Sikkim needs to study why its roads see so many accidents and its hospitals sign so many referrals
At around this time last year, there was an enquiry underway on what caused a bus mishap near Mangan in North Sikkim which had claimed three lives and left 40 injured. It was hoped that the enquiry did a thorough enough job to ensure that lessons were learned and corrective measures undertaken to avoid a repeat. To its credit, the SNT bus service is among the most reliable modes of travelling in Sikkim and last year’s mishap was after an eleven year gap. That said, there is always room for improvement and only a proper investigation by professionals could have established whether the accident was caused by human error, engine failure or road conditions, because once the cause is established, amends can be made and road travel made even more secure. And the issue is not about buses, because, as already mentioned, they remain the safer modes of passenger movement as compared to private vehicles, jeeps and two-wheelers in Sikkim. It is important to establish whether these mishaps are caused by poor driving skills, poor vehicular health or poor roads.
It might not be out of place here to suggest that a proper appraisal is made of the reliability of roads in the State. The monsoon has not been kind on road surfaces and repairs have been too piecemeal for too long to inspire much confidence. A proper check-up to verify the load-bearing capacities of roads across the state appears to be in order.
And while the experts deploy their expertise to address the issues flagged above, a parallel soul-searching should also look into the preparedness of healthcare infrastructure for situations like the one which visited the district hospital at Mangan on the day of the accident last year. Except one injured passenger, the remaining 39 were referred to Gangtok. While there can be no challenging the fact that injured patients should receive the best of treatment, including referrals if so required, one is also bound to wonder how a district hospital found itself equipped enough to handle only one of the 40 injured accident victims. Staffing does not appear to be the issue and neither can be the efficacy of doctors and nurses, but what even the collective experience of the health workers cannot cover up for is the lack of equipment. Could that be the reason why district hospitals are forced to perform like first-aid centres? If so, then clearly an upgrade is required because district roads are prone not only to mishaps, but the districts themselves also frequently visited by natural disasters which can cause large-scale injuries. The district hospitals should hence be equipped with the best possible personnel and equipment to handle trauma cases.
Even to a non-medical mind, referrals appear ill advised when it comes to accident victims because not only do the patients have to be left without a doctor watching over them (for the duration of the road journey), but also because they have to travel over road surfaces which do not lend themselves too well to travel for those with possible internal, or for that matter any, injuries.
The concerned authorities should now resolve to carry out a detailed appraisal of roads and their stability and also check the road-worthiness of the fleets pressed into passenger service here. They should then confer with nurses at the PHSC level to doctors at PHCs, CHCs and district hospitals and specialists at STNM Hospital and invite them to draw up a wish-list of support staff and equipment required to deliver the best possible care for the level of complications they are expected to handle at their level. Once this list is secured, arrange for the funds and make their wishes come true and draw up a check-and-balance system to discourage excessive referrals. If this happens, a giant leap would have been taken towards ensuring improved healthcare in Sikkim like governments are fond of saying, right at the doorsteps of the people.