Failure to acclimatise with high altitude, underlying diseases and not undergoing a genuine medical check have emerged as the main causes behind the rising number of deaths among pilgrims on way to Amarnath shrine in Kashmir valley. The toll, the highest ever, has touched 67 in just 16 days this year.
"We appeal to pilgrims to stay overnight at Chandanwari and Baltal. Most pilgrims come from plains and take arduous route without allowing themselves to acclimatisation with the height. If a pilgrim stays for a night, 12-14 hours stay can help his body circulate oxygen properly to brain and other parts," Kashmir director health Saleem-ur-Rehman told the Hindustan Times.
The death records with the state health department reveal that many pilgrims who died of cardio-pulmonary arrest were unregistered. Besides, accidental deaths like drowning were also reported.
"All pilgrims are requested to undergo proper medical examination. Don't get a certificate without actual examination. A simple ECG before starting for the yatra can reduce such deaths by 60%," said Rehman.
The health department has installed 900 oxygen cylinders on the two routes of Pahalgam-shrine in south and Baltal-shrine in north-east of Srinagar.
"Pilgrims are requested not to ignore any symptom like restless and report to a medical camp. Refilling of oxygen cylinders are being done at the spot to make all of them available round the clock," said Rehman.
Most pilgrims with underlying diseases are also facing difficulties during the yatra.
In 2011, 5.5 lakh pilgrims visited the shrine and the death toll in 45 days was 107. This year, 67 people have died in just 16 days since the yatra started on June 25. Twenty days are still left as the yatra will conclude on August 2, on the occasion of Raksha Bandhan.
A survey carried out by Sher-i-Kashmir Institute of Medical Sciences (SKIMS) and released in April this year had also called for rigorous health check up for pilgrims in the wake of last years' deaths among unregistered pilgrims.
The research paper 'Hyperglycemic Emergencies in Indian Patients with Diabetes Mellitus on Pilgrimage to Amarnathji Yatra' says that high altitude, strenuous exertions of going uphill, withdrawal of insulin or hypoglycaemic drugs, starvation, sepsis, alcohol intake were recorded as predisposing factors for death.
"After analysing patients during our research, we found all had come without medication and prescriptions. Those, who take medication along, stopped it while trekking," said said Dr Mohd Ashraf Ganie, the lead author of the survey. Ganai is currently consultant at the Endocrinology and Metabolism department at AIIMS in New Delhi.
Besides, most of the patients analysed in the research had consumed alcohol. Such patients during the trekking suffer from hypoxia and infection, said Ganie.
Reaching the shrine
The Amarnath shrine houses an ice lingum (stalagmite) at a height of 3,880 metres in south Kashmir's treacherous mountainous area of Pahalgam. The shrine can be reached by two routes -- one from Pahalgam (south of Srinagar) and other from Sonamarg (north-east of Srinagar). The journey includes a 42 km trek from the Pahalgam base camp in south Kashmir and 12 km trek from Baltal base camp in north-east.