Rx Redefined: Clinical Combat Against Troubled Hearts of Kashmir

Covid and cardiac caseloads have redefined the routine practice of conflict-hardened community medicos in Kashmir.

In his old-world charm clinic in Srinagar’s Rainawari area, Dr. Majeed Ahangar stands immaculately dressed in a black woollen cap, black feather jacket and brown baggy pants. The poorly-lit infirmary reeks with medicine whiff, while the plywood walls pasted with health-tip posters and charts make it a conspicuous classroom.

Amid this smelly and sullen setting, the sharp-eyed medico in his mid-sixties is checking his male patient complaining a heart pain with a stethoscope. With his meditative calm demeanour, the doctor is purportedly reading the painful pattern becoming another health emergency in the cold and chilled valley.

With the onset of winters, Kashmir has been witnessing sudden deaths due to heart attack. As young are falling to cardiac arrests, their families often say—“He was fine until a sudden pain collapsed and choked him.”

Medics playing frontline warriors are attributing the surging cases to the 3S Factor—smoking, stress and sedentary lifestyle.

But at Dr Majeed’s clinic, a typical indoor analysis is gravitating towards the grim reality of the region. “Forget about us,” says a brooding elder, “that hearts of our sons and daughters are stopping should worry us all.”

“It’s another curse on this cursed land,” another chips in, with a quick dismissive remark.

All these introspective interactions make Dr. Majeed’s clinic in Rainawari’s Naiedyar neighbourhood a universe of its own. As an archetypal clinic, it caters to community-level health crisis and emergencies. Such treatment centres are everywhere and are known for their own local legends.

Thirty years back, as explosive strife erupted in Kashmir, an average physician practising in SKIMS Soura transformed into a war medic. Ducking bullets, braving curfews and facing sudden situational shifts made Dr. Majeed’s part-time clinical trial a challenge he took head-on.

The same combat routine made the crippling crisis like Covid just another health assignment for this conflict-hardened doctor.

During the peak pandemic period, the physician kept his clinic open for public. It was a critical time when people were also grappling with daily health issues like hypertension and diabetes.

“Over the years,” Dr Majeed says, “diseases like diabetes, hypertension, hyperthyroidism, chronic obstructive lung disease and acid peptic disorder alarmingly rose in the valley.”

Inside his clinic, patients are waiting for their turns with blood sugar reports and thyroid tests in their hands. Their regular coughs are competing with deep breathes of a patient in the doctor’s check-up room. Among some pale and morbid faces in the waiting room sit patients with troubled hearts, like 54-year-old shoe-seller, Abdul Rashid.

Some six years back, Rashid was first rushed to Dr Majeed’s clinic when he felt unbearable chest pain and fell unconscious from his chair in his shop.

Diagnosed with a mild heart attack, Dr. Majeed referred him to SKIMS. But the shoe-seller turned down the medical advice, saying, “I’m totally fine”.

But at home, Rashid again felt excruciating pain and was rushed to the SKIMS—where a pacemaker replacement surgery was recommended.

Years later, Rashid religiously visits Dr Majeed’s clinic for a regular check-up. “It was the narrow escape from death,” says the shoe-seller, who once was a chain smoker. “Most of us don’t care until our health deteriorates.”

Besides these chronic patients, some new faces are also arriving with their troubled hearts. Akin to those cooling their heels in the clinic, many in Kashmir today wonder: What’s stopping these young hearts?

“When you have a special filter (cigarettes) for the valley, what do you expect?” Dr Majeed says. “Physical inactivity, mental stress, obesity and the ongoing severe cold are the key factors of cardiac ailments.”

In the waiting room, Ghulam Ahmad Dar, 45, is getting restless for his turn. Amid troubled lungs and hearts, he’s putting up a fight with his bladder. His uncontrolled nocturnal urination is ending his sleep.

As he steps in, Dr Majeed looks at his report very keenly. “Your blood sugar level is increasing day by day. Please take care of the diet, avoid sweets and exercise regularly.”

“My wife is also diagnosed with diabetes,” Dar says. “It costs me two thousand per month for the medicines only.”

Apart from diabetes, medicos equally blame hypertension for cardiac arrests in the valley.

Next in the queue is Imitiyaz Ahmed, a coppersmith of Rainawari. After bedridden for three months, he has come for a check-up.

Last November, Imitiyaz felt his head heavy—forcing him to leave his shop open, and rush home for some rest. Later that day, he was taken to Khyber hospital, where an MRI showed an ischemic stroke.

“He was shifted to SKIMS where a surgery to remove the clot was prescribed,” Tabasum, Imtiyaz’s wife, says. “But dissecting skull was the scary part and we were not ready for it.” He was eventually flown outside the valley for a critical-care treatment.

Apart from lifestyle problems, Dr. Majeed blames the carefree attitude in young Kashmiris—living stressful lives in strife zone—for their escalated hypertensive states, now increasingly culminating into the cardiac arrests.

“Hypertension is taking a huge toll on the health of Kashmiris,” the doctor says. “You will find the hypertension patient in every household. And this disease is clearly contributing to the escalating graph of cardiac problems in Kashmir today.”

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