About 800,000 doctors across India went on strike on Monday to demand better working conditions, following years of complaints about violent attacks from patients’ families.
A brutal assault on a junior doctor in Kolkata, the capital of West Bengal, appears to have been the final straw. Paribaha Mukhopadhyay was walking down a corridor at NRS hospital with a colleague when a group of men attacked them.
Neither doctor had been involved in treating Mohammed Sayeed, 75, who died at the hospital on 10 June, but his outraged relatives attacked the first doctors they saw, turning the hospital briefly into a battleground, according to witnesses of the assault
Mukhopadhyay suffered a fractured skull and needed a craniotomy.
Doctors at different hospitals have gradually been joining the strike out of solidarity, and on Monday almost all the country’s doctors walked out to demand better protection.
“The events in Kolkata were just a flashpoint. This has gone on for too long. We have a right to security as ordinary citizens. This violence against doctors is not acceptable in any civilised society,” said Dr Rajan Sharma, the president-elect of the Indian Medical Association (IMA).
Doctors in Kolkata were further angered by the hostile response of the state chief minister, Mamata Banerjee, who ordered them to go back to work without addressing their grievances. The anger, however, has spread nationwide. It has become increasingly common for doctors to be jostled, roughed up or beaten by angry relatives of the recently deceased.
IMA surveys reveal that 75% of doctors have complained of verbal abuse and 12% of physical violence. At India’s top hospital, the All India Institute of Medical Sciences in New Delhi, doctors became so fearful that the Resident Doctors’ Association began providing self-defence classes in 2017.
“That is not the answer. We are not trained for combat. That will make it a two-way battle. We are trained to save lives,” said Sharma. The crux of the problem is the shortage of doctors, hospitals, equipment and space. India has one doctor for every 11,000 people and the ratio is far worse in some states. The recommended ratio is one doctor for every 1,000 people.
India’s population is growing, along with expectations of good healthcare. This combined with increasing life expectancy is placing a greater burden on scarce resources.
The nerves of both doctors and families of patients are stretched to breaking point by the situation. Families travel by train for two days after scraping together the cost of brining an ill relative to a city hospital.
On arrival, they join the teeming crowds already there. No drinking water is providedand there are hardly any toilets. Nor is there anywhere to sit or rest, and there are queues everywhere. Exhausted, anxious and confused by medical terminology they are unable to understand, they become emotionally volatile.
On the other side are harried doctors coping with a deluge of patients every day, working in the same congested and overcrowded conditions for up to 18 hours a day. The outpatients department at AIIMS sees 10,000 people a day.
“Resident doctors have nowhere to sit or rest, no comfortable chair to be seen, they eat bad food, live in shabby hostels and have no holidays. It’s a dreadful life,” said Sharma.
When dealing with an accident victim, a doctor can struggle to treat the patient while dealing with the 20 or 30 relatives and friends who also came along.
When a patient dies, or when relatives are asked to take them to another hospital if, for example, there is a shortage of dialysis machines and a critically ill patient needs the bed - emotions boil over.
“We want the government to provide security in all hospitals and to amend the law so that anyone attacking a doctor is denied bail. We just want to do our work without fear,” said Dr Amarinder Malhi, president of the AIIMS resident doctors’ association.
The strike is not, however, expected to last long. Banerjee finally agreed to talk to doctors in Kolkata on Monday and the federal health minister, Harsh Vardhan, has been sounding sympathetic.