The country has been shocked by the gruesome rape and murder of a 32-year-old trainee doctor inside RG Kar Medical College and Hospital in Kolkata, West Bengal. A civic volunteer Sanjay Roy was arrested in connection with the case. Doctors from several hospitals across India have announced an indefinite strike to protest against the incident. Hospital elective services will cease nationwide beginning 12th August, according to a statement released by the Federation of Resident Doctors’ Association of India (FORDA). The protesters are also demanding adequate security for all medical staff.
The RG Kar Medical College Resident Doctors Association (RDA) declared they will only end the protests when their demands are fulfilled. A doctor at the hospital conveyed, “We have released a set of four demands: judicial probe, written apology from hospital authorities, compensation for the woman’s family, police must publish the progress of the probe regularly.” The institution spanning 26 acres in Kolkata is one of West Bengal’s largest medical institutions.
Meanwhile, the protestors asserted that the hospital’s lack of CCTV coverage in sensitive locations, tout rackets, lack of restrooms for on-call doctors and no screening for outsiders entering at night create a perilous atmosphere for the staff.
The demonstrators accused that there is no CCTV in the lecture room of the “emergency” facility where the doctor’s body was discovered. They revealed that there are no CCTVs in the floor wards or the corridor. Subhendu Mullick, a senior resident physician at NRS Hospital who was employed at RG Kar till recently mentioned, “Only the main gate of the building has CCTV. Most CCTVs you see are non-functional. There is no quick response team.”
The victim was forced to use the seminar room as a rest space because there isn’t one designated for female doctors, according to junior doctors at RG Kar. There is no washroom in the seminar room. “This hospital deals with a high influx of trauma patients. The doctor-to-patient ratio is very low. We lack support. If someone abuses us, there’s no one to turn to. There is no proper washroom or place to even change clothes,” A medical intern discussed the difficulties she encountered while on duty. A doctor informed, “On night duty we mostly use either the seminar room or sonography room.”
The “biggest problem,” per one doctor is “unauthorised entry.” He voiced, “Often, one patient comes with 11-12 relatives. Only people with ID cards should be allowed inside the ward. Look at Woodburn Ward of SSKM, where VIPs and politicians stay. They have strict regulations against unauthorised entry.” Additionally, doctors reported that there is no security monitoring outside the hospital at night. A female housekeeping worker unveiled, “As many as 15-20 people barge in the emergency with one patient. We come across drunk people in the emergency section as well.”
Several contract employees work at the hospital, noted a doctor who has joined the agitation while a postgraduate student at RG Kar added, “Many of them are involved in tout rackets at the hospital. Authorities have little control. They have access in every ward.” Doctors insisted that the hospital should have a sufficient police presence. “There is no security at all at night on the floor,” disclosed Dr Nihal Saha.
The hospital has its own private security in addition to the police stationed at the entrance. “Junior physicians, however, contended that private security disappears after 9 pm. The huge size of the hospital makes it unsafe for female employees to walk through dimly lit areas after night shifts. The property has multiple dark, lonely spots. “You cannot walk around at night. We all know it’s not safe,” highlighted a junior doctor. Protesters have demanded that female police officers be placed strategically throughout the premises.
Doctors on duty attacked, assaulted by relatives of patients
It is pertinent to note that doctors have been facing attacks in different parts of India which have consistently endangered their lives and safety. This year in March in Kerala, Joseph Chacko from Thiruvananthapuram attacked a female Ayurvedic doctor in her clinic and stole her thali chain. He walked inside the consulting room and asked for a tablet. She told him it wasn’t in stock after which he proceeded to physically and verbally assault her. Afterwards, the police filed a case against him, which prompted him to approach the high court for pre-arrest bail. Additionally, the doctor submitted a petition seeking that a higher-ranking police officer, ideally an IPS officer, be given charge of the inquiry.
The high court observed that attacks on medical personnel have not been reduced even after changes to the Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Act. This observation was made by Justice A Badharudeen at the dismissal of Joseph Chacko’s pre-arrest bail plea. The court added that it has become a norm to abuse, assault and manhandle doctors and hospital employees for trivial reasons.
A visitor, who was intoxicated, cut a 31-year-old doctor’s throat with a knife after a heated brawl at Puducherry’s Indira Gandhi Government General Hospital and Postgraduate Institute in April of 2024. According to the police, R Vinoth (39) of Boomiyanpet, went to see his 17-year-old who was receiving treatment in the intensive care unit (ICU) following a road accident that left him with critical injuries. He assaulted his wife and sister, who were attending to the patient after they confronted him about coming to the hospital while inebriated.
Dr Naveen Kumar of Tirupattur intervened and observed that the man was drunk and instructed him to leave the intensive care unit right away, which sparked a heated argument between the two. The man went outside, succeeded in getting a knife and waited for the doctor. He then sliced his throat as he exited the hospital. The doctor was saved and taken to the intensive care unit by hospital employees, patients and their companions. They subdued the man and turned him over to the hospital police checkpoint. Afterwards, the individual was handed over to the police in Grand Bazaar.
In July of this year, 200 to 300 junior doctors affiliated with Siddhartha Medical College’s Andhra Pradesh Junior Doctors Association (APJUDA) initiated an indefinite strike in response to a reported attack on a junior doctor by the family of a patient who died in the hospital’s intensive care unit (ICU). The 54-year-old male was brought to the casualty department of the Siddhartha Medical College-affiliated Vijayawada Government General Hospital (GGH). He had consumed an unidentified amount of glyphosate ammonium poison and had earlier received treatment at a private hospital. Afterwards, he was referred to GGH by the private hospital’s medical staff.
The victim, an on-duty casualty department doctor, checked his vitals and determined that he was seriously ill. The doctor told the patient’s relatives to take him to the intensive care unit (ICU) because of his critical condition. Despite his best efforts to save him, the patient tragically passed away from cardiac arrest within an hour of being admitted to the intensive care unit.
“When the doctor approached the patient’s family members to inform them about the incident, the relatives attacked the duty doctor. They blamed the doctor for inadequate treatment and assaulted him both verbally and physically. He was pushed and grabbed by his collar by the attackers,” revealed President of APJUDA-SMC wing Dr Dharmakar Pujari. After the assault, the APJUDA launched a strike in support of the junior doctor, demanding the arrest of the accused and urging the state administration to take measures to control attacks on doctors.
Kerala: Doctor stabbed to death by criminal who was in police custody
Dr Vandana Das, a 25-year-old house surgeon at Kottarakkara taluk hospital in Kerala’s Kollam was stabbed to death with surgical scissors and a scalpel by her 42-year-old patient Sandeep when she was dressing him, in May 2023. He was brought to the hospital by police for treatment of his injured legs and hands. He taught upper elementary school and had a history of substance abuse and alcoholism. The witnesses stated that he used a scalpel to injure police officers and a relative before targeting the doctor, however, the First Information Report alleged that he stabbed the doctor first.
She was brought to a private hospital in Thiruvananthapuram but unfortunately succumbed to her injuries. A special bench of Justices Devan Ramachandran and Kauser Edappagath of Kerala High Court also slammed the state government for its inability to protect the doctors. “It is a complete failure of the system. Having an aid post in a hospital is not enough. When you (police) knew the man was acting abnormally, you should have restrained him. You should be able to anticipate the unanticipated. Else there is no need for the police. Over time, we have become casual, Did you not fail this girl,” the court questioned. The bench emphasized that it had previously cautioned on multiple occasions that such an occurrence would happen if nothing was done.
26-year-old Dr Rahul Kanela, working in the orthopaedic department of Safdarjung Hospital was injured after he was attacked with a screwdriver by a patient when he was on duty in the emergency room in September of the same year. The latter yelled, “I will kill you,” while launching the savage assault which left the doctor with wounds to his neck and abdomen. “I also sustained injuries on two of my right-hand fingers during this incident,” the doctor mentioned in his complaint.
The patient became angry, according to the police, when the doctor asked him to seek a nurse’s assistance to remove a cannula from his arm as the latter was in the middle of work. The accused then abused the doctor and took out the screwdriver from his pocket to attack him. The doctor’s colleagues intervened immediately to prevent additional harm from the patient, who had been subdued by the security guards and turned over to the police. He was charged with assault on a public servant and attempted to murder while voluntarily causing obstruction in performing the official duty.
Rajasthan: Gynaecologist commits suicide after death of a pregnant woman due to complications
Dr. Archana Sharma was a gynaecologist employed by a private hospital in Lalsot, Dausa district in Rajasthan. The demise of a pregnant woman at the hospital led to the filing of a formal complaint against her under section 302 (murder) of the Indian Penal Code after which she hanged herself to death. The occurrence took place in March 2022, during the Congress government. She pleaded with people to stop harassing her husband, kids and innocent doctors in her suicide note which read, “I love my husband and children a lot. Please do not harass them after my death. I did not commit any mistake and did not kill anyone. PPH (Postpartum haemorrhage) is a known complication. Stop harassing doctors so much for this. My death may prove my innocence. Don’t harass innocent doctors. Please. Love you. Don’t let my kids feel the absence of their mother.”
Doctors in the state organised a protest and healthcare services at private hospitals remained closed. Doctors from all different medical associations came together at the Jaipur Medical Association to publicly and unanimously demand that the guilty parties in this case be charged with aiding and abetting suicide. The All India Institute of Medical Sciences in New Delhi also witnessed a demonstration against the occurrence by resident doctors.
2021: Relatives of 75 year old Mohammad Shahid brutally assault a doctor in NRS Medical College, Kolkala
After the death of 75-year-old Mohammed Shahid, a resident of Tangra, who passed away at the NRS Medical College and Hospital in Kolkata in June 2021, an intern doctor suffered a skull fracture when the former’s family members arrived at the institution and started a fight with the junior doctors on duty. Around 200 people, according to doctors, ended up at the hospital and converted the grounds into a battlefield during the night and the following morning.
The deceased’s family members claimed that his death was the result of medical malpractice and added that they were not given the body on time. They were demonstrating against two younger doctors, who were hurt in the altercations. One of the two doctors, Paribaha Mukhopadhyay, had a fractured skull after a brick thrown by the violent mob struck him in the head. According to medical reports, he sustained a deep brain injury. Fortunately, he was fine after undergoing surgery for wound debridement and elevation of a frontal depressed fracture. The instance sparked an uproar among doctors and medical professionals in the city.
Kerala doctor attacked by drunken men for asking them to follow rules
A group of four individuals attacked Dr. Sanoj, who was working at the Parassala Taluk Hospital in Thiruvananthapuram in August 2021. The doctors refused to report back for duty the following morning and insisted that the attackers be taken into custody before they could resume their duties. However, the perpetrators were apprehended by the cops as a result of the demonstration. Dr Unnikrishnan, superintendent of the hospital informed, “We had to boycott the duty to put the authorities under pressure which has resulted in the arrest of the four people.”
Four passengers arrived at the hospital in a Maruti Alto automobile and one of them was with a hand injury. Since none of them were wearing masks, the hospital’s security did not permit them to enter. They then attacked him and the doctor emerged from the hospital to investigate the disturbance. He also clarified that they needed to wear masks when stepping inside the hospital and that he would not treat them if they were not ready to listen. The drunk offenders who were unwilling to pay heed to the doctor assaulted him due to which he dropped to the floor. He was the only doctor on duty in the hospital then. “This is the fourth incident of attack against the doctors happening here in the past two months. Every time the issue happens during the night duty. Now, we have asked the district collector and the district medical officer to set up a police aid post at the hospital for our security,” Dr Unnikrishnan stated.
A few days prior to this incident, Dr Sarathchandra Bose was assaulted by Communist Party of India (Marxist) leaders in Kerala’s Alappuzha district. He had lodged a complaint alleging that MC Prasad, the president of Kainakari Panchayat and several other CPM leaders had assaulted him on 24th July. According to the allegation, they intervened in the vaccination procedure and assaulted him for not obeying their demand for vaccinating certain persons on priority. He complained that the cops were not taking action against the accused and protested in a novel manner by working on his off day.
Reasons behind violence against doctors
The aforementioned occurrences are only the tip of the iceberg as doctors have gradually become easy targets for criminal elements of society as well as others to vent out their anger and frustration. However, there are a lot more facets to the critical problem and India’s underfunded public health system is one of them. According to research by the Indian Medical Association (IMA), 75% of Indian doctors have experienced violence at some point in their employment while another report unveiled that 82.7% of doctors feel their job stresses them out, 62.8% responded they are afraid of violence and 46.3% think their stress is mostly caused by violence.
Issues such as inadequate staffing and resources, excessive medical expenses, and prolonged hospital stays in private facilities are cited as contributing causes to potentially violent situations. According to government statistics, the nation is home to 1.3 million allied and healthcare workers including doctors along with 3.4 million registered nurses. For India, which recently surpassed China to become the world’s most populated nation, the numbers are very low. The Indian Journal of Public Health estimated that by 2030, India will require at least 2.07 million more doctors. Other factors, such as the unequal distribution of the health workforce throughout India’s states and between rural and urban areas, deepen the imbalance. Inequalities exist between public and private healthcare facilities as well, with the former requiring consumers to cover all treatment costs out of pocket.
People also expect public hospital care to be on par with that of private hospitals in terms of quality. However, public hospitals are underfunded, congested and unable to provide excellent medical care. They get frustrated and angry due to their poor socioeconomic level and the escalating expense of their treatment, which fuels a mob mentality and a need for immediate justice. Furthermore, India ranks 152nd in the world for public health spending and invests just 1.2% of its GDP on public health. Due to a lack of funding, many hospitals are devoid of essential amenities like CCTV cameras, adequate security, and separate restrooms and rest places for female doctors.
A bad case outcome is often erroneously attributed by patients and their families to medical negligence. The general population is unaware that medicine is complicated and sometimes matters are not in the hands of doctors. Many medical illnesses have poor prognoses and treatment can sometimes produce adverse outcomes. Heavy caseloads and up to 120 hours of work per week for doctors are another contributing factor which leaves them with no time to speak with patients efficiently.
Notably, the epidemic of violence against doctors is global. According to the World Health Organization, between 8% and 38% of healthcare professionals experience physical abuse at some point in their careers. According to studies, 85% of doctors in China, 75% of doctors in India and 47% of doctors in the United States reported experiencing violence at work. Patients and their families make up the majority of attackers.
Doctors believe a federal rule that prohibits bail for violence against health professionals and facilities and that imposes harsh punishments and lengthy prison sentences will put an end to this kind of violence. In India, legislation has been passed in nineteen states to safeguard medical personnel and facilities against violence.
Violence against healthcare professionals hurts their physical and mental health as well as their motivation for their profession. Additionally, this lowers the standard of care and decreases the amount of healthcare provided, particularly to those in lower social classes. The health and well-being of the people are also negatively impacted. It also results in enormous financial losses for the health industry. It is necessary to create strategies to effectively handle aggressive patients and high-risk visitors while still ensuring security in medical institutions. Further research is needed to evaluate the effectiveness of these strategies, especially in public health institutions with constrained funding. Laws prohibiting this kind of violence might be helpful, but they are not a panacea and the issue needs to be addressed in its entirety.
