Silence Is Golden?

Obviously, the epitomes of brilliance governing Kashmir have found more promising fields to try their expertise on, and hence fallen silent on what until recently used to be the staple of political and governance speeches. Almost continuous verbal focus on healthcare, particularly its private-public dimension, has evidently yielded the desired results. And with satisfaction all around, the issue cannot be milked any more. Small matters like the pharmaceutical “drug mafia” virtually dictating healthcare administration and policy, too, is a field with huge potential for the vast reserves of talent in Kashmir’s political firmament. So, on the index of satisfaction, Kashmir figures quite high, if one discounts the condition and facilities of state-run medical facilities, and their patients – or should one say victims.   

Regardless of the implications of the data cited below, the government’s now- abandoned accent on private sector involvement in the state’s healthcare had it bothered to inquire minor matters like whether the private ‘nursing homes’ doing a roaring trade in Srinagar and elsewhere in the valley have mandatory Intensive Care facilities as stipulated by the Medical Council of India. With the state failing to enforce even such elementary guidelines in existing private medical facilities, who can guarantee big-ticket investment in the sector to be aboveboard, or less rapacious?   

Somewhere in the middle of the last decade, the World Health Organisation had said that private expenditure on health accounted for a whopping 75 per cent of India’s total expenditure in the ‘sector.’  Corporate health in the country has come a long way since, and Kashmir’s medical entrepreneurship is legion (with even a leading Indian practitioner of the art recently damning Kashmir’s fraternity of the ‘most noble profession’ in the valley’s raging trade in pharmaceuticals, a huge chunk of it spurious.) Given that the Himalayan valley ranks among the highest consumers of pharma drugs, driven mostly by high-profile private practices, the degree of ‘private participation’ in the state’s healthcare should be self-evident. Certainly, Kashmir would leave the Indian average of 75 per cent private spending far behind. (Need a mention be made of the proliferating private diagnostic centres boasting CAT Scans and what-have-you?)  

But the real mystery is Jammu and Kashmir’s official figures on health indices. Either Kashmir’s medical fraternity has been blessed by the saints of healing themselves, or else Kashmir’s duped, cheated, and exploited masses have some holy figure watching over their life - not a remote possibility in a region once graced by Sheikh Nooruddin Wali and Lalla Ded. Nothing else explains the miracle of the state actually scoring ahead, if only marginally, of national averages on some important parameters. The state’s infant mortality rate, for instance is 49 as compared to the national average of 53. Similarly, the state has a total fertility rate of 2.2  as against the all-India figure of 2.6.  The crude death rate in Jammu and Kashmir is 5.8 when compared to the national average of 7.4, and its crude birth rate stands at 18.8 versus the country’s average of 22.8. This magic has been wrought when doctors assigned to rural communities usually avail of sabbaticals courtesy their political patrons, and many well-known figures remain busy minting millions on unauthorised private practice. 

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