Healthcare knows no boundaries. The work of Red Cross and Doctors without borders is acknowledged globally. They work in conflict situations many a times risking their lives. Dwarkanath Shantaram Kotnis born on 10 October 1910 in Solapur, Maharashtra, also known by his Chinese name ‘Ke Dihua’, was one of the five Indian physicians dispatched to China to provide medical assistance during the Second Sino-Japanese War. He died serving the sick people in a land totally alien to him on 9 December 1942 at a prime age of 32. Bhai Kanhaiya, a legendary figure in Sikh history who would offer water to the wounded whether Sikh or Moghul soldiers in 1704 during the battle in Anandpur Sahib is well known for his human outlook. He was praised by Guru Gobind Singh for his humanitarian work.

Young doctors from many countries around the globe including India participated in medical relief work in conflict situation in Kampuchea (now Cambodia) in 1980 after the fall of Pol Pot regime when the society was in total disarray. Khalsa Aid is doing great work in such situations. Their special contribution of giving aid to the Rohingiya migrants, Earthquake & Tsunami Relief in Indonesia in Oct 2018, aid to Congolese (DRC) Refugee Response in Jan 2018, Life changing aid for Syrian refugees with disabilities in Mar 2017 has made history. The Indian Doctors for Peace and Development (IDPD) organized disaster relief work during floods, tsunami and earth quakes in Punjab, Uttarakhand, Kashmir, Tamil Nadu and Nepal in most difficult situations under serious risk to the team members in the high mountains having landslides or violence in Kashmir. Some doctors from Punjab took to the task of relief work in Nepal after earth quake and Kashmir floods on behalf of IMA.   

Now we have a special situation. The Kashmir valley is under siege for over a month. Despite the claims by the government the situation is far from normal. It is difficult to believe the statements of normalcy from those who have put the state in such situation. Because of lack of communication with their families the students and others who hail from the Kashmir valley living in other parts of the country are under extreme stress and strain. So are the people living in the valley. Denial of communication network for such a long period is seriously hurting the people who have already been living under persistent tension due to long standing violence in the region. This alienation gradually develops into lack of trust and hatred leading to post-traumatic stress disorder, which can have serious repercussions in times to come.

Global experience has shown that both physical and mental health is the biggest victim under such situations. Restricted mobility causes acute shortage of food, drugs and other essential items leading to serious effect on the population particularly health of the children. Shortage of supply of drugs leads to several health problems which need no explanation. The episode of Dr. Omar, a Urologist who was detained, just for requesting the authorities to make relaxation for providing healthcare, becomes a norm in such situations. Report of a lady dying during pregnancy because the junior doctors were not able to call the seniors due to restrictions and absence of telecommunication network must be one of the few such incidents. Healthcare requires day to day assessment of various needs including drugs and other equipment and their repairs. This is not possible under the situation of curfew and restricted mobility. 

In the absence of work and no income there occurs absence of proper nutrition leading to ill health. Such situations are bound to occur in situation of any conflict or any long term internal restrictions. The Medact, an organization of doctors from UK had done a study in Iraq after aggression by the US and allies and reported collateral damage and excess deaths among children.

It is thus the duty of all health professionals to seek conducive measures where health does not become victim. There is growing realization among the medical professionals now that the academic activity has to be connected with the public needs. The medical journals are now engaging outside the boundaries of academics on the public health concerns. The British Medical Journal has already taken over to study the humanitarian impact of nuclear war. They organized a south Asia Consultation on this issue in Dubai in May 2019. Latest Lancet publication dated 17 August 2019 is an example of that. The Lancet had pointed out the reality of situation in its article published on 17th August 2019 from health point of view. Tirade by the IMA and some other professional bodies against Lancet is very unfortunate. It amounts to putting blame on someone else for one’s dereliction of duty.

Kashmir is a specific situation where in the present situation the local people have no say. Their right to healthcare has been curtailed. It is thus the duty of the people from other parts of the country to demand from the government that healthcare services to them be made available freely. People of Kashmir are our own people and deserve every right to healthcare. Medical professionals have always stood against violence of all kinds. Denial of healthcare is also violence against the population.

It is time all medical bodies demand from the government to create situation so that people can access healthcare freely. We have to ask the government to permit free travel of doctors from rest of the country to assess the health situation and report correctly.  Silence of doctors on this by omission or commission will not be forgiven in history. Doctors have to be fearless and unbiased as far as healthcare is concerned.


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