M A I N   N E W S

One ill-equipped hospital for 1.17 lakh Ladakhis
Aditi Tandon
Tribune News Service

Ladakh (Leh), May 5
Persistent lack of health facilities in Ladakh has made the life of its inhabitants not just tough, but impossible. As if the peculiar geo-physical conditions of the plateau were not enough to challenge survival, the rising incidence of rheumatic heart disease and negligible treatment available for the same here has worsened the situation for Ladakhis.

Let alone Ladakh, even Jammu and Srinagar does not offer convincing tertiary level care which is the only solution for those suffering from rheumatic heart diseases. This leaves Ladakhis with the only alternative of travelling to Chandigarh or Delhi to seek replacement of valves, each of which costs Rs 92,000. Not to ignore the cost of travelling, which a poor villager can hardly imagine to bear.

In the name of medical facilities, Leh has only one district hospital against a population of 1.17 lakh spread across 65,000 sq km. Called Sonam Norboo Memorial Hospital, it does not have CT-scan or MRI facilities, for which people have to travel to Srinagar or Jammu. Remote villages in Khaltsi and Nyoma areas have no medical stores at all. When contacted, the district authorities listed many institutions — one sub-district hospital, 14 primary health centres and 122 medical aid centres. It is another matter that these have not been able to prevent rheumatic heart diseases in Ladakh.

More than 130 cases of rheumatic heart diseases with valvular legion (damaged valves) have been diagnosed in Ladakh over the recent past. The disease, which can turn fatal in case valves are not replaced, occurs predominantly among children aged 5 to 15 years. The infection begins as a routine throat infection caused by Streptococcus bacteria.

Due to lack of awareness in villages, the infection is taken casually, paving way for acute rheumatic fever which manifests in the form of swelling in joints and severe pain. Over the years the infection bites into the heart, though the joints recover. At this stage, the heart valves stand damaged, leaving the patient with the last option of valve replacement.

While there has been talk of setting up AIIMS-level hospitals in Jammu and Srinagar, Ladakh does not even have a medical college, despite its phenomenally difficult position. Local doctors have been advocating the need to make Leh district hospital part of the teaching hospital of Kashmir Medical College so that Ladakhis get their share of medical attention. The idea has not yet cut ice with the authorities here.

Meanwhile, Dr Norboo, a physician involved in preventing rheumatic heart diseases in Ladakh, admitted to the grim scenario. Citing economic implications of the disease as a major deterrent in its treatment, Dr Norboo said: “Those suffering from an advanced infection have little hope of life. But we are trying to prevent the disease among children. In Ladakh one infected child passes the infection to others at home. To avoid cold, Ladakhis normally confine themselves to the kitchen. Cross infection thus becomes highly probable.”

Dr Norboo has been using the international sledge-hammer method to prevent the disease among children. The process involves diagnostic criteria for strep-throat infection. If tested positive, prevention requires injection of Benzathine Penicillin Long-Acting-6 Intra-Muscular for children aged 5 to 12 years and Benzathine Penicillin Long-Acting 12 injection for children aged 12 years and above.

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