Only 1 of 40 stomach endoscopes functional at GMC Srinagar

Srinagar, Aug 21: Leaked internal communications at Government Medical College (GMC) Srinagar has exposed a severe shortage of critical equipment, leading to compromised patient safety as well as inadequate facilities for an overwhelming number of upper and lower gastrointestinal (UGI/LGI) cases.

Greater Kashmir investigation reveals, and the letter confirms, there is only one functional endoscope for upper gastrointestinal (UGI) procedures at the Department of Gastroenterology, Super Specialty Hospital (SSH) Srinagar.

These were 40 a few years ago.

The document, addressed to the administration of the hospital, highlights how the administrative lapses are pushing doctors to ignore the safety protocols – an invitation to cross-infections.

The delayed diagnoses are imminent, with a long queue for procedures due to the shortage of multiple scopes that could have allowed doctors to do more than one endoscopy at a time.

With Kashmir’s disproportionately high burden of gastrointestinal (GI) cancers, timely endoscopic diagnostics are essential for early detection and improved survival rates, but for the apathy towards strengthening the system.

“The UGI Endoscopy procedures should take approximately 15 minutes, followed by 8 minutes of cleaning and disinfection of the scope,” reads the letter. “At present, the Department has only one functional UGI endoscope, which limits our capacity.”

“The defective, old endoscopes have not been repaired, despite repeated written and verbal requests from the department,” it says.

The letter minces no words in stating, “This excessive patient load leads to compromised procedure time and inadequate cleaning, increasing the risk of missing vital diagnostic lesions and cross-infections.”

The communication urges urgent intervention from the authorities.

According to details obtained from hospital sources, in 2010, the Department of Gastroenterology was ordered to relocate to the new Super Specialty Hospital (SSH), Shireen Bagh.

It received state-of-the-art equipment to facilitate the move.

However, the SSH construction was not complete, and the equipment remained unopened until 2014.

That year, SMHS Hospital, GMC Srinagar, and many other hospitals were badly hit by the devastating floods of Kashmir.

This destroyed the stored equipment and set back the department’s capabilities.

However, the relief and restoration packages for hospitals post-floods resulted in the department procuring new equipment, including 85 endoscopes across five different categories tailored to specific patient needs. Apart from 40 UGI endoscopes, these included separate endoscopes for HIV patients, Hepatitis C, Hepatitis B, emergencies, and other general categories.

Over the past decade, these endoscope hospital maintenance contracts meant for upkeep of equipment have reportedly resulted in damage to the endoscopes.

An official told Greater Kashmir that out of the 40 UGI endoscopes, all but one are defunct now.

Two, he said, were under warranty and their replacement was expected soon.

The maintenance company, the official suspects, is incompetent.

“Non-technical people are sent to repair the equipment instead of qualified Biomedical equipment engineers, as per protocol,” he said.

In Kashmir, GI malignancies dominate.

A 2016-2020 study of 5,392 histologically proven cancer cases in the Kashmir found that GI cancers constituted more than one-third of all malignancies.

Stomach cancer was the leading malignancy overall.

Medical Superintendent SSH, Dr Rubeena Shaheen, told Greater Kashmir the endoscopes are subjected to “proper cleaning” as per protocol.

On how many endoscopes were available at the hospital, she said, “We have three UGI scopes, and 24 functional lower scopes in working condition.”

She said there are 85 scopes in total in the department.

“However, some are non-functional and under repair, which is normal for machinery, equipment,” she said. She said work in gastroenterology was “going on smoothly and on average, 25 to 30 endoscopies are done daily.