Sameer Ahmad of Baramulla believes his father could have survived, had he been provided first aid in the hospital vehicle shifting him to Srinagar. Eleven years before in 1996, a grenade was lobbed by suspected militants in the busy market of township on army vehicle. The grenade missed the intended target and exploded on the road injuring civilians, some of them critically. And Sameer's father was among them.

Although removed to the district hospital Baramulla in a jiffy, he was referred to the Srinagar's premier health care institute, Sher-i-Kashmir institute of medical sciences (SKIMS) by doctors, owing to less Medicare facilities available in the district hospital.

In the absence of any first-aid kit or trained paramedic in the ambulance, he was left unattended throughout the one-and-a-half hour distance along with several other injured people. All of them kept bleeding profusely and wither in pain.

Prior to reaching the hospital's emergency ward, he succumbed to his injuries, and doctors declared him brought dead and consoled the Sameer that he could have been saved if given the timely treatment inside the ambulance.

This is a usual affair in Kashmir and speaks enough about the infrastructure available in the name of health care in valley. So far thousands of the people have succumbed to their injuries or pain in the hospital vehicles usually called ambulances due to the lack of infrastructure inside them.

There is no designated emergency ambulance for the civilian population of valley and the vehicles with the department of health services, Kashmir having the names ambulance and red cross mark written in bold capital letters are simply the patient carrier vehicles.

"These vehicles by no way can be termed as ambulances because they don't have the required facilities available inside to provide first-aid or life support to the patients in critical condition," said Dr. Abid Koka, a orthopaedic surgeon.

The vehicles available in the name of ambulances at hospitals in Kashmir are just ordinary means of transportation. Most of the vehicles are worn out, rusty ramshackle and devoid of any essential facility to meet any emergency.  

Health experts argue that the vehicles do not meet the criteria laid down for the designated emergency ambulance.

"These so called ambulances are used for carrying the corpses, referring patients from one hospital to other and in most of the used by hospital staff for their convenience," said a doctor at Shri Maharaja Hari Singh (SMHS) hospital in Srinagar, pleading anonymity.

An ideal ambulance designated for health care to tackle emergency should have all the facilities available at the casualty department of the hospital. It must have proper couch for patients, splints for immobilization of fractures, First Aid kits, emergency care equipment and supplies like Airway care, oxygen cylinders, masks, blood transfusion facilities, ECG machine, external cardiac compression, prevention and treatment of shock, life saving drugs and injections, IV fluids, drip sets, blood pints, blood transfusion sets.

Besides this, refrigeration facility, communication facility, emergency childbirth and transportation of newly born infants is necessary for an ambulance.

There should be a highly trained paramedical staff for resuscitation of the serious patients.

Usually there are two kinds of ambulance one is Emergency ambulance and the other is patient transport ambulance. While the former is necessary for carrying critical patients from accident sites to hospitals, the later is used for transporting patients from one hospital to another usually non-urgent care centres.

Director Health Services, Kashmir , Dr. Muzaffar Jan said that there is only one emergency ambulance in the valley and that is with the Governor of the state.

"Health department in Kashmir do not have any emergency ambulance for the civilian population. There is one such ambulance and that is with the Honourable Governor of the state, "he said.

However the director is optimistic about putting the proper ambulance service in place.

"Right now we have the patient transport ambulances but we are going to revamp the system and I am hopeful we will soon be getting emergency ambulances," Jan adds.

As per data available with the Directorate of Health Services, Kashmir about 300 vehicles registered as ambulances have been kept at hospitals. However contrary to the official claims no a single vehicle is equipped enough worth calling an ambulance.

The growing official apathy and unconcern for the health care of people has introduced the culture of using even smaller vehicles like Maruti vans, and Tata sumos, cars etc as ambulances. Majority of the privately run hospitals, nursing homes and some government owned district hospitals have these vehicles to showcase the availability of ambulances in their hospitals.

"Today you can see smaller vehicles like Maruti vans, Tata sumos, cars etc having ambulance written on their front and a siren fitted to them. In such vehicles there is minimum possibility of laying a patient comfortably and no to talk of having necessary infrastructure," rues Burhan Majid, a law student at the University of Kashmir , Srinagar.

Majid is contemplating to file a public interest litigation (PIL) in the Jammu and Kashmir

High Court to bring proper ambulance service in place in the valley.

"They are simply jeopardizing the lives of people and so far thousands of people have died on their way to hospital in such vehicles. I think there is no other alternate but to knock the door of judiciary," he said.

The smaller vehicles with the hospitals are mostly donated by the legislators from their constituency funds but quite a few I have been purchased by the department as well.

SMHS hospital is the main hospital in Kashmir after SIKMS. Among the hospital's fleet of "ambulances", six are Maruti Vans, two are Tata 407, one Maruti Gypsy and one ambassador car. Most of the smaller vehicles are used as staff cars, said a hospital employee.

Health experts in Kashmir suggest that apart from complete emergency ambulances in hospitals, there is a need for full-fledged ambulance on call service in Kashmir , owing to the conflict in the region.

"There is a dire need to set up a complete ambulance service that would cater to the untoward incidents and would provide timely help to the people. That way the number of deaths can be minimized in

Kashmir," said Shahzada Musharib, a social work professional.

Ruing the efficacy of the Fire and Emergency Service in Kashmir , Musharib says that the word emergency has been forcefully attached in the nomenclature of the department to hoodwink the people.