Not only doctors, the hospital doesn't have enough paramedics, nurses, technicians, ward attendants and even sweepers. As a result, patients have to suffer.

"There has been no major recruitment in the health sector since militancy started in the valley. We desperately need a major recruitment of doctors, paramedics, nurses, technicians if this hospital does not have to shut down," a senior administrative officer of the hospital said.

To overcome the shortage, the administration engaged doctors and staff on contractual basis but that has done no good to the hospital.

"There are many doctors who have done MCH and MD degrees but they can't be employed permanently as there are no posts for them," a senior faculty member said.

The doctors thus work on contract basis and most of them go without salary for months together. "If the administration doesn't care about me why should I care about the patients," a doctor who holds an MD degree said when asked why he came late to the hospital. "I am without salary for eleven months".

Another doctor who did his DM from PGI Chandigarh was employed by the hospital some time ago but went without salary for six months. He left the hospital and has since gone to Saudi Arabia.

The contractual system of employing doctors also blocks creation of new posts. "In about nine years, a Lecturer becomes a Professor. When the Lecturers are employed on adhoc or contract basis, they remain on that post for 10-15 years blocking the entry of new people in these posts," said a senior doctor. "And when the senior faculty retires, there is no one fill up that posts causing shortage of staff".

The hospital also has an acute shortage of nursing and paramedical staff. The hospital, sources said, is short of about 300 nursing orderlies, sweepers, theatre boys, anaesthesia boys, lab attendants and about 200 lab technicians, medical assistants and senior grade nurses.

"Around twenty years ago each ward of the hospital was attended by 2 nursing orderlies, 4 nurses and 2 sweepers. Since then the number of patients coming to the hospital has grown many times but the staff is the same. Now, on some days, 4 nurses and 4 sweepers run the entire hospital," said a medical assistant. "As a result the patients are suffering".

According to the Medical Council of India (MCI) guidelines, the hospital should have one Professor, one Associate Professor, one Assistant Professor/Lecturer, two Registrars and six Post Graduate and Non-Post graduate Residents for every 60 beds in three major departments of Medicine, Surgery and Gynaecology. The same staff is required for 30 beds in other departments.

The shortage of manpower severely affects the functioning of the labs as well. "The CT scan centre of the hospital is run by four people. One of them who is on night duty takes two days off. That leaves three people to handle around 40 CT scans a day. As a result the quality of the work suffers," said a doctor who works in the hospital.

The solution, according to doctors, is to create sub-specialties like cardiology, neurology instead of clubbing everything under Medicine and Surgery. "SMHS should function as a specialty care hospital. At present it is no more than a big district hospital," the official said.

And if this was not enough, the new Super-Specialty Institute of Traumatology and Allied Specialties that is being built near SMHS will drain it of more manpower. "Instead of recruiting new people for the new hospital, the administration is sending the SMHS faculty for training. Once they return they will be put at the new hospital and SMHS will suffer," the doctor said.

The Medical Superintendent of the hospital, Dr Waseem Querishi did not deny that SMHS is deficient of staff. "I don't deny the shortage of manpower. But no posts in the hospital are lying vacant. But there certainly is a room for expansion," Dr Querishi said. "We have sent a recommendation to the government for creation of new posts to overcome the deficiency".

The Medical Superintendent also said that the new Super-Specialty Institute of Traumatology and Allied Specialties will not affect the SMHS Hospital. "New faculty and staff will be recruited for the new institute," Dr Querishi said. He, however, declined to comment on the issue of doctors not getting salary for months. "You should ask the Medical College Principal," he said.