WUNRN

http://www.wunrn.com

 

http://www.nytimes.com/2014/09/20/world/asia/hospitals-in-kashmir-struggle-after-flooding-deepening-a-health-crisis.html?partner=rss&emc=rss&_r=0

 

Srinigar, Kashmir - When the floodwaters of the Jhelum River rushed over the gates of the G. B. Pant Hospital, the top pediatric hospital here, on Sept. 6, the lights were the first to go. Half an hour later, the generators on the ground floor were drowned in water. Minutes after that, the oxygen tank that supplied air to the ventilators for newborns shut down.Six infants died within 24 hours.....

 

Kashmir Hospitals Struggle in Flooding, Deep Health Crisis - Massive Humanitarian Needs - Women & Children

 

A girl in her damaged home in Srinagar. Floods left hundreds dead in Pakistan and Indian-controlled Kashmir. Officials say conditions could lead to outbreaks of cholera and other diseases. Credit Farooq Khan/European Pressphoto Agency

SRINAGAR, Kashmir — When the floodwaters of the Jhelum River rushed over the gates of the G. B. Pant Hospital, the top pediatric hospital here, on Sept. 6, the lights were the first to go. Half an hour later, the generators on the ground floor were drowned in water. Minutes after that, the oxygen tank that supplied air to the ventilators for newborns shut down.

Six infants died within 24 hours, said Nisar Ahmed Dar, 26, an orderly at the hospital who handed the children’s bodies, wrapped in blankets, to army rescuers through the second-story window. He then handed them 10 more newborns whose skin had turned blue from lack of oxygen. At least five of them later died.

“It was horrible,” Mr. Dar said. “I was handing down dead babies. I was thinking that if help didn’t come soon, I’d be handing down more.”

Nearly two weeks later, the hospital was a shell of what it had been — white sheets that had been tied together for trapped doctors and family members to escape still hung from the second-story window. Equipment has been irretrievably damaged, and more than half of the staff members are gone — some scattered to their hometowns to assess the damage there — and cellphone service in the Kashmir Valley is still so bad that it was difficult to reach them.

In the aftermath of the powerful floods that hit Kashmir early this month, the area is in the midst of a health crisis. Much of the region depends on the premier hospitals in Srinagar, the summer capital of Jammu and Kashmir State, but most were badly damaged by the water. In the aftermath of the floods, people are living in neighborhoods choked by putrid, infectious and in some spots impassable water.

Fifty-four bodies have been recovered from flooded neighborhoods in the valley, according to the Press Trust of India. In Srinagar, the inescapable water on many streets and the fact that many residents have stayed in their flooded homes to safeguard their belongings have magnified the risk of outbreaks of cholera, hepatitis A and typhoid, just as the valley has little ability to treat these deadly ailments.

 “It is a crisis,” said Shafaq Hamid, a Kashmir-born anesthetist who traveled from Doha, Qatar, to help out after the floods and ended up working in the small private Ahmed Hospital, one of the only hospitals in a dry patch not hit by the floods. “Any place would be in a health crisis, because everything has been stripped away.”

This week, the state health minister, Taj Mohiuddin, outlined a plan to get hospitals and clinics working again and ward off an epidemic. He said he planned to send out mobile teams to pass out medicine and chlorine tablets, and hoped to get the main hospitals up and running in the next 10 days, though hospital administrators said it would take months before they were fully operational. Almost $25 million worth of equipment has been damaged, officials said.

“We will try everything — whatever we can do — to prevent such a disease to take the shape of an epidemic,” Mr. Mohiuddin said.

But the lack of medical care has already taken a toll, particularly for pregnant women and newborns who need specialized care.

One woman, Aasiya Sarebal, went into early labor on Monday morning, hours after dining on tea biscuits on the third floor of her father-in-law’s home, some distance from the water below. Just seven months pregnant, she was carried to a neighborhood hospital by neighbors and relatives, who lifted her over their heads when the water reached their chests. She cried in pain. By the time they reached the hospital, hours later, she was bleeding. When she gave birth to twins, a boy and a girl, they weighed about two and a half pounds each and needed urgent care.

But the hospital lacked ventilators for newborns, and by the time the babies were sent to the one major hospital still operating in Srinagar that has them, the girl was dead.

“If we had had access to G. B. Pant, we might have saved them,” said Dr. Waseem Rasool, a gynecologist who was helping out at Ahmed Hospital.

At a government hospital high on the hills of Srinagar near the sprawling homes of the chief minister and health minister, doctors have set up a makeshift pediatric clinic. Patients trickle in, some having walked three hours from central Srinagar. The children have chest infections, gastroenteritis and dysentery.

Mushtaq Ahmed, 30, a laborer, drove for hours through waterlogged streets from the southern town of Anantnag with his 14-month-old daughter, who was suffering from measles. He walked from central Srinagar to the virtually deserted G. B. Pant Hospital, where someone told him to come to the makeshift clinic. After a consultation, he was told to buy the drugs his daughter needed elsewhere. He stormed out, frustrated by his futile journey.

“What is there to say?” he said angrily. “There are no doctors and there are no medicines.”

One of the biggest fears here is the mounting sanitation crisis on Srinagar’s streets amid the partial breakdown of state and municipal governments. This week, water still surrounded the green-roofed compound of the new secretariat, the massive stone High Court complex and white jeeps parked in front of the Police Headquarters. In one downtown neighborhood, there was a hand-scrawled sign in Urdu on the brick wall of a store: “You have to help yourself to clean your gullies. There is no municipality.”

In the Bemina area, where homes were built on marshlands years ago, people walk over roofs to reach work. Houses surround a cattle farm, where over 300 cow carcasses were rotting until Tuesday evening, when the authorities began removing them. Neighbors shut their doors and windows to block out the smell. Gulam Qaider Matta, a shopkeeper who lives with his children and grandchildren, said that although he boiled the water in his home, one granddaughter had been vomiting for days.

In a neighborhood nearby, Mehraj Din Mir climbed onto a makeshift raft bound for dry land. He was in search of disinfectant for his brother, who had undergone surgery two weeks before for a tumor on his abdomen.

“This water is a disease,” he said. “And when the waters came, nobody would help us.”

Cholera cases have not been reported in great numbers, but the one hospital in Srinagar that can test for the disease is inaccessible to those mired in floodwaters or cut off from roads because of protests against the government’s delayed response to the floods.

“In the second phase, we are expecting it,” said Rauf Rashid Kaul, an assistant professor of community health at the Sher-i-Kashmir Institute of Medical Sciences in Srinagar.

Even as the floodwaters begin to recede, a new crisis is looming. Doctors anticipate droves of patients when the roads clear up.

Ms. Hamid, the anesthetist, sitting in the doctor’s lounge at Ahmed Hospital, said the government would be hard-pressed to respond to patients’ needs in the coming days.

“And for patients with complicated cases — God help them,” she said.

_________________________________________________________________________