One day, during her month-long trip to Bir, Dr Kumar happened to walk over to a woman in her 70s, fondly called Amma, who was working in the fields. “I found that she was completely breathless and had only been taking paracetamol," she says. “When I checked her with my stethoscope, she had clear signs of COPD (chronic obstructive pulmonary disease) and if she hadn’t got help that day, she could have lost her life."
This prompted the young doctor to make enquiries about healthcare in the region. Local healthcare workers told her the state was so short of doctors that the government was conducting walk-in interviews for them every Tuesday in Shimla. She seized the opportunity—and was selected.
In November, Dr Kumar got her first posting—the public health centre (PHC) in Rakcham village, in Kinnaur district’s Sangla block. Rakcham, a scattered village that is home to 700-800 people, had been without a doctor for months; today, Sangla’s six PHCs have as many doctors. “The people were quite shocked to see me, I was the first woman doctor there, and no one really thought I would make it because of the harsh climate," says Dr Kumar. “When I moved into my quarters in the PHC, I did not have staff here—I was the only doctor when I started working. I was the nurse, I was the peon, I was the clerk, I was the pharmacist, everything." She still doesn’t have staff.
The first thing Dr Kumar did was to make a log of the 40-50 residents suffering from diabetes or hypertension—she would manage this like a “report card", with regular checks. Many of the cases in her OPD were trauma cases—injuries or falls suffered while working in the fields with heavy machinery. When it came to pregnancies and deliveries, she would deal with them herself or, if she felt the need, send the women to the community health centre in Sangla, 13km away. The Rakcham PHC is not equipped for deliveries. In the last two weeks alone, she has assisted with three-four deliveries.
“I always knew that I wanted to do something which directly helped people on the ground, where I could be useful. When I started working in the emergency rooms in Delhi, the satisfaction of acting to save people’s lives was something I held on to," says Dr Kumar, who has lived in different parts of the country as the daughter of a Central Industrial Security Force officer. She was born in Bhilai, Chhattisgarh, and has lived in a host of places big and small, from Delhi and Mumbai to Devas, near Indore, and Mehsana, near Ahmedabad. “My brother and I studied in Kendriya Vidalayas in all these places and these experiences and interactions really opened up our minds," she says.
Today, her parents live in Bengaluru—her mother is diabetic, and her father goes in to work every day despite the risk of covid-19. She worries. Reaching home would be a two-day journey, with snow and road closures in winter making it even more difficult. “If I really want to go back, I can make a request and go home, but then I don’t want to do it because I don’t want to be irresponsible—I don’t want to be that person who just takes leave and disappears from here, particularly during a pandemic," she says.
In December, when the first few covid-19 cases were surfacing in Wuhan, China, an 80-year-old villager came over to the OPD, visibly anxious. Rakcham is just a village away from the border with Tibet, and he was worried the virus would make its way to them. Dr Kumar, who knew of the virus, calmed him down, and since the March-end lockdown, has been key in dealing with the outbreak. The village has had four cases so far.
Once the lockdown was imposed in late March, she surveyed all the households in the village, listing the family members, checking their vital signs and fever status and entering the details into a government database. “I entered the details of around 650 people personally—the homes are in different parts of the mountains, so I managed around 20 households a day and finished scanning the entire village in about a week," says Dr Kumar.
As the lockdown eased and people started returning to their villages from the towns they migrate to in winter, 17 men of the Indo-Tibetan Border Police, posted in the surrounding area, tested positive for the virus in Reckong Peo, part of Kinnaur district.
Dr Kumar now spends Mondays collecting up to 50 RT-PCR samples from the block—random checks on shopkeepers or workers from Nepal stranded during the pandemic, as well as those in home or institutional quarantine in Sangla. The samples are sent to Shimla.
For the rest of the week, OPD continues—tending, for the most part, to wounds and broken limbs. On Sundays, when she is usually free, she still cannot venture more than 8km from the village, since she needs to be available in case of emergencies—but she does go for short hikes with the villagers. Dr Kumar has also been helping out in other ways, tutoring children since schools are closed and their mothers are working in the fields all day.
Sometimes, she says, it does get overwhelming. “But then a patient will come at 3am, I will clinically diagnose appendicitis—it was about to burst!—stabilize them and send them to the more equipped hospital in Sangla for surgery, and realize that I am here because otherwise there would be no care," she says.
“I am here to serve."