A crisis of safety

This horrific crime, which occurred within a state-run hospital, is a stark reminder of the dire state of safety in our healthcare institutions. Sadly, this is not an isolated case but part of a disturbing trend of violence and insecurity that professionals in India increasingly face.

Amal Chandra

Amal Chandra

The Statesman

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Such a tragedy highlights the urgent need for stringent measures to address the alarming lack of safety in Indian healthcare settings. PHOTO: THE STATESMAN

August 19, 2024

NEW DELHI – The recent rape and murder of a postgraduate trainee doctor at RG Kar Medical College and Hospital in Kolkata have sent shockwaves across the nation. This horrific crime, which occurred within a state-run hospital, is a stark reminder of the dire state of safety in our healthcare institutions. Sadly, this is not an isolated case but part of a disturbing trend of violence and insecurity that professionals in India increasingly face. Just a few months earlier, in May 2023, the murder of a 23- year-old house surgeon at a government hospital in Kottarakkara, Kerala, further underscored this growing pattern of danger. These tragedies highlight the urgent need for stringent measures to address the alarming lack of safety in Indian healthcare settings.

The incidents at RG Kar Medical College and Kottarakkara, Kerala, are symptomatic of a broader, deeply entrenched problem of workplace safety in India. Healthcare professionals, who are at the forefront of saving lives, increasingly find themselves vulnerable to violence and harassment. According to the Indian Medical Association (IMA), over 75 per cent of doctors in India have faced some form of violence at their workplaces. These acts range from verbal abuse to physical assaults and, as recently seen, even murder. The causes of this violence are multifaceted. They include the growing frustration among patients and their relatives due to inadequacies in the public healthcare system, a lack of awar eness about the challenges faced by healthcare professionals, and the absence of adequate security measures in hospitals. Doctors face immense pressure, with long working hours, inadequate facilities, and high patient loads. When outcomes are unfavourable ~ whether due to systemic failures or medical complexities ~ doctors often become scapegoats for public anger.

This situation is worsened by the lack of security in many Indian hospitals, making healthcare professionals easy targets for frustrated individuals. Moreover, there is a pervasive culture of impunity where perpetrators of violence against healthcare professionals often go unpunished, emboldening such behaviour. Incidents like the rape in Kolkata are not just a reflection of structural issues within the healthcare sector but also of a broader societal crisis, one that underscores deeper issues of gender-based violence and the failure to protect vulnerable individuals. The brutal murders of young doctors in Kottarakkara and Kolkata are tragic reminders of the vulnerability of healthcare workers. But these are not the only cases that demand our attention.

In 2019, two junior doctors in West Bengal were severely beaten by the relatives of a patient who died during treatment, sparking nationwide protests. Despite the outcry, little has changed. In March 2022, two doctor brothers in Karnataka were attacked by the relatives of a patient who passed away despite the doctors’ best efforts. These incidents, which occur across India, have a profound impact not only on the victims but also on the morale of the entire medical community. It is deeply disturbing that those who dedicate their lives to healing others must live in fear of being attacked while doing their jobs. One of the key reasons for the persistence of violence against healthcare professionals is the lack of a robust legal frame work to deter such acts.

While some states in India have enacted laws to protect doctors and other healthcare workers, these laws are often poorly enforced. Fortunately, 25 states have laws addressing attacks on doctors and hospitals, but they are largely ineffective on the ground. The Central government’s proposed Healthcare Service Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019, which aimed to ad dress this issue at the national level, has yet to be passed into law. This bill proposes stringent penalties, including imprisonment and fines, for those who engage in violence against healthcare workers or damage hospital property. The delay in passing this bill reflects a lack of political will to prioritize the safety of healthcare professionals. In addition to legislative measures, there is a need for a broader societal change in the way we view healthcare professionals.

Beyond the Central Protection Act, the public must be made aware of the challenges faced by doctors and other heal thcare workers and the importance of treating them with respect. Addressing the issue of violence against healthcare professionals requires a comprehensive, multi-pronged approach. Strengthening legal protections is crucial, and the Central government must expedite the passage of the Healthcare Service Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019. This legislation should impose stringent penalties on those who en g age in violence against healthcare workers and ensure such cases are prioritized in the courts.

Additionally, enhancing security in hospitals, particularly in government-run institutions, is essential. This includes installing CCTV cameras, deploying security personnel, and establishing protocols for managing violent situations. The government must allocate specific funds for these improvements to ensure they are implemented effectively. Public awareness campaigns are also necessary to educate the public about the challenges healthcare professionals face and the importance of respecting their work. Such campaigns could utilize media, social media, and community outreach programs to shift public attitudes.

Healthcare workers should also receive training in conflict resolution and de-escalation techniques, integrated into the medical curriculum and ongoing professional development. Support systems for victims of violence should be established within healthcare institutions, offering counseling services, legal assistance, and peer support to help them cope with trauma and return to work. There must also be a strong emphasis on enforcing existing laws and holding perpetrators accountable, which requires co-ordination between the healthcare system, law enforcement agencies, and the judiciary to ensure swift justice. The vulnerability of healthcare professionals in the workplace is a national tragedy that demands urgent action.

It is unacceptable that those who dedicate their lives to caring for others should have to fear for their safety while doing their jobs. As a nation, we must do better to protect our healthcare workers and ensure that hospitals are safe spaces for both patients and staff. The time for action is now; we cannot wait for the next tragedy before taking this issue seriously. The government must prioritize the safety of healthcare professionals by enacting and enforcing strong laws, improving security in hospitals, and changing public attitudes toward those who work in healthcare.

This is not just about protecting individual doctors ~ it is about safeguarding the integrity of our entire healthcare system and the health and well-being of the nation. In memory of the doctors we have lost, we must resolve to take the necessary steps to prevent such tragedies from ever happening again. It is our collective responsibility to create a society where healthcare professionals can work without fear and where everyone can access medical care in a safe and secure environment.

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