'An Hour to Download ICU Guidelines': Amid COVID-19, Kashmir Doctors Struggle With Slow Internet

Srinagar: As the first COVID-19 case was officially confirmed from Srinagar on Wednesday and the Valley was subsequently locked down again, the doctors, healthcare workers, researchers and students in Kashmir are taking to social media to raise concerns about restricted information due to slow speed internet.

They’re demanding restoration of full-speed 4G internet so that people can be better informed and get critical information about the coronavirus pandemic.

“This is so frustrating. Trying to download the guidelines for intensive care management as proposed by doctors in England. It is as many as 24 MBs. It has been one hour…still not able to do so,” Iqbal Saleem, a professor of surgery at Government Medical College, Srinagar tweeted on Thursday about his inability to access intensive care management guidelines as the coronavirus pandemic spreads.

“While the world is helping each other in fighting #COVID, a professor of surgery in Kashmir had to waste hours trying to download treatment guidelines from the internet,” another Kashmiri doctor tweeted in response.

“Reason? Internet is deliberately slowed down! When will this collective punishment end?” he asked.

A research scholar from Kashmir also tweeted about the urgent need to restore high-speed internet which remains officially banned in Kashmir, after an unprecedented government-ordered shutdown following the reading down of Article 370 on August 5 last year.

“Restore the damn 4G internet, Modi. Human security and health of the people of J&K must not be kept hostage to the so-called ‘security of the state’ which is being invoked as the reason for the continuing internet restrictions in J&K,” Tahir Firaz, a Dublin-based Kashmiri researcher tweeted.

“Our doctors need internet now.”

According to Dr. Raiees Andrabi, PhD and HIV vaccine biologist and member of the faculty at Scripps Research in California, the outbreak of COVID-19 in the valley is a ‘potential explosion’ waiting to happen.

“In the current times, when the pandemic is creating health and economic scares all over the world, spreading awareness, without causing panic, is critical and necessary to prevent the spread of infection. Prevention is the only way to deal with this catastrophe as no healthcare system in the world, including western and developed countries is sufficiently equipped to manage the rising cases of infection and subsequent lethal complications,” said Dr. Andrabi, who hails from Kashmir.

“This becomes all the more important in Kashmir given the poor healthcare infrastructure. The effects of the pandemic are only worsening because of rampant misinformation and rumours,” he said.

Andrabi and his colleagues in the US tried to reach out to people in Kashmir by making informative videos in Kashmiri language about COVID-19 with facts about the infection and ways to prevent its spread. However, he points out, the biggest hurdle they’re facing is making the information accessible through the internet to people in Kashmir is the ongoing ban on high-speed internet.

“2G internet, which was recently restored, is no good because you can’t share videos or images pertaining to the pandemic related information. And spreading awareness through the word-of-mouth is contrary to the message that we want to share with the people,” he said, adding that this multiplies the effects of lack of awareness and sharing of factual information.

A desolate road in the Khanyar neighbourhood of Srinagar. Photo: PTI

“Therefore, it is absolutely necessary that the internet is properly restored in the valley before the problem become too big for anyone to handle, including the Indian government itself which will likely have plenty of coronavirus related problems of its own to deal with within a short span of time,” he cautioned.

Online consultations 

On Thursday, Doctors Association Kashmir (DAK), a doctors’ body in Kashmir started an online initiative which will make doctors available online for voluntary health consultations to people through WhatsApp and mobile phones in order to limit hospital visits of routine patients in view of the COVID-19 scare.

The doctors’ body has also requested more doctors to volunteer and provide online consultations to patients so that “people suffering from general ailments limit visiting hospitals.”

“Internet should be fully restored as it would be helpful in disseminating critical information by doctors about the coronavirus epidemic among people,” said Dr. Mir Mushtaq, a senior executive member of DAK. “Even the government can use the internet to disseminate a positive message and keep people updated about the steps taken by administration.”

A psychiatrist who works in a government hospital in south Kashmir told The Wire that given the rising anxieties and restricted mobility of people, the already stretched healthcare system in Kashmir will be soon overwhelmed by general patients instead of preparing and focusing on coronavirus patients. The doctor said that 4G internet access should be immediately restored by the authorities so that they can provide online video consultations to general patients in order to minimiSe the patient load in hospitals.

“It’s a double whammy for the Kashmiri population in general and persons suffering from mental health issues in particular. A video call to their physician/psychiatrist would have alleviated anxieties of the patients when every other doctor here is offering their personal cell numbers for their patients in this hour of need,” he said.

“Further, we will have severe long term mental health consequences of more restrictions on people and our mental health infrastructure here is not developed enough to deal with it,” he added.

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Another doctor, an assistant professor in a medical college said due to the months-long internet ban, he couldn’t follow up on many of his patients from August 5 last year who would otherwise consult him and remain in touch via video calls for their medication.

“In my personal practice, video call consultation, and videos through WhatsApp was a routine until the lockdown from August 5 last year,” he said, adding that it was very feasible for elderly and frail patients across the valley as well as they didn’t have to move out of their homes and travel.

“Many such patients have stopped medications and I have lost the opportunity to follow up on many more patients since last summer,” he said. “It has been a tragedy in my personal practice.”

The doctor said in the present situation when the coronavirus epidemic is posing a serious threat and claiming lives worldwide, the restoration of 4G internet services would “at least alleviate the anxiety and fears among people and also help the student community.”

‘Restore full access to internet’

Amnesty International India on Friday also urged the government to restore full access to internet services in Jammu and Kashmir and ensure that people have full access to health and safety-related information.

“As on 19 March (9 am), the Government of India has reported 166 confirmed cases of coronavirus in the country. Of these, four cases have been confirmed by the Government in the Union Territory of Jammu and Kashmir,” AI said in a press statement.

“Despite the rising number of cases, on 17 March 2020 the Government of the Union Territory of Jammu and Kashmir ordered for the continued restrictions on full internet services such as restricting the speed to 2G in the region. Complete internet shutdowns have also been imposed intermittently in certain areas in the guise of security,” the statement further said.

“There is a growing anxiety around the pandemic and unwarranted restrictions on content and dissemination of information only stands to add to the panic,” said Avinash Kumar, Executive Director, Amnesty International India.

The people of Jammu and Kashmir have the right to remain informed of the threat to their health, according to the AI, including the measures to mitigate risks, early warning information of possible future consequences and information on ongoing response efforts.

“They have the right to information in the local languages and through media and in formats that can be easily understood and accessed, so that they can fully participate and take informed decisions in the response efforts,” the statement added.

After a 67-year-old woman from Khanyar, Srinagar with travel history to Saudi Arabia tested positive for coronavirus on Wednesday, all public transport was suspended in Srinagar city and markets were also shut. All forms of public transport have been banned in the city in addition to the ban on the entry of public transport vehicles from other districts. All public places including gyms, restaurants, and clubs remain closed.

Banihal-Srinagar and Baramulla train services have also been suspended and all the educational institutions across the valley have been closed till 31st March. Restrictions have been imposed on the assembly of four or more persons under Section 144 CrPc.

Majid Maqbool is a journalist and editor based in Srinagar, Kashmir.