On the night of August 4, the ‘Save Heart Kashmir’ WhatsApp group buzzed for the last time — a patient from Qazigund in south Kashmir had suffered a major heart attack and the doctors at the peripheral hospital were seeking advice from cardiologists in Srinagar. The patient needed immediate thrombolysis (clot burst) and a referral to Srinagar.
“That was the last message on the group. The patient and two other MI (Myocardial Infraction or heart attack) patients were being referred to Srinagar,” said Dr Nasir Shams. He is one of the coordinators of ‘Save Heart Kashmir’ — a voluntary initiative by doctors from across Jammu, Kashmir and Ladakh that has saved over 700 lives over the past year-and-a-half by real-time management of major heart attacks at the peripheral hospitals of the three regions through a WhatsApp group.
“It was then that the internet went down and we lost track of the patients. We don’t know what happened to them,” he said.
For the past three months, the initiative has come to a halt because the internet ban snapped their only line of communication — WhatsApp.
Now, with the number of patients with myocardial infractions at Srinagar hospitals dipping, doctors who are part of the group are wondering about the fate of patients in peripheral hospitals across the two Union territories.
“Everyday, we were catering to about 55 critical patients. All the hospitals were connected across the Jammu, Kashmir and Ladakh. Several people in Haryana were also in touch. But for the last three months, we were not able to help anyone. We have no idea. God knows what is happening to such patients? We are really pained by this,” said Dr Shams.
A group of doctors started the initiative and over time 120 hospitals and over 1,200 doctors were connected through the WhatsApp group.
Whenever a patient with complaints of a chest pain was brought to a hospital in a remote village where no cardiologist is posted, the doctors would upload medical reports and investigations on the dedicated WhatsApp channel. Cardiologists and experts on the group — some of them abroad — would then advise doctors on how to treat the patient.
“There is a golden hour in (medical) emergencies. We were able to cater to these patients in that golden hour,” said Dr Shams.
Based on ‘Hub and Spoke’ model where the two tertiary care hospitals of Srinagar – Sher-i-Kashmir Institute of Medical Sciences (SKIMS) and Shri Maharaja Hari Singh (SMHS) Hospital – act as hub and the 120 peripheral schools as spokes, the initiative has helped to save 778 patients from major heart attacks, managed 2,723 minor heart attacks and 5,328 heart rhythm disorders.
“On daily basis, we used to discuss 50-odd ECGs for managing acute emergencies. There was timely management and timely referral and the tertiary care institute was kept in the loop that the patient is coming,” said Dr Imran, a cardiologist at SKIMS, who is another coordinator of the initiative.
Now, Dr Imran said he had no way to gather information on patients in remote areas because of the communications blockade. “But one thing is sure… These days, we receive such patients mainly from two centres – Anantnag and Baramulla. From all other district and sub-district hospitals, we don’t receive any patients who need thrombolysis. The number of such patients has drastically decreased.”