DR.FIAZ MAQBOOL FAZILI
National Doctors’ Day on July 1st honors Dr. Bidhan Chandra Roy’s legacy and celebrates physicians’ lifesaving contributions. In Kashmir, however, this commemoration unfolds against a backdrop of profound systemic challenges. While doctors here exemplify extraordinary compassion—evident during crises like COVID-19 and floods—they grapple with burnout, resource shortages, and administrative hurdles that threaten healthcare delivery. This piece examines Kashmir’s medical landscape, advocating for policy reforms that match gratitude with meaningful support celebrating compassion and courage.
During COVID-19, Kashmiri doctors worked tirelessly despite scarce PPE, with one noting they served as “warriors” while “even relatives feared infection” . Their dedication mirrors pandemic heroism with global ideals of medical altruism but occurred amid conflict-related stressors unique to the region.Beyond clinical care many physicians double as community healers. Recent initiatives like IMHANS-K’s collaboration with religious leaders to combat drug abuse (engaging 30 clerics for faith-based prevention) highlight innovative, culturally sensitive care. Such efforts underscore doctors’ role as societal anchors—a truth celebrated on Doctors’ Day but requiring year-round reinforcement.
The evolving burnout epidemic has causes and consequences which are alarming . A 2016 pan-India study revealed 65.98% of doctors experienced high depersonalization (emotional detachment), while 87.14% felt low personal accomplishment. Though Kashmir-specific data is limited, the region’s doctor-patient ratio (1:834 nationally) and infrastructure gaps suggest comparable or worse trends Published in: Journal of Clinical and Diagnostic Research (2022) 79.8% burnout rate among doctors at SMHS Hospital, Srinagar (post-COVID surge),Female residents at 2.3x higher risk due to dual caregiving roles,32% PTSD rates among doctors treating conflict-related injuries. Kashmir’s doctors are not burning out because they work 44 hours weekly—they are disintegrating under unregulated, exploitative conditions that disregard human limits.
Drivers of exhaustion on the top figure’s workload overload. Chronic understaffing forces excessive shifts. Vacant positions remain unfilled despite rising patient loads, compounding pressure. Compounded by administrative burdens, EHR systems and bureaucratic tasks consume hours daily, diverting focus from patients. As one study noted, doctors become “data-entry clerks” rather than clinicians. Treating trauma, PTSD victims amid conflict or facing preventable deaths due to lack of infrastructure and drug shortages erodes morale. The sense of “futility” intensifies burnout. “Infrastructure decay and its impact on clinical outcomes: A Case Study of Kashmir’s Tertiary Hospitals”, published in: Indian Journal of Public Health (2023)62% of hospitals lack backup generators (e.g., surgeries conducted under compromised lights).68% of doctors face monthly verbal/physical abuse (no prosecutions under Epidemic Diseases Act). No adequate heating/cooling facilities in 85% of OPDs during extreme weather.Resource and infrastructure deficits,with compromises on physical environment infection control and risk management are systemic challenges in Kashmir’s healthcare ecosystem: Clinics in remote areas lack running water, functional equipment, lack of hygienic washrooms, rest room facilities and hygienic facilities, undermining care quality and staff dignity .Medicine shortages, stockouts of essentials like opioids for pain management or mental health medications force doctors into “rationing” care .
J&K’s rotational transfer policy mandates 2-year postings in remote Jammu/Kashmir sites. Though “flexible on health grounds,” some Doctors express displeasure on implementation policy that ignores. doctors’ familial needs citing “prolonged separation from families” and dual-region responsibilities. Arbitrary transfers also disrupt patient continuity—counter to “right person, right place” ideals.Interference and at times harassment by law makers where the doctor has no role like infrastructure deficiencies the duty doctor bears the brunt.Transparent unbiased inquiries on complaints and grievances are to be ensured to boost morale and confidence in the accountability system.
With the entry of the corporate sector in the valley there is talent exodus and corporate exploitation due to low government salaries (versus corporate offers), limited specialist training, and meagre research funding drive talent to cities or abroad. The decline of general physicians—replaced by profit-driven specialization—worsens primary care gaps. Only 11.4% of Indian doctors feel fairly compensated financially, making Kashmir’s rural posts unappealing.
Poor coordination and lack of EBM best practice mutually agreed protocols between primary, secondary, and tertiary care, and amongst three primary healthcare service providers, SKIMS, DHSK, and GMC delays critical transfers. A cardiac patient in Kupwara might wait hours for Srinagar transport due to ambiguous protocols. This strains doctors at all levels and contradicts WHO’s “timely referral” guidelines.Futuristic solutions need a review from gratitude to action to induce policy reforms. Revise transfers as per policy of skill-based placements right person at right place at right time with facilities available to deliver best care Link rotations to family needs, health status, and skill-based placement. Fast-track replacements to avoid service gaps. Boost recruitment to fill vacant posts urgently, incentivize rural service with hardship allowances and career advancement. Resource allocation and allocate funds for infrastructure upgrades for equipment, medicines, and staff facilities (e.g., clean restrooms).Wellbeing Initiatives and programs to meet challenges of burnout must be implemented with close coordination of counsellor’s peer support groups, and mandatory leave. Adopt the 2025 Doctors’ Day theme, “Behind the Mask: Caring for Caregivers”. Leverage Technology, telemedicine for remote consultations encourages AI tools to reduce clerical tasks. Community Integration must be a regular feature, expanding IMHANS-K’s model by training religious leaders in mental health first aid. Use mosques/clinics for preventive campaigns, easing doctors’ outreach burden.
Caring for caregivers, ensure care providers display compassionate care the existing system demands change. Kashmir’s doctors embody the “health is wealth” ethos, serving amid adversity with unwavering compassion. Yet true celebration requires systemic action: fair policies, adequate resources, and societal support. As we honor their courage on July 1st, let us channel gratitude into advocacy—transforming healthcare from a battlefield into a sanctuary worthy of their sacrifice. Only then can “cure” prevail over “burnout,” ensuring doctors thrive as they heal.
“The physician’s duty is not to prolong life at all costs, but to make life worth living.”– Adapting Dr. B.C. Roy’s legacy for Kashmir’s healer’s.
The Author is a Surgeon at Mubarak hospital, Healthcare policy analyst, Certified Professional in Quality improvement in Hospitals can be reached at drfiazfazili@gmail.com
