Prof S Jalal Director SKIMS Vested interests indulge in mudslinging, maligning me. (Part II)

"In munafiqoon aur marwanoon ki aap sunte ho"

KO: Another allegation is that the nursing care in the hospital iscompletely missing. While a few junior nurses are visible during day, they disappear like deer in the woods by the fall of the night, leaving the patients to fend for themselves. The senior nursing staff are alleged to be an arrogant lot who dictate terms to their juniors, leaving the patientsat the receiving end. How would you set the order right?

Prof Jalal: We want it to be a shift system. Certain vested interests did not allow us or facilitate that. We wanted to put on shifts not merely nursing, butsecurity, medical and para-medical staff too. The nursing staff after 5 p.m are less in number except in critical areas such as surgical ICU, post operative, intensive care units or neuro-surgery. Other than that there isa less number of sisters because of migration, some are supposed to be on casual leave, some on maternity leave and this adjustment has to be done out of 300 or 400 sisters.You see, how many can go suddenly on casual leave, how many on earned leave because of the problems,... howmany are there on maternity leave. therefore, working force is less than 320 or 300 and that has to be distributed in 40 . the institute hasexpanded. When the institute started, it had no emergency. Emergency was only for 5 beds. Today the institute has observation and ward 2A emergency beds. It has expanded to cathlab; it has intensive care unit there; post operative work has increased. Whereas 15 surgeries were being carried out, now it is 45, in case there is no emergency. Therefore, the demand has increased. Under this demand, there is a shortage ofnursing staff. As we are having the faculty interviews next week and direct recruitment. Similarly, we are going to request the government to allow us to fill up those vacancies which are vacant for many reasons. People have retired, died or migrated. Under these circumstances, the growing demand is there. There used to be hardly one patient for dialysis; today we get 10 per day, without emergency, being dialysed. This is not with SKIMS alone. You go to PGI, you go to any other hospital..you go to Jammu medical college. Yes it is supposed to be a tertiary care that iswhy there are interviews and appointments every year.

KO: Those critically injured in accidents are left unattended in the emergency for hours resulting in the delay of the much needed medical attention. Consequently, people have succumbed to their injuries. Thereseems to be no facility for such contingencies, isn't it so?

Prof. Jalal: ... Absolutely wrong. These are allegations. Clearly sir, if you do not get annoyed, each and every word has been fed to you by a few faculty members who are deadly against the institute for their vested interests. Road accidents every day, bullet injuries every day, blast injuries - wherefrom are they getting treatment, Sir.

KO: It's also alleged that patients in the hospital are treated as guinea pigs who're subjected to all manner of unnecessary tests and investigations, even forced to undergo critical procedures such asangiographies unnecessarily. What's this happening?

Prof. Jalal: Allegations, only allegations, shame .. Why should one do it. Has he (doctor) not taken the oath? Haven't you seen patients undergoing investigations? If you say about a private hospital . . I may, plus-minus, doubt because they have to earn the money and run the hospital. Whyshould my faculty or a professor put a patient to unease. They are accountable before God and before their conscience. How many time Prof ... I have a case of a private hospital where a kidney was implanted which was removed because it had died out of necrosis. You will not project that thing.

KO: You're blamed of having spent lakhs of rupees on roof-topping tostop the leakage. What I've seen is that the problem continues as such. In ward blocks, for instance, the patients are exposed to fungal and other microbial infection due to leakage in bathrooms.Why hadn't the problem been identified in the first place?

Prof. Jalal: Ask your ... who is very close to you, it seems...who has fed you with the information. Ask . why he has not done it... It is taking me Rs. 2 crore to replace the heating system. Here is the great example of the paying ward. Put a commission who's involved. Nobody has taken it over. Who isinvolved in the construction of that? Who have designed and who have constructed that? Because you will not talk, every thorn is with Dr. Jalal. Ab mujhe pata chala, you too are the same flock.

KO: The attendants blame that the institute has turned into a concrete jungle. Don't you think people have to suffer with drop gates and doorscoming up at various places? Don't you think that charging attendantsRs. 5.00 as entry fee is too much for a poor person? No facilities such as lifts are in place for them. What do you say to that?

Prof. Jalal: This is what junior residents who had gone on a strike for thispurpose feel. Now I say categorically who has fed you this information. Go to AIIMS, you have to get a token to enter and when you leave from another gate, you have to return that token. Drop gates are there too. What a shame? The aim of the people seems to bring this hospital down to the level of Lalded hospital, which is a shame, a slur on the part of Kashmir. The premises of the hospital were used by vagabonds who were indulging in all manner of illegal activities such as gambling, charas-smoking, drugs, setting off fire-crackers, even for sexual acts. Would I have let that continue? Regarding payments, it is not the attendants but other visitors who are charged and they have to be. Thisis not a picnic spot and this thing is done to discourage people from entering the hospital in flocks. They are not hungry people. They cannot have dinner in the hospital. We are using that money for keeping the hospital clean and you can see the walls are reflecting like mirrors. Regarding lifts, one lift costs Rs 40 lakh. This time we are replacing two lifts and repairing four others. Ask my predecessors about the money which they had received.

KO: What are your future programs in terms of expansion?

Prof. Jalal: I'm literally begging before the central government for money for the expansion of the OPD, for the expansion of the maternity hospital and the regional cancer centre, which would be first of it kind in Kashmir.

KO: Thank you very much sir, you have been very forthright in answers.

Prof S Jalal Director SKIMS Vested interests indulge in mudslinging, maligning me (Part I)

"In munafiqoon aur marwanoon ki aap sunte ho"

Media in Kashmir has been very unfair while looking only at the dark side of the picture, says Prof. S Jalal, director, SKIMS, who has some genuine grouse against those associated with the Fourth Estate. He feels the press plays in the hands of one or the other agency and that the advancements, improvements and other positive developments in the institute have invariably been downplayed with a negative impact on it.Extremely sentimental and emotional on the subject of the institute, he urges mediamen to be free, fair and even-handed in their reporting and highlight the positive developments to build a congenial atmosphere so that the flow of funds, which he says otherwise gets misdirected, is not impeded. Prof. Jalal, who contemplates an ambitious expansion of thestate's premier healthcare facility, credits himself with holding itsconvocation after a gap of 18 years. He says he has been fairly successful in bringing some order in the services being provided at the institute.
Kashmir Observer chief correspondent, M Farooq Shah, caught up with the tough talking director at his office.
Excerpts: (The frequent dotted segments in the interview indicate portions that have been edited to avoid any controversy.)

KO: The institute was set up with an aim to provide medical facilities at par with AIIMS and all the infrastructure was made available to compete with any other medical institute in India. How do you react to the media reports that the dream simply seems to have gone awry?

Prof Jalal: You see the institute was only eight years old when the trouble started in the state. Unfortunately, all this happened when the institute was about to take a leap forward and grow in a manner as a tree grows. Even during the troublesome times, the institute served the people from the areas as far as Rajouri, Poonch and Jammu, not to speak of our own people here. The immediate casualty of the turmoil, however, was the institute itself, which fortunately has been retrieved from a near collapse. In certain areas, there was a total collapse while otherswitnessed a halt on progress. Yes, there've been problems but I'm happy that everything is back on track, thanks to all the staff who have spared no effort in their respective faculties and fields in uplifting the institute. I must say, all this waspossible because of the active participation and the co-operation of all thestaff that have tirelessly been devoting their time in providing quality medical care to patients. Criticism is welcome but that should have ascientific reasoning. If one looks at the statisticswith regard to the rate of patient admission, investigations done orsurgeries carried out, the doubts expressed would automatically be laid to rest.

KO: If reports were to be believed, your appointment as director has been politically motivated. Reports say that apart from the chief ministersupporting your appointment, the committee to make selection for the high profile post too was reportedly against your appointment. Did the Medical Council of India participate in the selection?

Prof. Jalal: The government had constituted a committee for the purpose which was the fairest in selection. There is a procedure in place. When I took over, the institute was in disarray. It was in a shambles.... Those indulging in mudslinging have a vested interest in maligning my reputation and credibility of the instutute...

KO: Majority of the staff blame that you've encouraged lobbyism to take deeper roots, consequently the team effort is seemingly missing. For instance, patients requiring cardiac surgery are shown the door and referred outside the state without the consultation of the in-housesurgeons. Your reaction?

Prof. Jalalal: Today when everything is open... whether it is procurement, whether it is patient care, whether it is the faculty orientation. You said cardio-vescular surgery..This is the first time where open heart surgery and coronary bye-pass surgery is being carried out in a routine manner on astatic and on a beating heart. That mortality and morbidity has come down to the national and the international norms. Every second day open heart surgery was being carried where today plastic surgery isflourishing. In cardiology, every intervention is being carried out. You see the surgical ICU. Couldn't the people who were in surgical ICU in dirty 5 or 7 beds see the difference. Today we are making it for 20 beds, We have renovated the medical ICU. We are procuring the equipment worth crores of rupees in two months. Each and every penny that we get for patient care, for drugsand for the institute, is accounted for.

KO: Is there any veracity in the allegations of nepotism and corruption in appointing HODs without considering their qualification?

Prof. Jalal: Prof Baldev has served the institute and the community for 15 years, otherwise the department would have been closed. ..All other people have to go up step by step..In its infancy yet, there's a technical committee. They will assess the things..

KO: You're the senior most cardiologist in the institute and the detrimental effect of alleged mismanagement has bifurcated even your department into two units, one headed by you and the other by Dr. Khursheed Iqbal. Why two units of the same department?

Prof. Jalal: The departments, in all 32, have to be divided into multiple fractions and it is my magnanimity because I did not want to be given a label that I'm revengeful and that I didn't close down that unit and in view of this I may have to take a tough decision with regard to the management of the departments. I'm putting up a word against everything..these malpractices..that is why I am a bad man and you too have come with a motivated aim.

KO: Most of the equipment required for various procedures is either out of order or seriously insufficient such as ventilators and monitors in cardiology, forcing surgeries to be postponed a number of times. No effort has been made to purchase the equipment. This, in view of thefact that Rs. five crore got reportedly lapsed last year. Is there any veracity in the allegation?

Prof. Jalal: ...Mr.. for nine years, no one bought the ventilators, whether it wasmonitors, or ventilators, when we have put in the last purchase committee. First, there was a central purchasing committee that money was not with me, it was surrendered and when in the last purchase committee...We put the 10 ventilators and monitors.Those very people, two professors who were supposed to plead the institute, they got the representations of the companies, whatever the reasons and intereststhey had got, who were supposed to deal with it. Therefore, financial commissioner as the chairman and I as the vice-chairman had no alternative to cancel that but because of his good offices, we could retain the money which is a unique case. We are getting the ventilators and monitors. Regarding Rs 5 crore having got lapsed, the reports are absolutely baseless. Two crore rupees are retained as advance withdrawal with us.... Go and ask Kundal Sahab and Aimn Lala whether it is a fact or not. I think it is a sin, aur apne aap ko Musalman kehte ho. In Munafiqoon aur Marwanoon ka aap suntey ho. I'll just give you one example, that of modern cathlab I have got for the department. I'm emotional under these circumstances...I have put in so much of effort for the betterment of this institute..Some people want to run it as a private nursing home.

                                     End of Part - 1