By ELLEN BARRY AUG. 28, 2016

SRINAGAR, Kashmir — The street outside is patrolled by riot police officers in camouflage, bracing for the nightly spasm of violence, but it is quiet here inside the operating room. The surgeon’s knife slides into an eyeball as if it were a soft fruit.

The patient’s eyelids have been stretched back with a metal clamp, so his eyeball bulges out of glistening pink tissue. The surgeon sits with his back very straight, cutting with tiny movements of his fingers. Every now and then, a thread of blood appears in the patient’s eye socket. The patient is 8 years old.

“Very bad,” murmurs the surgeon, Dr. S. Natarajan. But then, all 13 cases he will see today will be very bad.

Since mid-July, when the current wave of protests against the Indian military presence started, more than 570 patients have reported to Srinagar’s main government hospital with eyes ruptured by lead pellets, sometimes known as birdshot, fired by security forces armed with pump-action shotguns to disperse crowds.

The patients have mutilated retinas, severed optic nerves, irises seeping out like puddles of ink. “Dead eyes,” the ophthalmology department’s chief calls them.

Every season of popular revolt in Kashmir has its marker.

This summer’s protests in the part of Kashmir controlled by India, the most sustained and violent since 2010, caught the authorities in New Delhi unaware. The stone-throwing crowds have no political leaders, put forward no specific demands and metastasized with alarming speed. Around 60 civilians and two members of the security forces have been killed; on each side, thousands have been wounded.

Kashmiri doctors and paramedics, their eyes covered by patches, protested at a hospital in Srinagar on Aug. 10. They sought to evoke the plight of victims of pellet guns fired by Indian security forces to disperse crowds. Credit Tauseef Mustafa/Agence France-Presse — Getty Images

But 2016 will almost certainly be remembered as the year of dead eyes. The eye injuries have become such a focus of public anger that last week, in a conciliatory gesture, India’s home minister, Rajnath Singh, promised that the pellet guns, as they are known here, would be replaced by another type of nonlethal weapon in the coming days.

On the ophthalmology ward at the main Shri Maharaja Hari Singh Hospital, however, new patients arrive every day. Walking the hospital hallway, you first notice a handful of young men in blackout goggles. Then you see them everywhere. A weary ophthalmologist looks on from the break room as Dr. Natarajan’s young patient, waking from anesthesia, stirs and begins to moan.

“That 8-year-old boy, he will live for 70 or 80 years,” says the doctor, Afroz Khan. “The history remains there, even if it is not in the books.”

Retinal Repair

On July 9, Tariq Qureshi, the head of the ophthalmology department, was at a seminar on pediatric retinal repair.

The previous day, Indian security forces raided a village and killed Burhan Muzzafar Wani, a 22-year-old militant leader whose videos posted on WhatsApp and Facebook attracted a vast following. But major violence was not expected. Dr. Qureshi was in the seminar when his phone rang.

It was the hospital emergency room, calling to let him know that two patients had come in with pellets in their eyes. Dr. Qureshi sent a doctor over, and the seminar resumed. Ten minutes later, the phone rang again. It was the same doctor in the emergency room, telling Dr. Qureshi to come immediately, that the number of patients had risen to 15.

 An Indian paramilitary trooper held a pellet gun as he stood guard on a road during a curfew. Credit Sajjad Hussain/Agence France-Presse — Getty Images

The four ophthalmologists, who were across the hospital campus from the emergency room, ran.

For the next 72 hours, they operated in shifts around the clock, suturing the eyes to keep the matter inside from leaking out. In most cases, it became clear, the pellets had burst into through the cornea and out through the retina, leaving little hope of fully restoring vision. Twenty-seven patients were hit in both eyes. The pellets, when they could be removed, were preserved on the heads of cotton swabs.

“Once it goes in the eye, it rotates like this, and destroys everything there inside,” Dr. Qureshi said. “It’s physics. This is a high-velocity body. It releases a high amount of energy inside. The lens, the iris, the retina get matted up.”

The doctors were told to take all possible measures to save their patients’ vision, including complex surgery, at a cost to the government of 70,000 rupees, or around $1,040, per operation, Dr. Qureshi said.

The worst cases go to Dr. Natarajan, the director of Aditya Jyot Eye Hospital in Mumbai, whose visits are facilitated by the Borderless World Foundation, a nonprofit group. Dr. Natarajan specializes in patients whose eyes have been punctured by projectiles — typically, children standing too near fireworks, or industrial workers who did not wear protective goggles, or boxers whose eyes have been punctured by thumbs.

He works in a bubble of calm, eyes pressed to a microscope, using his hands to work a cutter and a light, and using his bare feet to control the machines that surround him. On a screen opposite him is an image captured by a microscopic camera inside the boy’s eye. At times the image is cloudy, a flashlight searching in the fog; at one point there are swimming glints of colored light, like those cast by a chandelier in the sun.

In cases of catastrophic injuries, Dr. Natarajan’s goal is to save a small portion of the eye’s function, enough to sense light, or movement of a hand.

A father, who said his son had been injured by pellets shot by security forces, comforted his son earlier this month. Credit Cathal McNaughton/Reuters

Boys Hurling Stones

For an Indian security official, to be engulfed by a hostile crowd in Kashmir is, without a doubt, a life-threatening situation.

At sunset on Friday, Bhavesh Chaudhary, the second-in-command of the 161st Battalion of the Central Reserve Police Force, was drinking tea in the camp garden when an officer called with the news that 20 or 30 young men had begun to gather, chanting slogans. He continued drinking tea. The crowd outside kept growing.

Then, all of a sudden, Commandant Chaudhary and his troops strapped on helmets and leapt into a column of armored vehicles. As they raced through the neighborhood, masked boys appeared from the left and the right, darting out of alleyways, hurling stones. The troops sent stones rocketing back with small slingshots. The convoy halted at an intersection. Chanting could be heard, coming closer: “What do we want? Freedom!”

Commandant Chaudhary would spend the next hour and a half trying to push the crowd back. His troops may be heavily armed, but especially at sunset, when they withdraw to their encampments for the night, it is clear to everyone that they are outnumbered.

On the streets of Srinagar, which have a ghostly emptiness after 50 days of curfew, people have scrawled, “Indian dogs,” “Go India, go back,” “We love Pakistan” and “Burhan is alive in our hearts.”

Commandant Chaudhary has dedicated much of his career to battling stone-throwing crowds. He knows the current of excitement that will surge through them if they see his forces retreat even a few feet — or, more powerfully, if they see an officer fall. If the stone-throwers managed to reach the camp, he said, they would set it on fire.

“They are not afraid, that is the thing,” he said of the protesters. “Once somebody has put on a uniform and picked up a weapon, the law should be maintained, just because the person is there. That is not happening these days. We lost that in 2010.”

Indian troops use pellet guns for crowd control only in Kashmir. They were introduced in 2010, halfway through a particularly bloody season of protest. Pellet guns have been used to break up protests in Egypt, Bahrain and Tunisia, but most countries do not use them on unarmed civilians, as the pellets spray widely and cannot be aimed. For Commandant Chaudhary, who sometimes faces crowds of more than 1,000 hostile young men with a contingent of 20 or 30, it is by far the most effective weapon at his disposal.

“It causes bodily injury, so you will be feared,” he said.

His battalion commander, Rajesh Yadav, nodded at this assessment. “If you pinch them,” he said, “only then people will understand.”

This year, the use of pellets on Kashmiri protesters increased sharply, with the police firing more than 3,000 canisters, or upward of 1.2 million pellets, in the first 32 days of the protests, the Central Reserve Police Force has said.

Though troops are instructed to aim them below the waist, “sometimes it is difficult to go in for precise aimed fire at a moving, bending and running target,” the police explained in response to a lawsuit seeking to ban their use. If they are withdrawn from the arsenal, Commander Yadav said matter-of-factly, troops will have to use their firearms.

As for the government hospital, now jammed with injured protesters and sympathetic volunteers, Commander Yadav said it was no longer a safe place for his officers to go. Not long ago, one of his men sought medical help for chest pain but fled in fear of being lynched.

8-Year-Old’s Prognosis

In a recovery ward at Shri Maharaja Hari Singh Hospital, a nurse pushes a trolley down a row of beds, distributing cups of tea and slices of white bread to a row of young men in sunglasses.

To converse with them is to see new energy coursing into Kashmir’s old cycle of violence. It is difficult to find a patient here who admits to mourning the loss of his eye. They say it is an acceptable price to pay for azadi, or freedom from Indian rule. Quite a few offer to sacrifice their second eye for the cause.

Wazira Banwo, 40, is watching her 8-year-old son, Asif Sheikh, recover from surgery. The boy is curled on his side under a blanket, his head swathed in surgical gauze, woozy and sick. It was his third operation; now, with his retina reattached, he may be able to see for a distance of three to five feet, according to Dr. Natarajan.

Asked whether she was grateful to the government for providing the child medical care, Ms. Banwo grimaces.

“Not a single person from the government has come to help,” she says. “If any one of them come to me, I will tell them, ‘You give me your eyes, I will put them in my child.’”

Ms. Banwo says she often participated in anti-Indian protests herself but discouraged Asif from taking part this summer because of his youth.

On the day he was injured, she says, he just happened to be standing in the market when security forces arrived in a van and fired pellet guns.

“This time he is very young,” she says. “But he will grow. He will understand what happened to him. And he will go out to the street and throw stones.”

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