In Kashmir, the young are paying for India’s lack of vision

Fourteen-year-old Insha Malik lies unconscious in the surgical ICU of the Sri Maharaja Hari Singh (SMHS) hospital in Srinagar, her eyes pierced by pellets. The damage caused to her vision, according to a doctor attending her, is irreparable.

“Her right eye has been ruptured and her left eye is lacerated. She will be blind in both eyes for her entire life,” said the doctor.

Among the toppers in her school at Sedow village in Shopian district, the class 9 student is the latest pellet-victim admitted to the SMHS hospital where hundreds of civilians – mostly teenagers injured in action by security forces in the wake of July 8 killing of militant commander Burhan Muzaffar Wani – are recuperating.

According to Vakil Ahmad, her cousin, Insha was having dinner at home on Tuesday evening when the pellets fired outside by security forces personnel came inside the kitchen and hit the teenage student in her face.

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With each passing hour the hospital receives fresh eye-injury cases, most of them from south Kashmir, the epicentre of renewed protests in the Valley after the killing of Burhan.

While the 70-bed ophthalmology ward of the hospital is full with the patients including teenagers and even minors, the administration had to manage space in the adjacent ward No. 3 and 4 (medicine wards) for treatment of eye-injury patients.

“We have already operated upon 102 patients with pellet injuries in one or both eyes,” said Dr S. Tariq Qureshi, head of the ophthalmology department at SMHS, adding that while 42 of these patients would regain “good vision” in their injured eye(s), the remaining cases would require multiple surgical interventions before “anything can be said about them.”

Termed a “non-lethal” weapon by the government, pellet guns were used by the police and CRPF for the first time in 2010 as a means of quelling protests.

The pellets, essentially tiny ball bearings, come in grades of 5 to 12 – 5 being the fastest and most damaging, said a police official, adding the preferred pellet grade in Kashmir was 6 and 8. The official said one cartridge contains 400-500 pellets.

“The pellets may not kill but they ruin life of a person. In many cases patients suffer from sympathetic ophthalmitis, a condition in which vision in the normal eye smears following the loss of eyesight in the injured eye,” a senior registrar at the ophthalmology department told the Wire.

In ward No 16-A, doctors feared that Umer Nazir, a 6th class student from Rajpora, Pulwama who was operated upon on Sunday for removal of pellets from his abdomen and intestines, would lose vision in both eyes.

Umer’s father Nazir Ahmad, a laborer said his son was on the roadside with his friends when he was hit by pellets fired by policemen on a group of protestors.

“Doctor, it is becoming shady in front of my left eye as well,” 12-year Umer told one of the doctors during his morning rounds to examine the admitted patients. Umer has suffered “severe retinal detachment” in his right eye with injury to the optic nerve as well.

The Numbers swell

Till Thursday, 123 patients with pellet injuries in one or both eyes, mostly in the age group of 15-30, were admitted to the hospital. The nature of the injury suffered by these patients varies from open to closed globe injuries, retinal and cornea detachment.

“We have never received so many cases in such a short span of time. It is the worst that I have ever seen,” said a surgeon.

As per official records, 60 patients with pellet injuries in one or both eyes were operated upon during the first two days of protests, i.e. Sunday and Monday – a record number of surgical procedures carried in a short span of time at the hospital.

Senior ophthalmologist Sajad Khanday said that apart from the cases at SMHS, there were around 28 pellet injury cases being treated at JVC hospital Bemina, on the outskirts of Srinagar.

“The SKIMS Institute (a tertiary care hospital) has also admitted eye injury cases. In total, the number of eye injury cases is more than 150,” said Dr Khanday.

He asserted that more than 75% of these patients would require retinal intervention. “Once a pellet pierces the eye, it damages its different components, resulting in loss of vision over the period of time,” he said.

Termed a “non-lethal” weapon by the government, pellet guns were used by the police and CRPF for the first time in 2010 as a means of quelling protest

Another senior doctor, who asked that he not be identified, said patients suffering from retinal detachment have “zero chances” of regaining vision. “And their number is more than 75. No matter which surgical procedure you follow, they aren’t going to regain their sight,” he asserted.

The news that his son, Muhammad Arif, a 12th standard student, may not be able to see with his right eye, left Hussain Muhammad shattered in ward No 8 this morning. Hussain, a resident of Baramulla district, cried aloud and hugged his son as he lay in bed.

Arif, however, was calm. “I am ready to lose both my eyes if we achieve azadi (freedom),” the 18-year-old student told this reporter.

Human rights activist Mannan Bukhari, who has documented pellet injuries in his 283-page book, Kashmir – Scars of Pellet Gun, said at least 10 people have been killed and more than 1500 seriously injured due to the use of pellets by the forces on the protestors since 2010.

“Today the number of the injured will be more than 1800,” said Bukhari.

‘War like situation’

A three-member team of eye specialists from AIIMS that was rushed to Srinagar on Thursday at the request of the state government to assist doctors at SMHS in treating patients with eye injuries said the situation was “intense and bad”.

“I haven’t seen such a number of eye injuries in recent years. In a war-like situation, you will get a lot of such injuries,” said AIIMS team leader Sudarshan K. Kumar after examining around 50 patients with injuries to their retina.

Commenting on the magnitude of the injuries, Dr Kumar said the eye injury patients would regain “20% or 40% of vision”.

“At least 70-80% of these patients will regain ‘some vision’ but they won’t have a normal vision… The pellets have done damage to their eyes,” he doctor, adding that he supported the idea of “avoiding” the use of pellet guns.

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The team was sent by the Union health ministry on the request of chief minister Mehbooba Mufti, whose government is facing severe criticism for the use of “excessive force” by security personnel.

So far, 38 civilians including a teenager, have been killed and over 1600 injured in the past six days. One policeman died in mob violence and several security forces personnel have been injured, including some with the shrapnel of grenades that they said were thrown by assailants hiding behind young stone pelters.

Banning pellet guns an option?

During its stint in opposition, the Mehbooba Mufti-led Peoples Democratic Party repeatedly cornered her predecessor Omar Abdullah over the use of pellet guns while seeking a ban on the “lethal” weapon.

However after taking over the reins of the state, her party, which is running the government in coalition with the BJP, has continued with the policy of using pellet guns.

Last year the international watchdog Amnesty International had asked the state government to stop the use of pellet guns after a teenager from Palhalan in Baramulla, Hamid Nazir, was hit by more than 100 pellets in his face and eyes, rendering him blind in one eye.

While the state government hasn’t commented on the issue of banning pellet guns, the police and CRPF have opposed any move to ban their use – saying the weapon was “far less harmful” compared to bullets.

Inspector general CRPF (J&K) Atul Karwal told The Wire that the use of pellet guns “saves lives”. “It is unfortunate that there have been eye injuries but the pellets are less lethal than getting hit by bullets,” he said.

To a question, the CRPF chief said a viable solution has to be arrived at before banning pellet guns, adding that if the government bans the weapon without providing an alternative option, the security forces would be forced to use bullets.

“Such a situation will increase the chances of fatalities,” he said.

A senior police official who asked not to be identified acknowledged the pellets have “devastated” many lives. “But what is the option with us? The pellet guns are far less dangerous than live ammunition,” he said.

This was originally published in The Wire, India