By: Rajibul Alam
The recent barbaric and brutal attack on Dr. Seuj Senapati in Udali of Hojai district and on some health workers in Sindura tea garden in Cachar has once again proved that we as a society still need to get matured to enjoy optimum civic facilities. However, the attitude of some people, especially from the elite section is even more barbaric. Terming the incidents, especially of Udali, as an act done by East Bengal origin people and looking at them from a communal angle is the lowest level of their intellectuality. Hence it’s a necessity that we went deep into the statistics and causes of violence against health workers in India.
Violence against doctors is global phenomena, irrespective of region and religion. Data shows that one-third of medical professionals of the UK face violence at the workplace. The Chinese Medical Doctor Association has reported more than 105 violent incidents between 2009 and 2015, where doctors were badly injured. More than 100 health workers died in the USA between 1980 and 1990 due to violence at the workplace. Though doctors across the globe have been subjected to attacks, be it abusing or physical, but in the case of the Asian sub-continent, the nature of the attacks has been different. In an article published in The Indian Journal of Medical Research in 2018 (Violence against doctors: A wake-up call), it was stated that in India, patients themselves are not trouble makers like in western countries, rather patient’s relatives, unknown sympathetic individuals(!) and the most surprisingly political leaders and political parties take law in their hand.
The trend is not new. We are always accused and sometimes even praised for being too emotional. At times we are praised for our empathy, kindness and cooperative social behaviour owing to our strong emotional quotient. But most of the other times when we are required to apply our intelligence quotient, we still depend on our hearts rather than the brain (Though biologically saying, the heart does not control any decision making). And it is proven time and again during elections, road mishaps, policy-making, and deaths in hospitals.
Indian Medical Association has reported that 75% of doctors face verbal or physical abuse in hospital premises and fear of violence is the most common cause for the stress of 43% of doctors. The highest number of violence was initiated at the point of emergency care and 70% of violence was initiated by the patient’s relatives. The incidence of reported violent crimes against doctors in India has been increasing from 2006 to 2017 with the highest violence rate occurring in Delhi, Maharashtra, and Uttar Pradesh. In July 2019, about 800,000 doctors went on to strike demanding better working conditions after a junior doctor was brutally assaulted in Kolkata. Statistics show that 8-38% of health workers in India face physical violence at some point of their career, 1.6 million people die due to poor quality of healthcare in India which often leads to violence against the doctor.
The most important reason for such violence against health care professionals is the low investment in the health care sector. Such low investment causes a lack of trained doctors and staff and modern medical apparatus, especially in Primary and Secondary health care facilities which serve a large chunk of the population. In such a scenario, the expectations of the relatives of the patients do not meet with the service of the medical staff. Added to that, the negative image of doctors creating a nexus with pharmaceutical companies erodes the trustworthiness of medical professionals.
But these can’t be solid reasons for violence against medical professionals. Indeed there can’t be any reason for violence in a civilised society. We need to understand that India is still a developing country and we still can’t afford the highest standard medical facilities in every other village. We need to understand that many of our doctors serve in extremely challenging situations, living away from families and adjusting with many obstacles. The awareness of people, as well as training of medical staff, is the prime requirement of the moment.
The violence against doctors has shown a trend cutting across the communities, financial and educational status. As recent as 26th April 2021, family members of a Covid-19 patient attacked doctors, nurses and other staff at the Apollo Hospital in Delhi after the patient died without getting an ICU bed. The frustration of the relatives found an easy target as the medical staff forgetting that it’s the government which should be made accountable for inadequate health facilities. The incident happened days after Delhi High Court ordered police protection to hospitals amid a spike in Covid-19 patients. “You never know how people will react when their near and dear ones are concerned”, the court had stated. It seems Delhi High Court had read the situations well ahead.
On 3rd April 2020, BBC had reported that several healthcare workers in India have been attacked as they battle to stop the spread of the coronavirus. In one viral video, it was seen that a team of doctors led by Dr Zakiya Sayed was thrown stones at by a mob when they went to a densely populated in Indore in search of a suspected Covid patient.
Indian Medical Association (IMA), with their past experience, was well aware of such complexities amid such pandemic and when there is a crisis of ICU bed and oxygen cylinders. Hence the parent body of Indian medical professionals has written to Union Minister Amit Shah on the 2nd of June stating the need for corrective actions at various levels to bring a halt to the heinous crimes against the medical professionals. They termed the violence against doctors in India as an emerging epidemic itself. A bill called Prohibition of Violence and Damage to Property Bill, 2019 was drafted by the Health Ministry in 2019, but the Home Ministry dismissed the requirement of a separate law to check violence against medical professionals. However, the Government enacted the Hospital Protection Ordinance under Epidemic Disease Act 1987 last year to stop violence against medical professionals. But IMA stated that the lack of tagging the Act to IPC or CrPC makes it poorly enforceable.
So rather than looking at this violence from communal and regional angles, administration along with active participation NGOs, civil societies and various other socio-political groups, now need to take a holistic approach. Since increasing investment in the health sector is a policy decision and requires a substantial time frame, at least other approaches starting with framing stringent law, mass awareness programs for common people and adequate training for medical staff to handle complex emotional situations, can be activated. In a paper called
“Has Violence against Doctors Become the norm in India?” authors Kaushik Bharati and Sunanda Das have suggested few steps as the way forward. These are framing and implementing laws, creating health awareness so that patients can make informed decisions, strengthening infrastructures of PHCs and SHCs in rural areas and their equivalents in urban areas, improving doctor-patient communications, improving workplace safety, engaging pro-active media, providing adequate security and monitoring system in public hospitals, lessening political interference and providing training to medical staffs for stress and anger management to change their attitudes towards patients.