Doctors’ Strikes: Why Does India Harm Its Healers?

Social Commentary

Doctors’ Strikes: Why Does India Harm Its Healers?

Illustration: Reynold Mascarenhas

On June 11, an 85-year-old man was brought to Nil Ratan Sircar (NRS) Hospital in Kolkata for treatment and died within a few hours. A few hours later, a truck full of people drove over to the hospital and wreaked havoc, critically injuring two medical interns. The junior doctors of NRS went on strike, demanding safer working conditions and criminal action against those who had attacked. Though troubling, this incident is only a drop in a larger bucket of violence against doctors across the country, who face disproportionate threats to their safety, considering their profession.

The NRS Hospital doctor’s strike began to snowball, as resident doctors closed the OPD, ran the emergency department short-staffed, and in some cases tendered their resignations in protest. Instead of listening to their grievances, Chief Minister Mamata Banerjee ordered the striking doctors to go back to work in four hours or vacate their hostels. As of today, the resident doctors’ association AIIMS met Harsh Vardhan, the Union Healthcare Minister, and doctors have gone on strike in Delhi, Hyderabad, and Maharashtra in solidarity. While the country’s medical services are stretched thin over a nationwide strike of doctors, it is important that we understand why violence against medical professionals is spiking in India.

Though violence against medical practitioners is a common phenomenon all over the world, the violence against doctors in western countries is at the highest by patients themselves, during house calls or at the ER. But studies conducted in India show very different reasons for persisting violence against doctors.

In a paper in the Indian Journal For Medical Research titled “Violence Against Doctors, a Wake-Up Call”, the author Kanjaksha Ghosh notes the recurring violence and vandalism in government hospitals is the work of secondary parties — relatives of the patients, political party goons, and in some cases even police — rather than patients themselves. Especially in West Bengal and Maharashtra, the reasons for violence are not just money but long waiting periods, unavailability of crucial investigations, inordinate delay in referral, and unhygienic and extremely crowded conditions.

The recurring violence in these institutes is a symptom of the general dysfunction of the healthcare system.

In a predominantly capitalistic system, healthcare is one of the only remaining bastions of the welfare models. The government medical institutes therefore, simultaneously train medical students and offer prioritised, cost-effective healthcare delivery to practically the entire population. The recurring violence in these institutes is a symptom of the general dysfunction of the healthcare system. Government hospitals offering subsidised medical care are swamped with patients and their attendants. On an average, a medical officer posted in the outpatient department, sees close to 350 patients a day. That means, these doctors are under inordinate amounts of stress and the patients sometimes have to wait for hours on end. The highest number of violent incidents (close to 50 per cent) occur in the ICU, and almost 70 per cent are caused by relatives of patients.

In another paper titled “Violence Against Doctors: The Class Wars”, Sundeep Mishra writes of government hospitals which cater largely to the working class. Since doctors, by virtue of their exclusive training, belong to an intellectual or elite class, in the working class — which believes in quantity over quality of work — there always persists a grudge against the elite. This basic suspicion and dissatisfaction is largely capitalised on by those at the top of the working class hierarchy to organise this social class and incite violence at the slightest chance.

Then there are those with political clout, who use hospitals as a place to throw their weight around. For example, on August 25, 2001, Shiv Sena leader Anand Dighe was admitted to Thane’s Singhania Hospital following injury in a highway accident. Mr Dighe was stable after an operation for a leg fracture, but he suffered cardio-respiratory arrest after surgery and died. Following news of his death, a mob of Sena followers went on a rampage, destroying furniture and equipment. Staff and patients fled the premises while a small posse of policemen looked on. The damage to the hospital is estimated to be around 10 crore.

According to an ongoing study by the Indian Medical Association, more than 75 per cent of doctors have seen violence at work in their careers and in the last two years, 32 incidents of violence were seen in Bengal’s hospitals alone. Even though the medical community faces constant threat to their person, there exist no laws for their protection or safety. Mamata Banerjee compared how police officers do their duty in the face of possible violence, but she forgot that it is an non-bailable offense to assault a uniformed public servant. However, even when doctors are putting their lives on the line, there exists no visible protection for them.

There is enough established data to show that doctors are subjected to violent behavior from the relatives of patients, but the government refuses to act on it.

In the Indian Heart Journal, Paurush Ambresh writes, “During night hours, it is often the medical officer who plays the role of the doctor, as well as that of the security guard. There is no established protocol for tackling violence or a shooting incident. Most of the police force is plagued by corruption and is prone to bribery. Hence relying on the police for safety is, more often than not, useless.”

This is the demand that most of the doctors on strike have — a safe working environment. There is enough established data to show that doctors are subjected to violent behavior from the relatives of patients, but the government refuses to act on it. In the long run, we need systemic change that would give everyone better access to education, an increase in resources so that we have more doctors to treat patients in this overpopulated country, and universal health insurance that would mean the extraordinary expenses of medical treatment didn’t terrify patients. But for now, basic security for the doctors is an imperative.

Under a capitalist system, medicine — which in South Asia was the jurisdiction of healers — slowly morphed into an industry. Doctors were once revered as gods, which is why when stories of corrupt doctors or shady medical practices began to break open, the disillusion was absolute. We relate most to stories of what could happen to us, therefore when the media began to actively cover, and sometimes even sensationalise stories of organ theft, medical negligence, malpractice, unnecessary tests, and invasive procedures, general distrust against doctors heightened.

No matter how powerful and strong you are, as a patient you are at your most vulnerable, and your life and dignified existence is handed over to someone else. When those figures are shown to be possibly corruptible, regular humans like the rest of us, it is a terrifying experience. We expect doctors to be above human wants, needs, and desires, so that we can trust our ailing, failing bodies to them, but this also means we lose sympathy for them in the process. Terrified that doctors are inhuman and exploitative, we have ironically dehumanised doctors themselves, leaving them to fight their own battles, no matter how overwhelming.

Right now, while the doctors are on strike, what they need most is solidarity from those around them. Ultimately, they are fighting for their dignity. If we fall for political obfuscation and abandon our healers to the jaws of common indifference, we will be failing those who once took an oath to save us all.