Golden Hour Slipping in J&K Emergencies

The absence of a dedicated trauma hospital in Jammu, the primary healthcare hub serving ten districts of the Union Territory, is not merely a missing link in the healthcare chain; it is a grave systemic failure that continues to cost precious lives, deepen socio-economic vulnerabilities, and erode public confidence in the healthcare system. Despite its pivotal role in catering to a vast and diverse population, Jammu still does not have a multi-specialty trauma centre capable of handling complex, multi-organ injuries under one roof. As a result, more than 80 percent of trauma patients are compelled to travel hundreds of kilometers to cities like Amritsar, Ludhiana, Chandigarh, or Delhi, often losing the critical “golden hour”, that brief but decisive window during which timely intervention can save lives and prevent lifelong disabilities.

The urgency of such a facility becomes even more evident when one considers the unique geographical and demographic realities of the Jammu region. Most districts, including Doda, Kishtwar, Ramban, Rajouri, and Poonch, are hilly and mountainous, where road accidents, landslides, and natural disasters like flash floods and cloudbursts occur frequently. Even the comparatively plain areas of Jammu, Kathua, and Samba record alarming rates of road traffic accidents, particularly along the accident-prone NH-44 and the dangerous roads of the Chenab Valley. The recent cloudburst in Chashoti village was a painful reminder of this gap: several critically injured victims required simultaneous neurosurgical, orthopedic, and cardiothoracic interventions — services that were unavailable locally. Families were left with no option but to shift their loved ones outside the Union Territory, losing precious time and, tragically in some cases, their lives. Globally, trauma centres are comprehensive medical ecosystems where orthopedics, neurosurgery, cardiothoracic surgery, general surgery, and emergency medicine function as an integrated unit. Studies show that 75 to 80 percent of trauma cases involve multiple systems, making a single-specialty hospital inadequate. Yet, instead of addressing this critical need, authorities sanctioned a Bone and Joint Hospital, a decision that, while important, does little to address the broader spectrum of trauma care. Without a fully functional trauma centre, patients with head, chest, abdominal, or spinal injuries cannot receive comprehensive treatment, resulting in preventable complications, disabilities, or deaths. The consequences of this policy oversight extend beyond the medical realm and into the social and economic fabric of the region. Transporting patients to distant cities incurs massive costs for travel, accommodation, and treatment, pushing already struggling families into financial distress. Many victims succumb to their injuries during transit, not because their condition was untreatable, but because critical care was unavailable when and where it was needed. This is not just a healthcare issue; it is a question of justice, equity, and human dignity. There is a strong and growing consensus among healthcare professionals, social activists, and policy experts that a state-of-the-art trauma centre must be established adjacent to the existing Bone and Joint Hospital in Bakshi Nagar. The site is ideal, with sufficient space for a multi-storey facility, and nearby land from the CD Hospital could also be repurposed. Such a trauma centre should include specialized operating theatres, a 24×7 emergency unit, dedicated intensive care facilities, advanced imaging and diagnostic capabilities, and rapid-response teams equipped for neurosurgical, orthopedic, and multi-organ trauma. The government must also address systemic inefficiencies that undermine existing trauma infrastructure. The so-called trauma units at Vijaypur and Ramban, strategically located on the Jammu–Srinagar National Highway, remain largely non-functional due to a lack of trained staff, modern equipment, and round-the-clock services. Revitalizing these centres, alongside establishing a central trauma hospital in Jammu, would significantly improve emergency response and patient outcomes. Moreover, investment in pre-hospital care, such as fully equipped ambulances, trauma-trained paramedics, and real-time coordination systems,is equally crucial to ensuring that patients receive life-saving care within the golden hour. It is encouraging that officials within the Health and Medical Education Department have acknowledged the necessity of such a facility, especially after recent disasters in Paddar (Kishtwar) and near Mata Vaishno Devi. However, acknowledgment is not enough. The time has come for concrete policy action, budgetary allocation, and time-bound implementation. The government must treat this as a public health emergency and prioritize the trauma centre project in its healthcare planning for the Union Territory.

The people of Jammu deserve more than promises; they deserve a healthcare system that meets their needs in moments of life and death. Establishing a trauma hospital is not just about infrastructure; it is about saving lives, reducing needless suffering, and upholding the state’s duty to protect its citizens. The golden hour should not remain a privilege reserved for those who can afford distant travel. It must become a guaranteed right, one that the government ensures through decisive action, strategic planning, and unwavering commitment. In doing so, Jammu and Kashmir can move closer to a healthcare system that is not only responsive but also just, humane, and truly worthy of the people it serves.