On June 11, hospitals in the eastern Indian state of Bengal shut down and went on an indefinite strike in response to a near-fatal assault on a junior doctor by a crowd, following the death of an elderly patient at an emergency ward. While the freshly-graduated young doctor battled for his life in the same ICU where he was saving patients till the night before, doctors across the nation were out on streets demanding stronger policy and stricter action against rising cases of violence on healthcare professionals in India. On 17th June, non-essential services at hospitals across India was suspended in solidarity with the nationwide protest called by the Indian Medical Association.
Though violence against health workers is nothing new and has been witnessed across the world through entire history, the recurring cases of assaults on doctors and nurses in India has now erupted to become a cause of serious concern. What is different in these cases is that the acts of violence have been committed in a non-conflict region by patients and their relatives who came to the hospital out of choice. Most incidents of assault has been directed towards junior and resident doctors working in government institutions. Government health services are the last resort for patients who have returned from private facilities after suffering huge financial catastrophe. As a result, the subsidized healthcare in a largely growing capitalistic nation is seen as a ray of hope for poor and debt-ridden patients. However, these Government health facilities have limited resources that do not allow for provision of quality, affordable and timely access to healthcare. And, the outpatient services at the institutions are largely catered by junior doctors, fresh graduates- interns, and junior residents who are untrained in soft skills and crisis management situations as a result of a book-focused learning environment. Unfortunately, these young physicians, acting as the frontline workers, become the face of a crumbling, resource-crunching and apathetic system
A large segment of society, on failure to receive the expected quality of treatment, perceive it as a sense of injustice. This could include long waiting time in out-patient departments and emergency rooms, delay in providing care, inadequate explanations on treatment and diagnosis, inadequate services, expensive drugs and treatment costs. A shortage of health workers only add fuel to the fire. Furthermore, these structural deficiencies are seen as a failure of doctors, resulting in resentment of general public towards doctors and not the system or policy makers. And, any mistake; negligence; or an innocent error pushes the attendants of these critically ill patients to commit acts of violence in a fit of anger and resentment.
However, for young physicians such as me and my peers, this creates a sense of a highly negative future in an already opportunity-limited system. Due to a fear of similar persecution and injustice, many junior doctors fresh out of graduation either choose to migrate out of the country or to change their profession entirely. For most of us, keeping our bones intact and brains inside the skull is a priority over serving a thankless society in a resource deficient system.
Regrettably, these days, only movies have a fairytale ending. Immediately following the termination of protests, after a reassurance from government to enact stronger laws, Supreme Court of India refused to pass order on plea seeking security of doctors at workplaces in spite of the multiple incidents of aggravated assault on doctors. Moreover, media has continued to vilify doctors and create misdirected resentment in public. A sensible and stronger policy and law might hold off impulsive actions from violent mobs, but to guarantee a long-term sustainable change the onus lies on public itself to understand that physicians are another set of professionals working in a highly stressful environment in an apathetic and resource constrained system. Till then, I’ll try to keep my bones intact!
About the Author
Dr. Ankit Raj is a junior doctor working with International Students Surgical Network and a blogger and freelance writer on healthcare issues such as system strengthening, global surgery and health policy. Follow him on Twitter @RajAnkit14