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They attend taekwondo courses, carry a gun on their belt to defend themselves against lynching by the patient’s family. They even refuse to treat the dying so that they won’t be found guilty of the patient’s death. In India, doctors are paralyzed by fear.
Photo Hospital in India
Rohit Tated – a resident at Sion Hospital in Bombay – was already finishing his 36th hour on duty when an unconscious 60-year-old girl with end-stage renal disease was brought in. Her blood pressure dropped drastically. She died. When Tated informed her son of the tragedy, the man began to cry. Two minutes later, he and his relatives rushed to the doctor. Two security guards on the ward could not cope with the aggressors. Only calling for reinforcements from the outside scared the lynching people away.
At the time of the attack, 45 patients were cared for by this resident in the ICU, including 7 in a serious condition. Tated had polio in the past – he was limping, using the leg clamp to walk. The attackers didn’t care.
During 2 weeks of this March 2017, in the state of Maharashtra (capital: Bombay), as many as 5 doctors were beaten by groups of several dozen relatives of patients. One of the medics, Dr. Rohan Mhamunkari, the crowd beat at the Dhule Civil Hospital for referring the patient to another facility with a neurosurgeon, because there was no such specialist in that facility. As a result of the lynching, the physician was threatened with blindness.
Lynch our daily
All of India, not only Maharashtra, has been flooded by attacks on doctors for many years. But it has never been as bad as the last 4-5 years. During the year it happens min. a dozen lynching on doctors.
In Calcutta, such attacks by the crowd or a larger group of relatives became even … regular: in January 2016 at the RG Kar Hospital, and 2 months later at the Nil Ratan Sircar Medical College and Hospital. By mid-2017, these attacks in the city had become so frequent that the NRS Medical College and Hospital began organizing taekwondo lessons for its students and residents. It was the first medical school in the country to opt for such a program. Dwaipayan Bispas, the doctor who looks after the project, said it has reduced the number of physical attacks on their medics. “They have also become mentally stronger and better resolve conflict situations in contact with relatives of patients,” explains Bispas. He knows what he says – he has 2 dan himself and a black taekwondo belt.
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Millions of people watched the scenes from the hospital in Dhula on March 12, 2017, thanks to the surveillance camera footage. Several dozen men found the resident of orthopedics in the hospital room. You can see them kicking him, beating him, but in such a dense crowd his figure disappears from sight. Only after 2-3 minutes, when the chatting has calmed down, does it appear jagged and bleeding. He hits one of the attackers and then several dozen male hornets attack him to finish the work. Paradoxically – on an empty hospital bed.
When a pregnant woman died in January 2016 at the Maulana Azad Medical College in New Delhi, a crowd of around 50 relatives rushed into the hospital. They were throwing chairs, bottles and medical equipment. They wanted to get the doctors on call. They avoided lynching by locking themselves into a safe room. Help has come this time.
In the states of Maharashtra and West Bengal, doctors have even been beaten by police or local political leaders.
Revenge, revenge, against the enemy …
Doctors defend themselves as best they can against this escalation of violence. When a patient who was in intensive care died in April 2018 at Nagpur’s Indira Ghandi Government Medical College and Hospital, dozens of angry relatives burst into the building. They beat up the security and began to plunder the facility. They destroyed fans and medical equipment. They were armed with knives, shouting for blood. They were looking for residents whom they blamed for the death of a relative.
It was another such attack in this hospital in 2 months. The next day the doctors revolted. They demanded permission from the authorities to wear… weapons under an apron. And they got them – everyone can apply for it individually.
Fearing the reaction of relatives after the patient’s death, doctors also refuse to treat people in a serious condition. But that doesn’t protect them either. On April 20, 2016, at the Udham Singh Nagar hospital, relatives of the girl who died shot Dr. Sunil Kumar Singh, a 51-year-old pediatrician. Because he refused to help the sick. In September last year the court found that the girl’s death was independent of the doctor’s decision. He also ruled that practicing this profession was … life-threatening.
For a long time, single institutions in the country have failed to save the dying. They shift the problem to other treatment centers. In 2014, in the Mansa district in Punjab, due to his terrible condition, the boy was not admitted by 2 hospitals. The third clinic took pity and took the sick. He died. Right after that, relatives… burned this little hospital.
In Agra – a metropolis with the famous Taj Mahal – private hospitals stopped admitting critically ill patients. They send them back to state institutions. Ravi Pachouri – president-elect of the Indian Medical Association – in September last year. with disarming frankness, he confessed: “We are afraid of taking the risk.”
Meanwhile, at least the victims of road accidents, every doctor in India is obliged to help, otherwise he will face 6 months in prison. The Indian Journal of Medical Ethics, however, states that despite the possible punishments, medics refuse to help.
We have enough!
In March 2017, as part of a protest after further acts of violence, doctors from the AIIMS medical complex in Delhi saw patients wearing … motorcycle helmets. Next to them were banners “Patients do not die of doctors, but diseases”, “Do not make doctors feel threatened, because they will practice defensive medicine.”
After a mob demolished the hospital at Puri District Headquarters Hospital in August 2016 and attacked a doctor and several paramedics, four of their colleagues resigned and 25 suspended their duties. The management introduced stronger protection.
When the relatives of a disgruntled patient cut the face of a resident at Safdarjung Hospital in the capital, doctors at the center went on a hunger strike. They were supported by other medics from the capital, demanding safety in hospitals. In total, as many as 2016 protested against the aggression in New Delhi in June 20. doctors!
Strikes are the most common form of fighting – mass strikes have already taken place in several states. In some cases, many times. Only in Mumbai alone, only in one day, as many as 500 operations had to be canceled due to the strike.
Doctors are just fed up. The Indian Medical Association reports that as much as 75 percent. of its members have experienced physical violence at work. Other studies show that as much as 88 percent. specialists were affected by anger and violence from patients and / or their relatives.
Between 2007 and 2016, as many as 18 states in India enacted laws specifically protecting doctors. It usually includes a sentence of up to 3 years in prison for any physical attack on hospital staff or its infrastructure. This does not deter intruders.
Two minutes per patient
There are many reasons for aggression. The underfunding of the state health service is fundamental. India – a nuclear power, with a huge army and rockets sent into space – spends only 1% of money on protecting the health of its citizens. GDP. In Andhra Pradesh, 1 state hospital has well over 300. residents. Hellly overburdened residents work in them. Entire units are assigned to one physician who is still in training, who works 18–20 hours a day on average. According to a study by the British Medical Journal, a statistical doctor in this country spends less than … 2 minutes on a patient. While in state hospitals they do it because of overload, in private it is the result of pressure from the bosses – the doctor is a money-making machine, he is to admit as many patients as possible.
The cause of aggression is also the poor communication between medics and patients and their relatives. They lack empathy. The information about the death is given by the doctor in such a way that the relatives become furious. They demand lynching in the crowd. Here and now.
However, few people know that a very important reason for the aggression is the gigantic increase in health care costs in India. According to New India Express, the costs of hospitalization in private hospitals increased threefold in 10 years (2004–2014)! The average income of the entire average family in this country in 3 was sufficient for… 2014 days of hospitalization! In addition, in private hospitals, it is standard to order completely unnecessary tests, examinations, procedures and drugs. Everything to earn as much as possible on the client – this was proved by the Reuters investigation. Treatment means enormous expenses, because the overwhelming majority – 1,5 percent. in villages and 85 percent. in cities – of this nation of more than one billion three hundred million citizens, there is no health insurance at all! Without savings, they borrow from moneylenders and fall into a spiral that is hard to jump out of. And if it is … through a window – 82 percent. suicide people in India decide to take such a step because of debt to treatment, or lack of money for it. According to WHO data, of the more than 16 million people in the world who fall into poverty and poverty every year because of medical expenses, half are… Hindus! So when a family goes into debt for many years and the doctor fails to save its member, the relatives become furious.
Another issue is the “culture of violence” – India is a country where the sovereign very often brings justice through lynchings.
Pendulum rule
“I have been practicing in clinical practice for 28 years. I had the opportunity to observe the glory days of medicine, when a patient with a normal gall bladder, even though it was operated on incorrectly, still touched the surgeon’s feet. ” In gratitude.
This memory is described by Dr. Neeraj Nagpal of Medicos Legal Action Group. The article is about aggression against doctors, and the title says a lot: “Is India At War With Doctors?” Nagpal’s text was written in 2013, ie 1-2 years earlier than the most massive attacks on medics began.
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A culture of violence
Physicians’ self-judgments account for only a negligible percentage of lynching in India. Kiran Kumbhar, a physician and columnist, writes in The Wire that lynching is not just an experience of a small part of the country’s citizens. It’s something that grows out of the “culture of violence”. He claims that the Indian constitution as if somewhere in hidden records gave Indians the “right to beat”, to impose punishments with their own hands. Lynching by mobs of suspicious people is still relatively common on the Ganges – data collected by India Express and Amnesty International in India (AI) show that more than 100 people per year die in the lynx of mobs. AI chief Aakar Patel writes that in June 2017 alone, there were 14 lynch victims. The Observatory Research Foundation (ORF), in turn, calculated that there were months between 2014 and 2017 when the crowd made more than 20 lynchings. They can be counted in hundreds per year. The crowd is “administering justice” out of a sense of a lack of justice in the judiciary and prosecution service. It’s easy to bribe prosecutors, judges. Criminals, rapists, criminals, businessmen, influential people, politicians can actually escape punishment. But often the crowd kills people only accused of committing some act: rape, murder, assault. All you need is a rumor, a rumor whispered or on Facebook. Most often, such victims are accused of stealing cows or trading their meat, or … kidnapping children. On June 8, 2017, in the village of Panjuri Kachari, Assam, a crowd of 500 bludgeoned to death Nilotpal Das, 29, and Abhijit Nath, 30. The first was an audio engineer who worked in the village collecting sounds, the second was his friend who helped him. The inhabitants did not like these two artistic souls in dreadlocks and earrings, wandering around the countryside. A week earlier, a rumor had gone out in the forums that child kidnappers were circling the area. In the evening, at the end of the friends’ work, the crowd caught up with them and beat them. The village killings of people accused of kidnapping children have become so common that the offices have sent workers there to explain that this is nonsense. Sukanta Chakrabart was one of them – he straightened out such rumors spread over social media. He spoke to the residents through a megaphone, he was accompanied by 2 helpers. In one of the villages, the crowd killed Sukanta, and his colleagues were badly beaten. Reason? Suspicion of… kidnapping children.
Source: “Służba Zdrowia” 7-8 / 2019