Lack of trauma center makes Kashmir deadlier for firearm victims


The absence of a holistic trauma center in Kashmir has rendered the embattled valley deadlier for its residents who regularly encounter armed violence the nature and extent of which has intensified during the last two years.
Since July 2016, Srinagar-based hospitals received at least 4000 people with firearm injuries from across Kashmir, some of whom died because they lost critical time while being shuttled between different hospitals for different kinds of treatment, doctors say.
A trauma center would provide all kinds of treatment and care under one roof, significantly decreasing chances of fatalities. 
Last week, a standard six student, Tahir was brought to SMHS Hospital from Shopian, grievously injured in a blast. After preliminary examination at this general specialty hospital, the child was referred to Bone and Joint Hospital, six kilometers away, for treatment of limb injuries. 
To save Tahir’s life, his hand was amputated.
But a few hours later, when his condition did not improve, doctors realised that a liver injury continued to pose danger to the child’s life. The orthopedic surgeons needed opinion and intervention of general surgeons, who were located at the hospital wherefrom Tahir had initially been sent. 
They packed Tahir up in a rickety ambulance and sent him back to SMHS Hospital, again.
Although Tahir is doing well now, just a day before he was injured, Ubaid Manzoor, a student who had been hit by a bullet in his leg lost his life, his family alleging because of “shuttling between hospitals”.
There is no Trauma Center in Kashmir to provide holistic and complete accident and emergency services. 
As per records accessed by Greater Kashmir, since July 2016, over 4000 people with firearm injuries were admitted in Srinagar-based hospitals. 
During the last two years, the Bone and Joint Hospital has treated 290, and over 350 have received treatment at SKIMS, a majority, 3300 injured people, were brought to SMHS Hospital, owing to its more accessible location in the city. 
Considering the high volume of the injured, doctors have often referred to the situation in Kashmir as “dangerously volatile” and demanded that government set up a fully-fledged Trauma Center to save lives.
Senior doctors say staff of SMHS Hospital, over the past couple of years have set an example of service and provided 24×7 care, resulting in minimum loss of life, the back-up of infrastructure and supportive services pose a big impediment. 
Last month, a police constable Habibullah was injured in an attack right outside this hospital. Hit with a bullet in his head, he was brought in to the Trauma theatre within minutes. 
Although a team of neurosurgeons and other specialists was available and waiting to save his life, he could not be operated upon as no ventilator was available at SMHS Hospital to sustain the injured policeman after brain surgery. 
So, after giving him preliminary treatment the policeman in critical condition was sent to Sher-e-Kashmir Institute of Medical Sciences (SKIMS), about 7 km away. He lost the battle for life a week later.
A senior surgeon at SMHS Hospital said that in cases like that of Habibullah, every minute counts.
“Perhaps he could have been saved had we been able to intervene in time,” the surgeon said.
In 2007, government had announced Institute of Traumatology and Allied Specialties for Kashmir. This institute, if it had been set up as planned, would have provided complete trauma care under one roof and helped doctors save more lives. 
“The institute would have been a boon for people injured in violent incidents, road traffic and other accidents,” a senior specialist at Government Medical College (GMC) Srinagar said. 
“Right from its inception, the Trauma institute suffered set-backs, beginning with change of its name to Super Specialty Hospital,” 
This hospital, although authorities claim it to be fully functional, has a defunct surgical intensive care unit and no casualty reception department.
As a result, patients with poly-trauma are forced to shuttle between hospitals in the crucial time following their surgery, doctors say.
A senior doctor at SMHS Hospital said, with the current set up a patient is expected to get treated for head injury at Super Specialty Hospital, sent to Bone and Joint Hospital for leg injury and expected to get his abdominal injury addressed at SMHS Hospital. 
“And because there are just eight functional ventilators at this entire network of hospitals, the patient will be sent to SKIMS for life support in the end,” he said.
The transfers between hospitals for specialty services, not just causes inconvenience to the injured and their families but many a time results in loss of the “golden hour”, the most critical period when chances of survival are maximum.

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