Friday, March 20, 2020

An Inquiry in to the Anti-Muslim Violence in Northeast Delhi by a Team of Doctors that Visited the Affected Area.

An Inquiry in to the Anti-Muslim
Violence in Northeast Delhi by a
Team of Doctors that Visited the
Affected Area.





“An Inquiry in to the Anti-Muslim Violence in Northeast Delhi by aTeam of Doctors that Visited the Affected Area”. 

FOR PHOTOGRAPHS PLEASE CLICK ON THE LINK 

The documents includes- horrific photographs of the massacre, do not watch if you have a weak stomach. The ferocity and barbarity of this demands that International bodies take IMMEDIATE ACTION and NOTICE (although I see a slim chance of that happening) the savagery of this massacre should   prompt Indians to take action, if they don’t they will rue this fact.
Rape was used by India as an instrument of war in: Partition; Indian Occupied Kashmir; Indian Punjab, in Naxal Maoist hit regions of the North West and elsewhere in India. This resulted in rape being an accepted way of life; Indian became the rape capital of Asia.
If this massacre is unpunished the savages who did this will repeat this and the victims could well be the 30% Indians who do not support BJPs Muslim hate thesis and actions.
 The ferocity of this massacre resembles the Pol Pot actions and need to be investigated and people punished. Perhaps Government of Pakistan should take this to UNHRC, even a citizen, say an Indian Muslim   could also report this to UNHRC ( IF ANY ONE WISHES TO DO THAT I WILL ASSIST AND PROVIDE FORMATS   AND PROCEDURES)
Members of the medical team1:

1. Dr Vikas Bajpai – Assistant Professor, Centre for Social Medicine and Community
Health, Jawaharlal Nehru University, New Delhi (Ph: 9717820427).
2. Dr Harjit Bhatti – Former President, Resident Doctors Association, All India
Institute of Medical Scientists (AIIMS) (Ph: 8586848479).
3. Dr Sumitran – A consultant radiologist with a government hospital in Delhi.
4. Five doctors from the All India Institute of Medical Sciences

It took a 25 to 30 km drive from AIIMS (All India Institute of Medical Sciences), to the
violence affected areas of Northeast Delhi. We were visiting the area in the context of
the massive communal violence, primarily directed against Muslims living in the area,
in the wake of their resistance to the CAA Act passed recently by the parliament along
with NRC-NPR which threaten to rob millions of Muslims of their Indian citizenship
and render them illegal in their own country.
The effort to send this medical team was initiated in the context of massive scale of
medical emergency that arose as a result of this violence. In this report, apart from
reflecting on the medical suffering of the people, we shall also try to provide a snapshot
of the violence that was unleashed and the role of the political-administrative
machinery to address the same and its consequences, as were narrated to us by the
people we met.
This report is constituted in four sections – ‘Constitution of the medical team’ and
methodology of data collection; ‘Medical emergency and the relief work’; ‘How the

1We have deliberately concealed the identity of five doctors from All India Institute of Medical Sciences
on a precautionary note to avoid trouble from the administration. However, we wish to acknowledge
that this effort could never have succeeded without their yeoman service and support.
Dr Harjit Bhatti (National Convener) and Dr Vikas Bajpai are members of PMSF. Dr. Sumitran and
others went with the team though they are not members of PMSF.

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violence happened’ and the ‘Role of the political parties’; and ‘Observations &
Recommendations.’
Constitution of the team and methodology
Violence broke out in Maujpur, Bhajanpura and Chand Bagh areas of Northeast Delhi
on the evening of Sunday the 23rd of February, 2020. Since the breaking out of the
riots, especially since the 24th of February, there were reports of people having suffered
grievous, or rather ghastly injuries, and that there were several deaths due to
widespread arson, looting, stone pelting and houses being set on fire. There were
several calls and appeals for urgent medical aid to be reached to the affected area, as
the local health practitioners were neither capable of nor did they have the
wherewithal to deal with the nature of medical emergencies being reported. The
situation was particularly precarious in the absence of no outside ambulances or
medical supplies being able to reach the violence affected areas, as also the fact that
ground situation prevented people from accessing the nearby government hospitals
like the Delhi government run GTB hospital and the Swami Dayanand Hospital
managed by the East Delhi Municipal Corporation, which were equipped to handle
such emergencies.
The Al Hind hospital in Old Mustafabad locality of Northeast Delhi was one medical
facility that had been totally overwhelmed by this tragedy. It is important to remember
here that it was after talking to Dr M A Anwar, the proprietor of Al Hind hospital that
the special bench of Hon’ble Justices Muralidhar and Bhambani of the High Court of
Delhi, ordered Delhi Police to provide safe passage to the injured patients to various
government hospitals.
We had tried to reach the area on the 24th February itself, as the reports of violence
and casualties started arriving; however, the police stopped our hired private
ambulance on the Signature bridge and instructed that only government ambulances
shall be allowed. Finally, when we could manage to get a government ambulance after
repeatedly dialling 102 number for emergency ambulance services, even that
ambulance was stopped by the police from entering the area and the driver was
roughed up. On the 25th February, upon receiving another SOS for urgent supply of
medicines, dressing material, stapler stiches and the like, we again attempted to have
some medical supplies sent to the violence hit Old Mustafabad, but the ambulance was
stopped by fifty to sixty persons raising slogans like ‘Jai Shri Ram’ and others of the

kind that are identified with the Hindu right wing, at the Brijpuri T point on the Delhi-
Meerut highway and the driver of the ambulance was threatened with dire

consequences if he insisted on entering the area. Fortunately for us, it could be possible
for us to contact people at Al Hind hospital in Old Mustafabad, who sent persons on
motorcycle to pick the medical supplies from another point on the highway. The full
team could reach the violence affected area on 26th February. Ours was in fact the first
medical team which could actually enter the area.

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Considering the poignancy of the situation, on the 25th February evening PMSF
(Progressive Medicos and Scientists Forum) assembled a medical team to reach Al
Hind hospital in Old Mustafabad area of Northeast Delhi, the next day i.e. Wednesday,
the 26th of February. It took a while for us to arrange medicines and other
consumables. Finally, a team of eight doctors was mustered which included doctors
from AIIMS and those associated with JNU. The team set out for Al Hind hospital by
10.30 am on the 26 February.
Some other doctors (1 from Jamia Hamdard Medical College Hospital and 2 senior
resident doctors from AIIMS) of PMSF, under the leadership of Dr Harjit Bhatti again
visited Old Mustafabad on 28th February, where they first attended to violence victims
at Al Hind hospital and later went to the Idgah located in the adjacent Shiv Vihar area.
It needs also be noted here, that PMSF doctors and volunteers have been going to
various 24 x 7 protest sites in Delhi, including Shaheen Bagh and Jafarabad, to provide
medical relief. However, this report concentrates on the visits after riots.
Methodology adopted for collecting information
This report is largely based on what we saw at Al Hind hospital and the testimonies
collected from the doctors, patients and their relatives and the local residents who
were in the said hospital. The testimonies included personal narratives, the videos and
pictures of the violence and arson in and around their homes, taken by the people
themselves or their neighbours and friends and shared with them. Often times, the
people supported their narrative by showing these pictures and videos. Where ever
possible every attempt was made by us to triangulate the information given by one
person by asking about it from another person or trying to confirm the reported fact
from other sources such as the news reports and hospital data. In times when rumours
and fake news could be flying thick, we tried our level best to avoid these getting
incorporated in this report.
Efforts were also made to collect hospital specific data regarding the number of injured
or dead brought to different hospitals, the kind of treatment given, and post-mortems
performed. Some of the secondary sources were consulted from the net.
It need be remembered here that on the day of our visit, curfew had been imposed in
the various violence affected areas, and that it had not been possible for us to speak
with any authority of the civilian or police administration to seek any kind of help from
them. All that we had in terms of police protection was the number of the area DCP
(Deputy Commissioner of Police) just in case there be any emergency. As we confined
ourselves to the hospital, we do not make any claim to the findings being
representative of all areas where violence had been unleashed. But from the
information that is already in public realm, we can assert that our findings here may
only present a milder picture of the consequences that this violence has led to.
Another handicap of the data presented here is that the doctors and other staff at Al
Hind hospital were so overwhelmed by the humongous tragedy that they simply could
not maintain any record of the patients they attended to, in order to facilitate

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identification of the photographs (taken by the doctors or the hospital staff) of either
the dead bodies or those with ghastly injuries who were brought to their hospital.
Though some effort was made by the doctors at Al Hind to get the MLC details of some
patients shifted from their hospital to the GTB Hospital at Dilshad Garden, it was still
insufficient. As the doctors at Al Hind told – ‘Sir, believe it or not, we have handled all
these grievous injuries, even though we neither have the training or the infrastructure
to handle this kind of emergency.’
Barring the name of Dr Anwar, the proprietor of Al Hind hospital, whose name had
already been mentioned by the Hon’ble High Court in its order, we have changed all
of the names of the patients and those who provided us the information, since it is far
beyond our capacity to defend them lest they be troubled in any way on this count.
Medical emergency and the relief work2
Old Mustafabad is a Muslim majority locality, lying in the Mustafabad assembly
constituency, which is surrounded on all sides by Hindu majority localities.
After crossing the Signature bridge across river Yamuna, the highway leading up to the
Brijpuri turning, from where we turned inside to reach our destination, Al Hind
hospital in Mustafabad, was nearly completely deserted except for the police and
paramilitary pickets in between. However, there were tell-tale signs of violence on
either side of the highway, with a burnt-out petrol pump in Bhajanpura, burnt
buildings and mangled steel frames of burnt out vehicles all along the route. In large
tracts the road had turned brick red under the cover of crushed bricks that had been
deployed in brick-batting on previous days.
As we turned into the inner localities from the Brijpuri turning on the main highway,
Police pickets apart, what caught our immediate attention were groups of men, women
and children, carrying their bags and baggage and walking furtively to traverse
through the narrow lanes in search of safe passage out of the area. We stopped to talk
to a few of them, but the only brisk reply we got was ‘going to our village’ or ‘to the
relatives.’ The other set of people who were to be seen in small groups were young
journalists, many of them women.
While the burnt homes and shops, mangled metal frames of burnt vehicles and hand
pulled trolley carts owed their hapless destiny to the exertions of the goons who had
run riot, the pot holed, unravelled state of the inner roads with overflowing open
drains on either side, putrid effluents overflowing from the closed caps of underground
severs, that is where they existed, and collections of garbage, which by their size,
seemed to date back to before the violence, were some of the other characteristics of
the area which peeled off, layer by layer, the onerous honorifics alluded to India, to

2 All figures are given in Annexure 1.

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reveal the existential reality. In the middle of all this is located the Al Hind hospital in
gali number fifteen on Pachees futa (twenty-five feet) road.
Al Hind hospital – the establishment and its people
Al Hind hospital is a tiny nursing home located on the lower two floors of a four-storey
building. Established around two and a half years back, in normal times Al Hind
hospital operated from the ground floor only which is a partitioned into a pharmacy,
a receiving area for patients, a doctor’s chamber and a ward on the back side which
has space for around fifteen beds. But during this violence, the massive flow of injured
and dead victims led to the first floor of the building also being incorporated into the
hospital by turning it into a makeshift ward by simply spreading mats on the floor. The
infrastructure and the medical expertise of its doctors is too short to cope with the rush
of patients witnessed on 23rd, 24th and the 25th of February when the violence was at
its peak. It is simply a general practitioner’s clinic.
In this trying time the proprietors of the hospital Dr M A Anwar, his three brothers –
one of whom is a BDS, the other a bachelor of Unani medicine and the third a
pharmacist played praise worthy role. Around six to seven general practitioners of the
area, with degrees in alternative systems of medicine, or just RMPs (registered medical
practitioners) also lent round the clock efforts in rising up to the challenge along with
untiring commitment of twenty-one volunteers who worked day and night for tending
to the injured victims. Most of the doctors and many of the volunteers had not slept
since the night of 23rd February when we met them on 26th afternoon. Apart from this
the common people of the locality pitched in with their meagre resources to not just
support the medical services at the hospital, but also to host scores of persons and
families uprooted from their homes in the nearby areas.
The 38 years old proprietor of Al Hind hospital, Dr Anwar is an extremely soft-spoken
person with a rural background from East Champaran district of Bihar. He completed
his MBBS degree from a Medical college in Meerut.
When all hell broke loose over Al Hind hospital
Going by the photographic record and the oral testimonies of the doctors, volunteers
and common people at hand, we can only make an estimate of what must have been
the scene at the hospital on two days since the evening of 23rd February. Reliance need
be placed here on what Dr Naseer Ahmad narrated about the situation at his hospital.
He said:
These people (referring to the attackers) had so severely assaulted the
victims that they were dying of agony, and we had nothing in our hands.
Despite being medical doctors, we couldn’t do much because some had had
their heart punctured, someone’s lungs had been punctured, while kidneys
of others – all vital organs of the body. Some had had their skull pried open
from both sides with knives. Some patients presented with iron girdles
inserted into their skull. Police had laid down a three-month pregnant

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woman and beaten her up brutally. The Imam of Farooqia Masjid was pulled
out from his chamber and beaten up by the police. Acid was thrown on the
face of the Imam of the Masjid in Shiv Vihar. We were helpless in providing
any treatment to him due to lack of infrastructure; still we sent him from
here after stabilizing his condition. We did not know whether he is living or
dead.
The condition was very bad. At the time when we needed ambulances to
ferry the patients, no government body came forward to help, and there was
no help from any Muslim organization either. Now that the condition has
improved somewhat, the local influential people came to meet with starched
sleeves and scented overalls. We did not allow them in, as we don’t need
them now. ................ Live people, writhing with agony had come to the Al
Hind hospital. We did not even have the courage to look at them; we were
becoming dispirited. But it is the local people of this area who gave us
courage. They said – ‘Doctor sahib if you lose heart like this then we will die;
We shall lose all hope.’ It is the people of this area who have assured us that
- ‘Doctor sahib we are there with you. People have died, yet the tears you
shed are the testimony to your commitment for humanity.’
We do not even know that those who died were Hindus or Muslims. We were
weeping because we were seeing people die of their agony and that we were
feeling helpless. (Translated from Hindi)
Referring to the chaotic situation, especially the role of the police, Dr Anwar added:
On 25th evening we spoke to the civil society people, it is through their
intervention that we could converse with the High Court judges and
appraise them of the ground situation. It is only after the High Court
ordered that ambulances came to this area. When the government
ambulance was not coming, we tried to get in private ambulance, but even
those were not allowed in. (Translated from Hindi)
Dr Anwar also informed that repeated calls were made from the hospital at 100 number
(for police assistance) and 112 number (all in one emergency number launched by
Union Home Ministry during the first term of the present government). Initially, these
calls received evasive response from the other end, but later the calls were not even
taken. Calls to the emergency number of CATS (Centralized Ambulance and Trauma
Services) for sending their ambulances also met the same fate. Describing the
conditions, another RMP of the area who was assisting in relief efforts at Al Hind
hospital stated:
The oxygen supply with us had run out completely. A patient came to us who
desperately needed to be oxygenated. Dr Anwar had spoken with the local
authorities at 11.30 am to provide an ambulance. The ambulance was
stationed at a distance of around a kilometre from here; even though there
is a way for the ambulance to reach here through the colony, but the

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ambulance was stopped there only. The patient ultimately died after
struggling between life and death for about one and a half hours. (Translated
from Hindi.)
The numbers of patients received at Al Hind hospital from 23rd night onward, speak
for themselves. A hospital that catered to between 30 to 40 patients daily, and that too
suffering from common ailments, was simply overwhelmed with more than 200
patients who came on the 24th February itself. By 25th February, this figure is estimated
to have rested between 350 to 400. But the expanse and depth of the horrendous
catastrophe befalling these brave-hearts becomes evident only when we look at some
of the pictures of the victims (See Annexure 1). Nearly seventy-five percent of the cases
were those who had sustained piercing injuries either from charras (pellets), or bullets.
Of the rest, majority were orthopaedic injuries consisting of fractured limbs or skull
etc. A small proportion of cases were those of simple blunt injuries or grievous injuries
of various kinds, for example burn injuries. As per the various persons we talked to,
the use of firearms in this violence was common.
Sampling the cases of different types of injuries sustained by victims of the
violence
By the time our team of doctors reached Old Mustafabad on 26th February, the
mayhem had subsided, though there still were some fresh cases of those with injuries
coming to the hospital. According to various doctors and medical volunteers working
at Al Hind hospital at that time, on 26th February morning itself, after the ambulances
had become available, around fifty seriously injured patients had been shifted to
different government hospitals, with maximum number being sent to the nearest
tertiary care GTB hospital. Most of the patients attended to by the doctors of the team
were those who had sustained blunt injuries, and by the latter half of the day maximum
patients started presenting with common ailments for which they had not been able to
take treatment for past three days.
Nonetheless, some of the cases that presented were remarkable both for the
grievousness of the injury and as a telling comment on the situation as it prevailed in
the area. Two male patients, both young unorganized sector workers, presented with
bullets lodged in their bodies, a good two days after sustaining the injury. They had
been hiding for more than forty-eight hours out of fear of the police, which they said
would more likely treat them as rioters rather than as victims. One of the patients was
22 years old, and presented with a bullet lodged in his left axilla (Figure 6). He had
sustained the injury on 23rd evening when a mob attacked him as he was returning
from work in the evening. The other person (Figure 7) had sustained a bullet injury in
the abdomen.
In medical terms, such delay in treatment could potentially be lethal as the situation
is prone to develop many complications. This information was shared with the patients
and they were suggested to go to the nearby GTB hospital for further treatment, which
they refused on the plea that they had little trust left in that hospital given the manner

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of treatment of riot victims in GTB, of which they had heard from people in the
neighbourhood. It was better, in their opinion, to die an honourable death at home
than be ill-treated in the hospital, especially as they felt that as Muslims they would be
suspect.
PMSF convener, Dr Harjit Bhatti, assured the patients that he would personally
accompany them to the hospital and talk to the doctors there to ensure that they are
treated properly. Both of them were shifted to our ambulance and they set out for GTB
hospital with Dr Bhatti accompanying them. The distance between Al Hind hospital
and the main highway leading to GTB hospital is barely a kilometre or so; but in the
process of traversing this much of a distance, the policemen stopped the ambulance
four times, and each time they removed the dressing over the bullet wound to check it
for themselves, despite Dr Bhatti assuring them that he is a former specialist doctor of
AIIMS. Most shockingly, the policemen insisted that ‘you can only transfer the patient’
and made the victim’s relative disembark from the ambulance. It needn’t be left to
imagination as to how a patient, with a bullet embedded in the abdomen and awaiting
an operative procedure to take the same out, could manage all by himself in a hospital
where the doctors and other staff are overstretched and overburdened even in the
normal times, let alone at the time of such a calamity as had befallen the people of
nearby areas.
The criminality it seems defies all depths
The pictures of the victims (Figures 8, 9, 10, 11, 12, 13, 14 & 15 in Annexure 1) and the
statistics speak louder than all the words that can be used to describe the violence
unleashed in Northeast Delhi.
Some cases of grievous injuries which were received at Al Hind hospital before our visit
The pictures of the injured victims referred to in this section here had all arrived on
the days when our repeated attempts to reach out to the victims had failed. The person
in Figure 8 is the Paish Imam of a Mosque in Shiv Vihar of whom Dr Naseer Ahmad
has talked above.
The victim pictured in Figure 13, a resident of C block, Yamuna Vihar, was returning
from the Ijtima along with several others, when they got beaten up by RSS-BJP goons
shouting slogans like – ‘Musalman murdabad’, ‘Katua murdabad’ and ‘Mulla
murdabad’ etc. This man had been hit on the head with rods and his brain was popping
out from the fractured skull. There were several other young men who had sustained
injuries in various parts of the body; some of these had brought this victim to Al Hind
hospital.
A government ambulance, it was known, was stationed on the main highway barely a
kilometre away at the place where the police had put up a barricade on the road turning
in to the inhabited area. Doctor Anwar made several attempts on his part to talk to the
local administrative authorities over phone to send this ambulance for shifting this

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patient to the GTB hospital; however, they were instructed to get the patient to the
ambulance on the main road instead. The patient was put on a stretcher and trolleyed
right up to the police barricade on the main road. Considering the nature of injury to
the patient, pulling the patient along on a bumpy ride on potholed lanes strewn with
rocks and brickbats was highly risky and adventurous to say the least. This however,
was still not a disaster.
When the team of young men pulling the patient trolley, accompanied by Firoz Khan
and Dr Naseer reached the barricade, the police refused to let them put the patient in
the ambulance. The young injured and bandaged men accompanying the patients were
severely beaten up by the Delhi police men stationed there whose constant refrain was
– ‘inhone hamaare do-teen log mare hain; das-pandrah inke bhi marne do.’ It was only
upon persistent pleading by Dr Mehraj, and intervention by the CRPF personnel that
the police ultimately allowed the patient to be taken to GTB hospital. Dr Naseer and
Firoz Khan accompanied the patient to the hospital.
The viciousness of those unleashing this gruesome violence is self-evident from Figure
14. This young man’s testicles were chopped off by men reportedly shouting ‘Jai Shri
Ram’, and the attendants accompanying the man had told the doctors that the
attackers first pulled his legs apart stretching the area where the lower limbs converge
(the perineum), causing a massive tear and then deepened it with a sharp edged
weapon. To stop the bleeding the person was given more than 90 stitches, and later
transferred to the hospital once the ambulance could be accessed.
The reported deaths
Of all the deaths reported in this violence, 38 deaths have been reported from the Guru
Teg Bahadur Hospital, 3 at Lok Nayak Hospital, 1 at Jag Parvesh Chander Hospital &
4 at Dr. Ram Manohar Lohia Hospital’. Annexure 2 gives the list of dead persons as of
2nd March, 2020. While the youngest person reported dead was aged 15 years, the
oldest victim was a woman aged 85 years. Among all the reported casualties, only 2
are women. Up to 4th of March 11 highly decomposed bodies were reported to have
been fished out from the drains. The official acknowledgement till date is of 53 deaths.
Table 1 below gives the age distribution of the deaths as of 2nd March, 2020.
Table 1: Age distribution of the persons who died in the violence as of 2nd March.
Age group 15 to 20 years 21 to 40 years 41 to 50 years >50 years
Number of deaths 6 31 6 5

Figures 15 shows the two dead bodies that were brought to Al Hind hospital. There
isn’t any proper facility at the hospital to keep the dead bodies safely, and yet the dead
bodies kept lying in the hospital for nearly two days due to non-availability of any
ambulances. Both the bodies, it was reported, bore the marks of bullet injuries as also
stab wounds. It was only when the ambulances became available after the orders

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issued by the Hon’ble High Court of Delhi, that it could be possible to finally shift the
dead bodies to the GTB hospital at around 3 am on 26th February. Along with these,
one dead body from another nursing home situated on 35-foot road in the same
locality, and another one that was lying on the road in gali number 5, near the Mosque
close to Brijpuri pulia were also shifted to the hospital. 21 seriously injured patients
were also shifted in three ambulances to GTB hospital on the intervening night
between the 25th and 26th February under the escort provided by 7 to 8 CRPF personnel
and 3 Delhi police gypsies.
We were informed that even after the High Court orders, the police told the doctors at
Al Hind to arrange private ambulances, and that they will provide protection to them.
The DSP (deputy superintendent of police), who was present in nearby Bhajanpura
locality also expressed helplessness in providing ambulances. The ambulances were
finally arranged at 3 am when doctors at Al Hind hospital firmly refused to send
patients in private vehicles as these were being attacked and burnt by the mobs.
Some hospital statistics
We have already presented the total number of casualties reported from different
Hospitals. Of these, the Guru Teg Bahadur Hospital & University College of Medical
Sciences at Dilshad Garden in East Delhi was the mainstay of providing specialist
services required by the victims. As per the information collected by us from GTB &
UCMS, more than 200 injured patients had either been treated in the casualty or were
admitted to the hospital for treatment. Annexure 3 shows that of the 38 deaths
reported from the hospital, 22 (58 percent) were brought dead. Table 2 gives the
distribution of the brought dead cases by cause of death.

Table 2: Distribution of brought dead cases by cause of death.
Cause of death Gunshot Stabs Assault, burns
or both

Gunshot and
stab injury

The number of dead due to
the specific cause

9 3 9 1
Source: Office of the medical director, Guru Teg Bahadur Hospital.

Table 3: Admissions and deaths of violence victims in the neurosurgery dept.
Victims of violence admitted in
department of neurosurgery till

27th Feb.

Deaths reported among the
victims of violence admitted in
neurosurgery

Case
fatality rate
(percent)
10 7 70

Annexure 4 gives the list of patients admitted in the neurosurgery department of GTB
Hospital (most of whom sustained injury to the head) and the number of deaths
reported until the 27th of February. Based on this data, Table 3 shows that the case

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fatality rate among this group of patients was as high as 70 percent, which further
attests to the viciousness of the violence unleashed on the people.
Annexure 5 is the list of surgeries performed in GTB hospital on the victims of the
violence unleashed in Northeast Delhi. Given the diagnosis for which these surgeries
were performed, all of the surgeries were very high-risk surgeries in terms of the risk
to life, as also risk of permanent impairment of a part or organ of the victim’s body. A
total of 24 such surgeries were performed on the 24th, 25th and the 26th of February,
2020 and all of them were performed on male patients. Annexure 6 gives the list of
patients admitted in the orthopaedic department of GTB hospital between 24th to 27th
February. Again, all of these patients were male, with most of them suffering from very
serious injuries like crushed hand or limbs with ruptured arteries, slashed tendons and
compound fractures where the fractured bones are exposed rendering the patient
liable to develop deep seated infections of the bones which are particularly difficult to
treat even though the patient may be discharged after operation. Such injuries
obviously have serious repercussions for the person’s ability to work and be
economically and socially productive.
The other hospital to have received a large number of violence related cases was the
Lok Nayak hospital where a total of 56 cases had been referred as of 27 February. 1
person was brought dead and 2 died in the course of treatment. Barring 10 patients
who were admitted for treatment the rest were discharged after treatment in the
casualty.
4 patients with orthopaedic injuries had been referred to the Safdarjang hospital in
south Delhi from GTB hospital emergency. No casualty was reported among these
patients. However, at least 2 deaths were reported from Burns ward of Safdarjang
Hospital, all of whom had suffered from burns due to acid attacks. Annexure 6 gives
details of one of the victims who died in Safdarjang Hospital from burn injuries. AIIMS
Trauma centre received a total of 5 riot injured patients till 27th February, of which 4
were gunshot injuries, while 1 presented with stab wounds in the abdomen. No death
among them was reported. These numbers increased by the 3rd of March, 2020.
Annexure 6 gives the details of some of the patients operated upon in the surgery
department of AIIMS Trauma Centre, all of whom suffered from injuries of very
serious nature.
The sincerity and quality of medical response of the government
A word need be reserved here for the kind and quality of care received by these
patients, especially those who had gone to the GTB hospital. Even at the best of times,
public hospitals in India cannot really be said to be welcoming of the patients, most of
whom belong to the poor sections of the society. The many reasons for this need not
be gone into over here. However, when human tragedies are manufactured by design,
by the powers that be, the malaise seeps down to the deepest caverns of our social
attitudes.

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When we asked some senior doctors at the GTB hospital over phone, if they could
facilitate our being able to talk to some of the riot victims admitted in the hospital, we
were told that there were policemen in plain clothes sitting inside and outside the
wards to keep a watch on the patients as also those who came to meet them. They were
being especially watchful of the members of the press and civil society. This situation
seemed designed to intimidate the victims and their family members lest they speak
out to the press or civil society, and least of all to provide comfort or allay anxieties of
the people.
Even as the dead bodies in the GTB hospital mortuary were mounting, the hospital
authorities had not performed the post-mortems of these bodies within time, as they
were waiting for “instructions” from the government. This was read as possibly an
attempt to tamper with the cause of death. That these fears were not entirely
unfounded, is borne out by the fact that in an order dated 26 February, 2020
(Annexure 7), the Delhi Minorities Commission instructed the Superintendent of GTB
hospital that – “You are directed to conduct post-mortem procedure on all these
bodies and on any fresh cases within 24 hours of arrival of each dead body.”
Even in the community, we came across victims with complicated fractures of their
limbs who had simply been returned from the GTB hospital emergency with a plaster
cast without setting the fractured bones in proper anatomical position. On 28th
February our team treated a patient with a bullet injury in the left thigh. The patient
told that he had earlier been treated at GTB hospital. The bullet had entered through
the medial aspect (inner side) of thigh and large exit wound on other side with area
surrounding wound being swollen. The wound was infected and copious amount of
pus was oozing from the wound giving out a foul smell. Our team of doctors
immediately started debridement (removing the dead tissue from the wound) of
wound and stapled from outside. Patient told that after initial treatment from GTB
hospital he was discharged early without proper care.
There are numerous reports available of how victim’s relatives were fending from pillar
to post to find their loved ones in the hospital. Relatives had to wait for around more
than 2 days to be able to confirm whether their son, daughter, parent etc were among
the dead in the mortuary. Nobody at the hospital, it seems, had the time to properly
guide the relative of different victims. Even though it is a routine practice during train
and air-plane accidents that the authorities put up a notice board informing of those
who died, those who were alive and are under treatment etc., but somehow this was
not to be the case at GTB hospital, which received the maximum number of dead and
persons injured in violence.
Despite this, when told that people were forced to go to small, ill-equipped private
nursing homes for treatment as they were trapped in the violence hit areas, the Delhi
Chief Minister, Kejriwal had the temerity to tell a group of prominent women from the
civil society, who met him on the 25th evening, that:

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‘Voh wahan quyon gaye; Dilli Sarkar ke aspatalon mein aate to ham unki
sewa karte.’ (Why did they go there [to the private nursing homes]. Had they
come to the Delhi government hospitals; we would have served them.)
A few days later, when it faced the line of fire from various quarters, along with
announcing monetary compensation, the Delhi government made the gesture of
converting 9 night shelters into relief camps for the victims of the violence, but it
couldn’t make provision for tents to be pitched or special counters to be opened, and
social work volunteers to be stationed in its hospitals to facilitate a coordinated, speedy
and effective relief for the agony of violence victims.
In fact, the morass afflicting the social and political canvass of our society, as also its
health system couldn’t be better epitomized than the fact that it took the intervention
of Delhi High Court, and two conscientious judges who were willing to listen to a
special plea at their home at 12.30 am on the night of 26 February, to actually force the
authorities to reach out to the victims in the violence affected areas. The court in its
brief order stated:
The Court at this stage is primarily concerned with ensuring the safety of
the lives of the injured and immediate medical attention that they require
and for that purpose to ensure the safe passage of the injured victims to the
nearest available government hospitals. The Court accordingly directs the
Delhi Police to ensure such safe passage by deploying all the resources at its
command and on the strength of this order and to ensure that apart from
the safe passage, the injured victims receive immediate emergency
treatment ........
As we learnt from our own experience in the process of reaching out medical relief to
the victims, as already narrated above, none of these impediments were inadvertent
consequences of the situation on ground.
We inquired from many people in Mustafabad whether any representatives of the
central government or Delhi government had actually reached out to the people in the
affected areas. The response from all had been categorical – there had been no such
attempt. On being asked about the availability and the role of ‘Mohalla Clinics’ in this
situation, Rafiq Alam, a volunteer at Al Hind hospital responded that there was no
‘Mohalla Clinic’ in the whole of Mustafabad. Likewise, not many in his opinion had
coverage under any kind of government funded health insurance schemes. At least he
did not know of any of his acquaintances to be covered under such schemes. Another
of the volunteers, Shamshudzzaman remarked that:
“Many of the poor people in the area are migrant labourers who have come
from other states; they neither have the documents required for coverage
under such schemes, nor are they actually covered. Anyways, which private
hospital will be willing to provide ‘world class treatment’ to these victims of
violence who have been pouring in to Al Hind hospital over last three days.”

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What have been discussed above are only some of the most glaring cases, but a larger
public health tragedy is as yet only unfolding in the wings, and which unfortunately is
never going to attract the attention of the government. In the medical camp which we
set up at Al Hind hospital on the 28th February, most of the patients, specially females,
presented with general anxiety symptoms like restlessness and palpitations. They told
that they were feeling insecure and didn’t really know where to go. Many patients of
chronic diseases like diabetes and hypertension also came whose medication had been
disrupted due to violence and disaster that had struck their lives. The mental and
psychological trauma suffered by these people knows no bounds, and yet these are
precisely the kind of problems which are likely to be ignored by the government,
especially as they lack the ‘shock and awe’ appeal that goes with ghoulish physical
injuries.
Another aspect of relief which we think need be thought of aloud is the fact that direct
agencies of the government were absent from providing relief and rehabilitation
measures on the ground. On the 28th when we visited the Idgah in Shiv Vihar area of
Old Mustafabad, we found that a large relief camp had been set up by the Delhi Waqf
Board by pitching in tents within the Idgah premises. Our medical camp was set up
within this compound, as indeed were other medical relief camps by the St. Stephens
Hospital, Holy Family Hospital and some other NGOs.
It is our considered opinion that the government and its relevant agencies should be at
the forefront of relief work, while that of other agencies could come in as a

supplementary to that, because in any society that claims itself to be secular and non-
discriminatory towards any section of its people, it is the government that is looked

upon as the principal guarantor of these values. More than its words, it is its actual
actions on ground that shall enable the government to command the loyalty and
confidence of the citizens in restoring the secular fabric of the society.
It is in this context that we need think aloud, that if private missionary hospitals and
civil society organizations can reach out to the people, then what prevented the
government from pressing its own medical and relief teams into action, where in they
could have also sought the help and participation of private organizations and
individuals. Provision of relief through religious organizations ultimately reinforces
the belief We think that Indian polity need learn some useful lessons from the New
Zealand Prime Minister Jacinda Ardern, who left no stone unturned to reach out to the
families and survivors of the attack on two mosques in Christchurch a year back.
Indeed, she led the entire nation in not only reassuring the Muslim community in New
Zealand of the abiding support of the entire country in their moment of grief, but also
that it was entire society’s grief.

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The political establishment and the violence
Exploring the political factors behind this violence was not the objective of our visit.
However, the difference of course is that the causes of the kind of medical emergencies
described above are not biomedical, but are socio-political. Without making any claim
of doing a thorough investigative work, we still feel obliged to state briefly our
impressions in this regard.
It was in 1992 that massive violence had rocked these very areas in the aftermath of
the demolition of Babri Masjid in Ajodhya. At that time as well, as part of the then
Delhi Medicos and Scientists Forum (DMSF) we had sent a medical relief team for
nearly a week to different localities of Northeast Delhi that had been pulverized by
massive anti-Muslim violence. One of the consequences of our relief effort was a report
that we brought out on how the violence was perpetrated and the suffering it
unleashed. The then Congress government at the Centre instituted a witch-hunt
against the doctors of the DMSF team. In the 28 years since, little seems to have
changed, except that as a society we seem mired even deeper in the quicksand of
majoritarian communalism.
The AAP (Aam Admi Party) appeared with its ‘plaster bags’ once the lives had been
lost and homes and hearth ruined.
If it was their stark absence on part of others, as was widely believed by the people we
interacted with and the observations made by other reports on this violence, the
imprint of the well-oiled Sanghi Communal machine in engineering the anti-Muslim
violence was equally stark.
It need be emphasized that nothing about this violence was spontaneous. There were
tell-tale signs of prior planning and preparation to unleash this violence. Figures 1 and
2 show that the roads had virtually turned brick red with crushed bricks, and this was
the case not with isolated roads, but with large tracts as we drove through the area.
These had of course been reached to different points in the entire area, and where the
supply chain was hampered, the police facilitated collection of whatever material could
be made good on the spot (Figure 16). Gas cylinders which were used to trigger blasts,
smoke bombs, and of course firearms were some of the other accessories that were
part of the supplies. All of this cannot be arranged spontaneously, and was not
arranged spontaneously. Firoz Khan, the tailor master referred to above, told while
speaking to us at Al Hind hospital, that – ‘trollyion se malba utarvaya gaya – Maujpur
mein, Bhajanpura mein; aur sab RSS ke log the’ (debris of construction material was
unloaded from trollies at many places – in Maujpur, in Bhajanpura, by RSS men.)
The opinion on the ground was unanimous, that it was the speech given by Kapil
Mishra, the defeated BJP candidate from Model Town constituency, on the 23rd
February afternoon at Maujpur, in Northeast Delhi which started it all. Mishra
threatened to forcibly have the roads vacated of the sit-ins by Muslims, in the presence
of the Northeast Delhi DCP, Ved Prakash Surya.

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The local people categorically remarked that barring a few known local elements of
Sangh, the rioters in their area were from outside. Name of Jagdish Pradhan, the
previous BJP MLA from Mustafabad who lost the elections this time, came up
prominently in conversations with different people as the person who had mobilized a
large number of people from area of western Uttar Pradesh like Bhagpat. Another local
BJP leader, Bishan Sharma, is also said to have played prominent role in mobilizing
people for attacking Muslims.
The ferocity and viciousness of the violence can be made out from Figures 17, 18, 19
and 20.
We needn’t say much about the role of Delhi police in this violence, which has already
been extensively written about and commented upon in other reports on this violence,
except to reiterate that from all accounts gathered by us, the police were complicit in
the whole affair. In fact, now a pattern of sorts seems to have been established where
ever BJP is in power, that is, either the police have been allowed to side with the
attacking mobs, or it has turned into a mob itself, with impunity.
Observations & Recommendations
This he said despite the fact that his own house had been attacked and he had been
lucky to escape with minor injuries on his face due to an acid attack. Towards the end
of our visit, there was some commotion outside Al Hind hospital at around 5 pm.
Around a dozen men, women and children had been rescued from their homes in Shiv
Vihar and brought to Al Hind hospital in Old Mustafabad. These Muslims had been
sheltered by their Hindu neighbours in their homes, even as their houses had been
consumed in the violence. A young man who had actually been part of the rescue,
announced loudly to the crowd that had gathered:
‘Bhaiyon, ek baat hai ki Shiv Vihar ke Hinduon ne hamari bahut madad kari
hai. Wahanki Hindu behne, chalet waqt in auraton se aisa chipat-chipat ke
roi hain ki bata nahi sakta’ (Brothers, I wish to let you know one thing, that
the Hindu families in Shiv Vihar have really helped us a lot. When these
women were departing from their homes, it is beyond description how our
Hindu sisters embraced them and wept profusely, as to why you are going).
Likewise, Jaan Muhammad, a resident of Rajiv Gandhi Nagar in New Mustafabad
narrated the tales of how Muslim neighbours saved the homes of their Hindu
neighbours and their temples in Nehru Vihar, Bhagirathi Vihar and Guru Nanak Nagar.
In E block of the adjacent Nehru Vihar, Gali No. 15 is the only lane with Hindu
households. Hindutva Mobs came from outside in the name of protecting the local
Hindus, but the local Hindus of E block, Nehru Vihar, told them to leave as they felt
perfectly safe in the protection of Muslim neighbours. The attempt to harm the local
temple in Nehru Vihar was foiled by the Muslims of the area.

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The narration of these examples is no doubt simple, but we dare not interpret it
simplistically. These examples had weathered the challenge of criminal mendacity that
threatened to consume all and everything that is good and beautiful about humanity.

The findings presented above, enable us to conclude the following:
• We would like to iterate our deep conviction that loss of human lives on such scale
and in the manner in which they were inflicted is a matter of utter shame for any
civilized society. As is typical of all communal violence, the minorities have
constituted an overwhelming proportion of the casualties and the victims.
• It is indeed remarkable that such a high number of casualties occurred due to
gunshot wounds. For such casualties to occur firearms and bullets needed to be
available at hand in large numbers, and that they were indeed available, shows
that quite some preparation seems to have gone into staging this violence.
• A big consequence of when the agencies of the state are seen to be acting with
partiality, is that it sends a clear message to the marauders that they can wreck any
level of violence on the innocent masses and count on the state to protect them.
• Despite being the National Capital Territory of India; despite the fact that some of
the best medical institutions of the country of national and international repute,
as also the fact that Delhi has hospitals which attract a large number of
international patients by way of medical tourism, none of this stands any
guarantee of easily accessible, effective medical care for the people in the times
when medical catastrophe strikes, given the fact that the victims of such
catastrophe are invariably the poorest segments of the society.
• Lofty proclamations regarding government schemes like ‘Mohalla Clinics’,
‘Ayushman Bharat’ and the like notwithstanding, these schemes not only fail to

reach those who need them the most, but actually prove to be particular non-
starters in times of such catastrophe.

• Instead of reaching out to the people in the most testing of the times, the public
health institutions, let alone the private ones, fall much short of what is expected
of them.
• The tertiary care GTB Hospital is barely a few kilometres away from the violence
affected areas, and yet in terms of being actually accessed by the victims, the
distance seemed insurmountable. Just as there is behaviour of the people with
respect to seeking health care, which we call as ‘health seeking behaviour’ in
public health terms, there is also the behaviour of health institutions. The
experience of this violence directed primarily against the Muslim minority,

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actually shows that dominant social and political attitudes can make health
institutions inaccessible to the suffering masses even though these may be
physically located right in the midst of the people.
• The salience of this violence obtains from the context in which it has been played
out, which is that of a state sponsored effort against Muslims in India. The
majoritarian communal forces have had the highest anxieties about the ongoing
sit-ins by women, in various Muslim majority areas against CAA, NPR and NRC.
Some recommendations for alleviating the immediate suffering:
Winning back peoples’ confidence by providing them effective relief and assuring them
that the society at large does not share the world view of those who attacked them and
that of their political sponsors, remains a big challenge for all of us. Anyone who has
visited the area would know that the tragedy is too huge to be mended by the efforts of
civil society alone, howsoever spirited these may be. There has to be a large-scale
organized effort on part of the government to heal the physical, mental, psychological,
social and financial wounds which have disfigured the lives of people in the violence
affected areas of Northeast Delhi. Provided the government has the will to implement
them, we feel the following measures can be of immense help in providing medical and
other relief to the affected people. Our recommendations in this regard are:
• There clearly is a need for medical services to proactively reach out to the
community in the violence affected areas, seek out the patients and provide them
effective treatment for physical injuries, mental and psychological trauma in
facilities existing or created closest to their homes. Only those cases requiring
specialized care in hospital settings need be shifted to hospitals.
➢ In order that this can be done effectively, outreach teams constituted of doctors,
and other paramedical staff, equipped with necessary equipment, medicines and
other consumables be constituted forthwith.
➢ The teams should have appropriate mix of doctors including specialists in
general surgery, orthopaedics, paediatrics and internal medicine. Apart from
some senior doctors, resident doctors and interns need also be included in the
teams.
➢ The population to be covered by each team should be decided depending upon
the size of the population and the density of violence in different localities.
➢ Existing public infrastructure in different localities be used to create field
hospitals, may these be government dispensaries, urban Primary Health Centres
or the schools and other such places.
➢ Social workers and civil society volunteers need to be deployed in large numbers
to reach out to the people house to house and inquire about the injured or those

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sick and requiring help. Help need be taken in this regard from departments of
Social Work in universities in Delhi.
• In the hospitals nearest to the affected areas, a ward need be separately designated
for some time to expeditiously deal with cases of serious injuries due to communal
violence.
In the outbreak of violence of the kind Northeast Delhi has been a witness to, death
could sometimes be far more imminent than in case of an outbreak of a dreaded
infectious disease. The high case fatality among victims of violence pointed to above
clearly establishes this. Hence, if separate facilities can be established in the
hospitals to deal with cases of such infectious diseases, the same needs to be done
with respect to treating the victims of such communal violence as well.
• Mental and psychological health, even though a most pressing need in such
situations, falls by the way side when it comes to dealing with the victims of such
violence. We feel that teams of psychologists and mental health experts shall have
to be created to provide the necessary counselling and medical relief in this regard
on a more long-term basis. This certainly should not be treated as a substitute for
all other material and physical help required by the victims, but constitutes a
necessary measure to fortify the healing touch.

-Sd- -Sd -
(Dr Harjit Bhatti) (Dr Vikas Bajpai)
Convener, PMSF Executive member, PMSF
(Contact: 8586848479) (Contact: 9717820427, 9810275314)



Thursday, March 19, 2020

Monday, March 16, 2020

Hindu history (JR 214)


Hindu history (JR 214)
Introduction
Abrogation of article 350 and 35A, citizenship laws change, NRC, were all designed to initiate the assertion of Hindu supremacy. The present campaign to enslave the minority Muslims is , however, not a new occurrence in Hindu history.
Vedic Hinduism to Classical Hinduism
The first instance was when the Aryans took hold of what is now Pakistan. They resided there for a considerable amount of time. During that time they managed to acquire the skills and knowledge of the much more advanced ruminants of the Indus Valley Civilization. During this two way exchange both the religion (Vedic Hinduism) and language (Sanskrit) evolved to Classical Hinduism and classical Sanskrit. This evolution however, encompassed a much more harsh social change. The pre Aryan population was enslaved and made either caste less or of low caste, they were relegated to the outer portions of society, given tasks that no one else wanted to do.  Their women, or better looking ones at that, was allocated to the Temples as Dasis , free game for caste Hindus. Thus was done cleverly, the religion , included karma, which meant that the slaves had no option but to perform , since the only way out of slavery was to be born in a higher caste status in the rebirth.

Jains
Jains suffered the same fate, their temples were either destroyed or converted to Hindu temples, their status was also of outcaste person, and their deities were absorbed into Hindus religious believes. Jainism went into serious decline, much later the Buddhists suffered the same fate, and Buddhism was almost wiped out from the place of birth, it survived for some time in what is now Pakistan, present Afghanistan and eventually escaped to Central and East Asia for survival. .
Muslims
Muslims were already assigned a status along with the Dalits, caste less people and untouchables. They were denied education opportunities and subsequently were denied job opportunities. Muslims, however, had inborn ability, which they utilized to establish small businesses. This was deemed as unacceptable to the carefully crafted Hindu majority, which us why Muslim businesses were attacked, what was developed, painstakingly, over 70 years was wiped to nothing in days. Muslims had to be put in place and relegated to the outer limits of society. This was done with the support of the majority of the Hindu population. If there are any romantic notions that the electorate will make a change, this should be abandoned. After five years the Hindus will again vote in BJP, with Muslims put in place, this will be done “almost” within the norms of democracy.  History would have truly repeated itself.

Tuesday, March 10, 2020

Northern Areas: Gilgit and Baltistan (JR213)






Northern Areas: Gilgit and Baltistan  (JR213)
Introduction:
After Pakistan's independence, Jammu and Kashmir initially remained an independent state. Later on 22 October 1947, tribal militias backed by Pakistan crossed the border into Jammu and Kashmir Local tribal militias and the Pakistani armed forces moved to take Srinagar but on reaching Uri they encountered defensive forces. Hari Singh made a plea to India for assistance and signed the Instrument of Accession.
Gilgit Action
Gilgit's population did not favour the State's accession to India. The Muslims of the Frontier Districts Province (modern day Gilgit-Baltistan) had wanted to join Pakistan. Sensing their discontent, Major William Brown ( the major part was played by Muslim Officers nd the British Officer later joined in ) , the Maharaja's commander of the Gilgit Scouts, mutinied on 1 November 1947, overthrowing the Governor Ghansara Singh. The bloodless coup d'etat was planned by  Col. Hasan Khan,  to the last detail under the code name "Datta Khel", which was also joined by a rebellious section of the Jammu and Kashmir 6th Infantry under Mirza Hassan Khan. Brown ensured that the treasury was secured and minorities were protected. A provisional government (Aburi Hakoomat) was established by the Gilgit locals with Raja Shah Rais Khan as the president and Mirza Hassan Khan as the commander-in-chief. However, Major Brown had already telegraphed Khan Abdul Qayyum Khan asking Pakistan to take over. The Pakistani political agent, Khan Mohammad Alam Khan, arrived on 16 November and took over the administration of Gilgit.  Brown outmaneuvered the pro-Independence group and secured the approval of the mirs and rajas for accession to Pakistan. 
 Provincial Government
The provisional government lasted 16 days. The provisional government lacked sway over the population. The Gilgit rebellion did not have civilian involvement and was solely the work of military leaders, not all of whom had been in favor of joining Pakistan, at least in the short term. Historian Ahmed Hasan Dani mentions that although there was a lack of public participation in the rebellion, pro-Pakistan sentiments were intense in the civilian population and their anti-Kashmiri sentiments were also clear.  According to various scholars, the people of Gilgit as well as those of Chilas, Koh Ghizr, Ishkoman, Yasin, Punial, Hunza and Nagar joined Pakistan by choice.
Ladakh Action
After taking control of Gilgit, the Gilgit Scouts along with Azad irregulars moved towards Baltistan and Ladakh and captured Skardu by May 1948. They successfully blocked the Indian reinforcements and subsequently captured Dras and Kargil as well, cutting off the Indian communications to Leh in Ladakh. The Indian forces mounted an offensive in Autumn 1948 and recaptured all of Kargil district. Baltistan region, however, came under Gilgit control.
UN
On 1 January 1948, India took the issue of Jammu and Kashmir to the United Nations Security Council. In April 1948, the Council passed a resolution calling for Pakistan to withdraw from all of Jammu and Kashmir and India to reduce its forces to the minimum level, following which a plebiscite would be held to ascertain the people's wishes. However, no withdrawal was ever carried out, India insisting that Pakistan had to withdraw first and Pakistan contending that there was no guarantee that India would withdraw afterwards. Gilgit-Baltistan and a western portion of the state called Azad Jammu and Kashmir have remained under the control of Pakistan since then.
Inside Pakistan
While the residents of Gilgit-Baltistan expressed a desire to join Pakistan after gaining independence from Maharaja Hari Singh, Pakistan declined to merge the region into itself because of the territory's link to Jammu and Kashmir.  For a short period after joining Pakistan, Gilgit-Baltistan was governed by Azad Kashmir if only "theoretically, but not practically" through its claim of being an alternative government for Jammu and Kashmir.  In 1949, the Government of Azad Kashmir handed administration of the area to the federal government via the Karachi Agreement, on an interim basis which gradually assumed permanence. According to Indian journalist Sahni, this is seen as an effort by Pakistan to legitimize its rule over Gilgit-Baltistan
There were two reasons why administration was transferred from Azad Kashmir to Pakistan: (1) the region was inaccessible to Azad Kashmir and (2) because both the governments of Azad Kashmir and Pakistan knew that the people of the region were in favour of joining Pakistan in a potential referendum over Kashmir's final status 
 
In 1970 the two parts of the territory, viz., the Gilgit Agency and Baltistan, were merged into a single administrative unit, and given the name "Northern Areas".[ The Shaksgam tract was ceded by Pakistan to China following the signing of the Sino-Pakistani Frontier Agreement in 1963.  In 1969, a Northern Areas Advisory Council (NAAC) was created, later renamed to Northern Areas Council (NAC) in 1974 and Northern Areas Legislative Council (NALC) in 1994. But it was devoid of legislative powers. All law-making was concentrated in the KANA Ministry of Pakistan. In 1994, a Legal Framework Order (LFO) was created by the KANA Ministry to serve as the de facto constitution for the region.
In 1984 the territory's importance shot up on the domestic level with the opening of the Karakoram Highway and the region's population came to be more connected with mainland Pakistan. With the improvement in connectivity, the local population availed education opportunities in the rest of Pakistan.  Improved connectivity also allowed the political parties of Pakistan and Azad Kashmir to set up local branches, raise political awareness in the region, and these Pakistani political parties have played a 'laudable role' in organising a movement for democratic rights among the residents of Gilgit-Baltistan.
In the late 1990s, the President of Al-Jihad Trust filed a petition in the Supreme Court of Pakistan to determine the legal status of Gilgit-Baltistan. In its judgement of 28 May 1999, the Court directed the Government of Pakistan to ensure the provision of equal rights to the people of Gilgit-Baltistan, and gave it six months to do so. Following the Supreme Court decision, the government took several steps to devolve power to the local level. However, in several policy circles, the point was raised that the Pakistani government was helpless to comply with the court verdict because of the strong political and sectarian divisions in Gilgit-Baltistan and also because of the territory's historical connection with the still disputed Kashmir region and this prevented the determination of Gilgit-Baltistan's real status.[
A position of 'Deputy Chief Executive' was created to act as the local administrator, but the real powers still rested with the 'Chief Executive', who was the Federal Minister of KANA. "The secretaries were more powerful than the concerned advisors," in the words of one commentator. In spite of various reforms packages over the years, the situation is essentially unchanged[ Meanwhile, public rage in Gilgit-Baltistan is "growing alarmingly." Prominent "antagonist groups" have mushroomed protesting the absence of civic rights and democracy.  Pakistan government has been debating the grant of a provincial status to Gilgit-Baltistan.
According to Antia Mato Bouzas, the PPP-led Pakistani government has attempted a compromise through its 2009 reforms between its traditional stand on the Kashmir dispute and the demands of locals, most of whom may have pro-Pakistan sentiments. While the 2009 reforms have added to the self-identification of the region, they have not resolved the constitutional status of the region within Pakistan.
The people of Gilgit-Baltistan want to be merged into Pakistan as a separate fifth province, however, leaders of Azad Kashmir are opposed to any step to integrate Gilgit-Baltistan into Pakistan. The people of Gilgit-Baltistan oppose any integration with Kashmir and instead want Pakistani citizenship and constitutional status for their region.  Gilgit-Baltistan has been a member state of the Unrepresented Nations and Peoples Organization since 2008.
 Supreme Court Of Pakistan
The Supreme Court of Pakistan’s recent verdict on the constitutional status of Gilgit-Baltistan, declaring it an inseparable part of the Kashmir issue and the inability due to international law governing it, to assimilate the region into the body-politics of the Pakistani state, has once and for all laid to rest the confusion over the region’s political status, especially within the minds of the masses of Gilgit-Baltistan (GB) itself. The urgency displayed at times by certain elements to unconditionally absorb the region into the Pakistani state, not only defied legal logic and historical processes but also undermined contemporary imperatives of preserving the region’s core indigenous rights and identity, especially in the milieu of a shifting strategic calculus.
The verdict has set the ball rolling for a reset of the region’s relationship with Islamabad especially in the popular imagination — something that was earlier missing or made to be irrelevant. The various lacunae in the CPEC framework with regards to the region if not addressed prudently especially in terms of local rights and share in development could sharpen the emerging fissures between ambitions of the Pakistani state and the indigenous aspirations of the region. The evident prejudice in the projected windfall of CPEC towards GB beyond the extractive transit route (Karakoram Highway — KKH) could bring to the fore the hitherto veiled deprivation institutionalized in the “management” of the region. While not much ground has been lost yet, unattended fault lines could prove an inflicting inflection point.
Conclusion
The spirit of Jihad inspired the people of Gilgit and Baltistan to enroll as volunteers to fight alongside the Gilgit Scouts. They managed to defeat the enemy and routed the Maharajas forces, which liberated an entire area which subsequently was called Northern Areas. Northern Areas came into existence to join freely on its own accord with Pakistan