Healthcare delivery and doctors' safety

Dr Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

Very often we come across news of the assault on doctors and on a few occasions even the killing of doctors on trivial matters in different hospitals across India. A section of people in India is frequently harassing and abusing doctors physically and mentally in the slightest pretext for the alleged negligence without going into the merits of a case. It has become increasingly common for doctors in India to be jostled, roughed up or beaten by angry relatives of patients. Surveys by the Indian Medical Association reveal that about 75% of doctors have complained of verbal abuse and 12% of physical violence in India. Hitting a doctor when the patient dies has become a norm in India. We are also witnessing frequent incidents of vandalism of hospital property in different health establishments across India on various pretexts.

The act of assaults on doctors and vandalism of hospital property in Assam also have registered a spurt in recent years. Ransacking of hospitals has become commonplace across the State, irrespective of the educational level of people comprising the mob. There are several recent incidents of assaults on doctors and vandalism of hospital property across the State, while some are reported, most of them go unreported. Yet another incident of violence against doctors stirred up the medical fraternity of Assam on June 1, 2021, when a recently passed out young on-duty doctor Dr Seuj Kumar Senapati was brutally attacked at Udali covid care centre in Hojai district by an irate local mob following the death of a Covid-19 patient. The local people claimed that the Covid-19 patient died due to the negligence of Dr Seuj Kumar Senapati who was on duty. The video footage of the attack on the doctor by the mob has sparked outrage not only in the state but across the country as well.

According to sources, a Covid-19 patient, Giasuddin, was admitted to the Udali covid care centre at noon on June 1, 2021, and the patient collapsed soon after. The incident led the relatives and attendants of Giasuddin to engage themselves in an altercation with on-duty Dr Seuj Kumar Senapati on the pretext that the patient died due to his negligence. Around six/seven people entered the hospital and beat up the doctor mercilessly, besides vandalizing the hospital and ransacking the important equipment required for treating patients. The attackers then dragged the doctor out of the hospital where more people joined to beat the doctor up. Currently, Dr Senapati is under treatment at the Gauhati Medical College and Hospital. A nurse, Lalita Bharali, also sustained an injury in the incident. This physical assault on Dr Senapati is not an isolated case that takes place in Assam; before this also several assaulting cases rocked Assam. Assaults and intimidation of doctors by residents in Assam seem to have become a frequent feature. It may be recalled that on August 31, 2019, a 73-year-old on-duty doctor, Dr Deben Dutta, was brutally attacked and killed at Teok Tea Estate of Jorhat district by an irate tea garden mob following the death of a patient, Sukra Majhi, who was a labour in the tea estate and in May 2019, the senior medical officer of Dikom Tea Estate, Dr Prabin Chandra Thakur was brutally assaulted. The tea garden labourers claimed that Manjhi died due to the negligence of Dr Deben Dutta who was on duty. In this case, the labourers who killed Dr Dutta crossed all the ethical limits when they not only prevented the ambulance from coming but scared it away depriving Dr Dutta of any medical aid.

The Government of Assam must punish the culprits involved in the June 1, 2021 incident and take necessary steps to ensure the safety and security of all the doctors serving in Assam. Meanwhile, the police have arrested around 24 persons including women identified as culprits. Moreover, the Chief Minister of Assam has issued an instruction to conduct a trial against those responsible for the attack of Dr Senapati in a fast-track court for exemplary punishment. The steps initiated by the State Government sends the message loud and clear that such actions would not be tolerated. A strong deterrent action against the perpetrators of the crime is a must to ensure that such incidents don't keep recurring. While attacks on doctors on duty are always deplorable, it is more so when the Covid pandemic is raging. The doctors along with the other frontline workers are putting their lives at great risk while combating the pandemic.

The violence against doctors is not acceptable in any civilized society. Nowadays people are becoming increasingly intolerant and appear to be in a mood to pick up a quarrel with doctors over any petty matter. Unfortunately, a large section of our society doesn't understand the philosophy of the medical profession. Nowadays people come to doctors with unreasonable expectations, failing to meet which is leading to assaults on doctors. The doctors are also as human as the patients they treat. The doctors are not magicians or wizard. No one should be under the delusion that the doctors are capable to fix any illness that the patient brings to them. No doctors have a personal interest in seeking their patients die, doctors look forward to filling up a discharge card, and not signing a death certificate. Moreover, doctors may commit mistakes as they are human too. If any doctor commits any kind of malpractice and medical negligence, the doctor should be prosecuted under the law instead of people taking the law into their hands. If the perverse trend of assault on doctors continues, very soon it will become impossible to render medical services to the needy. This entire situation needs to change.

The Government, healthcare providers and the public should try to avoid the triggers (shortage of doctors, medicine and infrastructure in hospitals, rude behaviour of doctors and intolerance of public, etc.) to violence against the doctors.

The repeated incidents of assault on doctors and the recent assault of Dr Seuj Kumar Senapati imply that the doctors in Assam are not secure at all. Today the security of doctors has become a matter of serious concern to the medical fraternity of Assam. Doctors are not trained for combat; they are trained to save lives. The doctors need security and support from everybody. The doctors seek protection from the authority concerned. The doctors need legal and political support also. Give the doctors at least a safe working environment, where they can be sure of their survival before they start saving other's life. The doctors want to do their work without fear. Doctors also have a right to security as any other ordinary citizens. There should be strict implementation of the Assam Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2011, so that the lives of the medical practitioners are protected and medical services are ensured in Assam. This Act makes assaults and attacks on any medical practitioner a non-bailable and cognizable offence. Of course, in 2019, the Central Government proposed a harsher legislation "the Healthcare Service Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, in this context. But, non-bailable warrants against the perpetrators are not a measure of security. The doctors want full security so that no incident of assault on the doctor repeats in Assam.