Chushul is a very remote village which lies barely 4 km from the Line of Actual Control (LAC) south of the famous Pangong lake in the Changthang region of eastern Ladakh.
At the centre of the recent flare-up along the LAC, the people of Chushul are often the first to suffer the consequences with key modes of communication with the outside world cut off and grazing land lost to the westward spread of Chinese forces.
It’s not like the situation is any better when tensions don’t flare up with shoddy 2G connectivity and only a few hours of electricity supply at this village. Despite their troubles, the people of Chushul are, in the words of their Councillor, Konchok Stanzin, “the government’s eyes and ears there”. They notice everything that goes on along the LAC.
So, when 42-year-old Dr Jigmet Wangchuk, a medical officer with more than a decade of government service, received his transfer order on 27 July 2020 to the PHC (primary health centre) Chushul, some of his friends and family members saw it as a ‘punishment posting’. Before his transfer there, he had been serving at the COVID-19 designated Mahabodhi Karuna Charitable Hospital near Leh.
“I was astonished to witness the attitude of these people. Contrary to their perception, I was not depressed. In fact, I was really motivated to do some good work and pledged to inspire younger doctors to work in these peripheral regions. There are many doctors and specialists available in Leh city, but people of peripheral regions don’t have access to their services,” says Dr Jigmet, speaking to The Better India.
Within months of his posting there, Medical Officer Dr Jigmet has transformed a once dilapidated PHC into a model health centre while simultaneously treating COVID-19 patients and volunteering to assist our armed forces along the LAC. Here is how this native of Skurbuchan village, which lies 125 km from Leh, made all this happen.
Getting to zero COVID-19 patients
Constructed in the early 1990s, the PHC in Chushul has long served the people inhabiting these remote corners of Eastern Ladakh. However, upon joining there, Dr Jigmet found a centre in an utterly dilapidated situation. Forget the fact that the X-Ray machine had been out of order for the past two years, besides the lack of other basic medical equipment, the centre was in serious need of plastering, whitewashing and painting as well.
Meanwhile, he had also recently come to know that the National Health Mission (NHM) under the Central government’s health ministry, had earmarked PHC Chushul among many PHCs of UT (Union Territory) Ladakh for an upgrade to a Health & Wellness Centre as per their Ayushman Bharat programme. Before his arrival, the NHM had sanctioned the first instalment of funds for said purpose but due to COVID-19 and distance from Leh, it became very difficult to obtain logistics and manpower to renovate the hospital.
“With real difficulty, we managed to find a mason and three labourers and started work. Motivated by the efforts of these labourers, the entire PHC staff also offered their assistance. We had to complete our renovation work by the end of October. With the onset of a biting winter season ahead, we had a short window to complete our work. However, a few days after this renovation work had commenced, I suspected one of the patients who had come to our PHC of having COVID-19. I immediately conducted a Rapid Antigen Test (RAT) and he came back positive. We had to screen the entire staff since most of them had come into contact with him. Three staff members tested positive,” recalls Dr Jigmet.
After rigorous contact tracing, they discovered more cases. They were shifted to dedicated COVID-19 care centres at a government school and a few rooms belong to the local wildlife department. Today, however, the PHC has a proper eight-bed COVID care centre containing two beds in their ICU with ventilators, cardiac monitors and oxygen concentrators. Since the onset of the pandemic, the PHC has reported 66 cases of COVID-19 (57 locals and nine non-locals).
While most cases were asymptomatic, there was an old lady who came in with respiratory distress. She was cared for at the PHC and discharged just a couple of days back. All the other cases were isolated and managed as per the government’s COVID-19 guidelines.
“While we were struggling with the pandemic, we never let our renovation work suffer and continued slowly and steadily. We hired a painter for re-painting and distempering work on the walls was done by the staff. Meanwhile, none of the staff here were trained to conduct RAT test and sampling for RT-PCR Test. I trained them in batches and today most of our staff are experts in these procedures. We have been able to control the COVID-19 situation here thanks to the dedication and utmost enthusiasm of the staff working here. Whenever we needed it, equipment and other logistics were provided by the Health Department, for which we are deeply thankful to the UT Administration,” says Dr Jigmet.
There are no active COVID-19 cases at present in Chushul.
“From his previous experience at the Mahabodhi Hospital, he understood what was needed to contain COVID-19. He went door-to-door raising awareness, conducted thorough contact tracing exercises, tested all possible contacts extensively, supervised those who tested positive, gained the trust of the people and did a great job managing the cases in his own jurisdiction. Having said that, our PHC still needs some oxygen concentrators and there are some heating issues as well,” Councillor Konchik Stanzin.
Arming the staff with the right tools
In transforming the PHC, he especially credits the assistance offered by the chief medical officer (CMO) of Leh district, Dr. Motup Dorje. According to Dr Jigmet, he played a pivotal role in providing the PHC with the required funds and logistics to purchase and obtain medical equipment like ventilators, cardiac monitors, oxygen concentrators, ICU beds, electronic ECG machines and extra oxygen cylinders for the PHC. In addition, Dr Dorjay also ensured that the PHC got sufficient quantities of PPE kits, RAT kits and VTM tubes.
The renovation work, which began in mid-August, was completed by the end of October.
Meanwhile, Dr Jigmet got the X-Ray machine, which was almost defunct for almost two years, repaired recently, besides upgrading the laboratory in which most of their basic blood and urine tests are conducted. Under his stewardship, the PHC has also procured a refrigerator where they store various medicines and reagents at optimum temperatures.
“Today, we also have an electric operated labour/delivery table with LED OT lights in the labour room where normal deliveries are being conducted. Recently, we conducted a delivery of a pregnant mother who was COVID-19 positive under all the safety guidelines. Both the mother and child are safe. We have a fully functional dental OPD as well, which is managed by our dental assistant,” says Dr Jigmet.
Dr Jigmet is adamant that none of his work at the PHC would have been possible without his 18-member strong staff, which includes three doctors (one allopathic, two Tibetan medicine), three nurses, two ANMs (Auxiliary Nurse Midwives), technicians, orderlies, among others.
Spirit of public service
Meanwhile, Dr Jigmet also had to perform three postmortems, including that of the Late Nyima Tenzin, a soldier of the seven Vikas battalion of the Special Frontier Force, who was recently killed in the line of duty during the recent border stand-off with China.
“Before COVID-19, we would get 20-25 patients on a daily basis but since the first cases were detected here, this number has decreased. I utilised that time to visit our soldiers along the LAC on three occasions delivering medicines, water and kerosene. Having said that, we generally get patients of osteoarthritis, respiratory problems, hypertension, antenatal cases and people with a variety of dental problems. We provide free ambulance services for senior citizens for consultations, while pregnant ladies also receive the same for deliveries as well. We got the first instalment of Rs 2,50,000 fund for the renovation work while awaiting the second instalment of the same amount,” he says.
Konchok Stanzin, Councillor of Chushul, is all praise for Dr Jigmet’s work.
“Dr Jigment Wangchuk and his entire team have completely changed the entire scenario of Chushul Primary Health Centre within a short span of time. They have completely transformed it. I have never seen such a dedicated officer and team. In fact, both the doctor and his team were involved in labour work. I am glad that I could help deliver an ambulance and some construction-related material to this hospital. However, more needs to be done in the coming year for Chushul, which lies nearly 15,000 ft above sea level. I recommend greater official recognition for Dr Jigmet,” he says.
Dr Jigmet shares that he has only one objective.
“I want to provide the possible healthcare facilities to the poor living in this remote place. I have seen that healthcare infrastructure in remote areas needs total revamping to make them functional. Patients from these parts shouldn’t find the need to visit Leh for even minor ailments. This will be the main objective of my professional career wherever I am posted in the future. I am proud to be a healthcare worker,” he says.
(Edited by Yoshita Rao)