injured. Only those who can make it to a hospital can get some care. Though hospitals are generally stocked with supplies, staff have found it difficult to reach the hospital. Hospitals that are usually overcrowded are largely empty now. Some doctors worry about their patients on dialysis as only a few patients requiring dialysis from Srinagar have been able to come for treatment, while those living outside have not been able to reach the hospital. Certain medications are out of stock in the local stores and there is at least one report of a person having to fly to New Delhi to purchase medicines for a sick relative. There are reports of other patients who have not been able to reach the hospital in time for their scheduled cycle of chemotherapy. The situation has also led to a lot of mental stress among a population already living with high levels of psychosocial stress. Some women due to deliver were moved closer to a hospital when the troop buildup began as they anticipated some trouble. There are likely to be many more women who are not able to get to a hospital for their delivery, or have got there very late.

In the current situation there is a blatant denial of the right to health care and the right to life. We call upon the Indian Government to ease restrictions on communication and travel at the earliest, and undertake any other measures that are required to allow patients to access health care without hindrance.

Sincerely,

Competing interests: Jain Y is on the BMJ's Patients' Rights Committee as an email group member. All the rest have no competing interests.

16 August 2019
Ramani V Atkuri
Public health physician
Ashok S, Babde S, Biswas T, Chatterjee M, Choudhrie R, D'Souza R, Goel G, Gore A, Jain Y, Jesani A, Joseph N, Karpagam S, Mohan P, Noronha M, Prabir KC, Sequeira R, Tambat S, Zachariah A.
Independent
Bhopal, Madhya Pradesh