During Pandemic, Dialysis is a New Deadly Distress in Kashmir

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A fortnight ago amid covid-19 lockdown, a software distributed among the health service providers in Kashmir rendered scores of Ayushman Bharat golden cards defunct. The decision during pandemic times has only left many dialysis patients in the lurch.

 Bhat Zubair

A decade-long harrowing tryst with bad kidneys had ended in December 2019 for Basharat Hussian—when he got a golden card promising Rs 5 lakh medical insurance to him per annum.

But a year later, as the card stands blocked, he’s back to square one — seeking a desperate help for survival from the people themselves grappling with the covid-19 lockdown and stress.

Hussain, 41, was diagnosed with kidney failure in 2008, the year when Kashmir was out on streets against the controversial Amarnath Land Deal.

Since then, his tolling and taxing treatment has consumed his family’s lifetime savings, his shop at Fateh Kadal and countless hours of sleep.

“But last year, when I got the golden card through an Aanganwadi worker, my family, including four sisters, sighed in relief,” Hussain, a resident of Braripora, Nawakadal in Srinagar, said.

“The card was a big relief to well-off as well as underprivileged section of the society. Thing is, even if you’ve a fortune, it will get consumed in dialysis treatment.”

A dialysis patient shows his documents

Everything was going fine for him, until his dialysis centre refused to acknowledge his golden card 14 days ago.

“They told me it’s no longer valid,” said Hussain, an Antyodaya (AAY) ration card-holder.

The AAY ration cards are issued to “poorest of poor” households, making Hussian an eligible for all the government schemes.

The treatment denial, however, was a huge setback for him.

It meant to self-afford dialysis twice a week, which is a monthly cost of around Rs 20,000.

To ensure to meet his medical cost, he’s back to his old routine these days: seeking help from some Samaritans in the locked down society.

“To plead my case, I even visited SMHS, where the card is being checked,” Hussain continued his anguish. “But officials told me that nothing can be done right now.”

Even if they had to block the card, he said, they could’ve chosen some other time.

“How should we deal with our deadly ailment right now, when hardly anything is working in Kashmir?”

Out of 120-odd golden card-holders at his dialysis centre at Khyber Hospital, only 10 or 12 patients are now eligible for the treatment.

Part of the problem, Hussain said, is an ID number which golden cardholders receive upon getting the card.

“But most of us never received that,” he rued.

Launched under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme, golden card was launched by New Delhi in November 2018.

As part of universal health coverage scheme, the set target for Jammu and Kashmir was 6.13 lakh families.

As New Delhi is its sole issuing authority, the latest mass card-blocking move is seen as the Centre’s new directive for J&K.

The decision, however, has already unsettled the unprivileged section of the society who were availing the critical treatment with the help of this card.

Within six months of its launch, Jamsheed Khan, 44, of Manzgam Brein was one among the 12.63 lakh beneficiaries of the golden card in J&K.

Before becoming a card-holder, Khan was managing his dialysis for nine years, with the financial support of his siblings, relatives and mosque committees.

“But last year, everything changed when I got the golden card,” Khan said. “After a year, however, I was told that I’m carrying a fake card. I don’t understand how come it became fake suddenly, and that too amid lockdown, when I was using the same from last one year?”

To seek official response and intervention to save their lives, Khan and his ailing tribe tried to visit the officials, but due to strict covid-19 lockdown in the valley, they’re not able to move around.

“Yesterday I had to borrow an amount of Rs 3000 from my friend to pay for my dialysis cost at Khyber Hospital,” he said, with a sad face. “But I don’t know how long I’m going to manage this way.”

At Srinagar’s Khyber Hospital, Dr. Shahnawaz Amin, in-charge operations, said the fully-funded scheme coming in the form of golden cards is a tie-up between four parties, including NRHM (National Rural Health Mission), Bajaj Allianz  (as insurance company), MD India and empanelled hospitals.

“Hospitals act as service providers in this scheme,” Dr. Amin informed.

“Once we receive the patient with golden card, we follow the guidelines of the government. We have been lately given new software to check the authenticity of the card. Before that, we used to just scan the card and send it to the department for an approval.”

The so-called software, Dr. Amin continued, was delivered amid lockdown, barely a fortnight ago.

This software now acts as a gatekeeper of the golden cards, the doctor said.

“When we enter the name of any particular person in the software, it checks its authenticity. In case of any mismatch, we can’t provide services to a card-holder.”

But why many golden cards are suddenly being rejected by this software?

“Only the concerned authority, like NHRM or Bajaj Allianz , can explain that.”

Bupinder Kumar, Director NRHM, is yet to respond to the written query from Kashmir Observer. As and when he responds, the story will be updated.

Meanwhile, Rouf Yatoo, incharge of Bajaj Allianz  in JK, said that the names of the families, whose golden cards have been blocked, haven’t figured in Census 2011.

“Somehow these patients have availed these cards through fake means,” Yatoo said, whose Bajaj Allianz  had settled around 40,000 claims and cleared Rs 19.7 crore by December 2019.

“Actually the card they were carrying belonged to other family, that wasn’t getting its benefits.”

Under this scheme, a family gets an insurance cover of Rs 5 lakh per year on floater basis, sharing between family members.

The authorities first got alerted when a genuine cardholder visited SKIMS recently and found his vault balance zero in the card, he said.

“Upon investigation it was found that 18 dialysis patients were linked with that genuine ID,” Yatoo continued. “This initiated a quick fact-checking which unearthed a scam in the scheme.”

It’s funny, Yatoo said, how a Budgam resident had been linked with an ID of a Srinagar man, and Baramulla resident with an ID of an Anantnag local.

The lapse, Yatoo said, happened at Khidmat Centre level.

But why that lapse happened in the first place is something which is even beguiling dialysis patients.

“But there is nothing to worry about,” Yatoo assured. “The golden cards have now become universal—meaning everyone in J&K will get one, within a month or two.”

But till then, the growing worry among the dialysis patients of Kashmir remains to meet the rising cost, that too, when the viral lockdown has created its own issues in the community.

“Earlier, there were some dedicated NGOs and Welfare Trusts working to provide sustainable dialysis treatment to patients,” said Wasim Ahmad, son of a dialysis patient from Srinagar.

“But after government provided golden cards to dialysis patients, these NGOs and Welfare Trusts stopped their services.”

And this is where many dialysis patients of Kashmir — caught between poor financial conditions and the covid-19 lockdown — are today finding themselves at the fatal crossroads in their lives.

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