Journalism of Courage
In focus
In 2016, a 35-year-old pilgrim undertaking the long trek to the Amarnath cave suffered a heart attack in the Baltal area of Jammu and Kashmir’s Ganderbal district. As he was brought into the makeshift medical bay set up for pilgrims, a young doctor — unsure of administering drugs to thrombolyse the patient — called his senior, cardiologist Dr Imran Hafeez, for assistance.
“He was a bit unsure, but I told him to stay on the call and administer the drug. Once the pain settled, the patient was brought over to the Sher-e-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar and saved just in time,” Dr Hafeez told The Indian Express.
The incident was the spark that led to the creation of a network of doctors across J&K that has been working on ensuring that patients on the peripheries of the state’s healthcare infrastructure get the required treatment within the “golden hour” — the first 60 minutes after a heart attack, during which proper treatment can significantly improve chances of survival.
According to its members, over 6,000 lives have been saved through early intervention via their WhatsApp group since the network started in 2017.
Currently, the network covers nearly all hospitals in Kashmir, large parts of Jammu and some areas of Ladakh.
Every few minutes, Dr Hafeez’s phone lights up as his colleagues interact on the WhatsApp group, uploading ECGs and seeking the expertise of cardiologists on the platform.
“In remote corners, say at a primary health centre, the set-up includes a medical officer and consultants. So, when a patient with heart complications comes in, whether or not the person on duty is a cardiologist, they upload the ECG on our WhatsApp group and the cardiologist available at the time responds and guides the doctor on further treatment before they are referred to SKIMS or a district hospital if required,” he said.
SKIMS is the Valley’s premier health institute and caters to a majority of Kashmir’s patient load. Dr Hafeez, who has been a cardiologist here for 20 years, said, “In cardiology, time is muscle. So, ideally, the sooner a patient reaches us, the better the chance we have to save the heart. With our topography and the distances involved, a patient can sometimes take even four hours before reaching the hospital.”
In places like Kupwara and Kulgam, which have remote villages that often face issues of connectivity, the expertise of the cardiologists on the group has helped save several lives.
Dr Aijaz Ahmad Bhat, posted at the Sub-District Hospital in Kupwara, said that while he has been posted at the hospital for the last 19 years, he first conducted thrombolysis on a patient with assistance from doctors on the group in 2017 and since then, “thousands of patients have been saved through early intervention of the doctors on the group”.
He said, “ECG facilities are available in every hospital, drugs are available everywhere, so in case of cardiac emergencies – even as far as Machhil or Keran – we upload the ECG and the patient is immediately treated.”
Dr Bhat emphasised that this has reduced referrals to tertiary care, and the key benefit is that they are able to treat the patients in time – within the “golden hour”.
In Kulgam, Dr Irfan Dar, posted at the district hospital for the last four years, said that in this period, at least 350 patients who came to the hospital have benefitted from the early diagnosis of heart diseases.
“What happens is that sometimes, people available at the hospital do not know how to read or even conduct ECGs. But with this network, they are administering medicine to thrombolyse a patient. This has been an excellent collaboration,” he said. “Even a young doctor with little cardiac experience can get assistance on the group and help patients.”
Though the group started in 2017, the internet shutdown in 2019 following the abrogation of J&K’s special status under Article 370 of the Constitution took a toll on the effort. During the Covid-19 pandemic, the group again served as an asset, with doctors already connected through WhatsApp.
Dr Hafeez also credited the J&K Health Department for providing drugs required for pharmacological interventions at primary health centres and training for doctors where necessary.
As per data collected by the collective, nearly 64 per cent of cardiac emergencies in the Valley come from peripheral regions where the average time between diagnosis and treatment had been about 250 minutes. In many cases where there has been a delay in treatment, the reason has been misdiagnosis at the primary level. With the doctors’ network, such misdiagnosis has reduced.
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