Opinion: Ek doctor ki maut, and what public protests around it must not miss

Public anger over the brutal killing of a doctor on duty in Kolkata must go beyond momentary outrage; it’s time to press for long-term reforms.

As I write this, there is a rapid and continuous swell in protests and rallies being organised to demand justice for the 31-year-old junior doctor brutally raped and murdered in Kolkata’s R G Kar Medical College and Hospital. Also rising in numbers and volume are the indignant voices demanding answers from the state of West Bengal on the many inconsistencies and procedural lapses following the incident.

The crime committed during the wee hours of August 9th invokes memories of another similar incident on the streets of the national capital in December 2012, now infamous as the ‘Nirbhaya incident’. But several factors make the current crime even more shocking and egregious in public eyes.

One, the fact that this happened while the female doctor was on duty at her workplace, which also happens to be one of the oldest and largest hospitals in the metro city. Where are women safe then?

Second, and perhaps more importantly, public anger is boiling over at the shoddy and suspicious handling of affairs following the discovery of the body. Many of the developments since point to the likely complicity of people within the hospital machinery, and poorly disguised attempts by the state itself to hush things up.

R G Kar Hospital Rape & Murder: Some facts to know

On August 9th, the semi-nude body of a female post graduate trainee doctor on duty was recovered from the seminar room of the state-run R G Kar Medical College and Hospital. The body bore clear signs of rape and brutalisation.

Piecing together conversations with her colleagues, it emerges that she had dinner with her juniors at around 2 am, after which she went to the seminar room to rest for a while, since there is no separate on-call room for doctors on duty to rest. 

Autopsy reports reveal that she was raped and killed here some time between 3 am and 5 am.

A civic volunteer with the Kolkata Police has been arrested based on CCTV clips around the scene of crime, even though there was no CCTV inside the seminar room. The arrested has reportedly admitted to the crime, though there is widespread suspicion that there are others involved.

The family was initially told that their daughter had committed suicide, and alleges that they were made to wait hours before they could see their daughter’s body. 

Neither the Principal nor the hospital superintendent took any initiative to file a police complaint for the obvious killing, which happened inside their hospital premises. 

While the Principal resigned under pressure, he was immediately reinstated by the government at another state hospital, the Calcutta National Medical College. 

The Calcutta High Court came down heavily against the police and hospital administration and directed the Principal to go on long leave. 

Upon the Court’s orders, the investigation was transferred to the Central Bureau of Investigation (CBI) with immediate effect.

There seems to be growing consensus among large sections of civil society in Bengal that this cannot be treated as an apolitical incident and that the ruling Trinamool Congress at the helm of the state must own responsibility for what has happened. Which is certainly a legitimate demand given the circumstances of the case, but which is also increasingly defining and characterising the tone and direction of public protests in the state and elsewhere.

And while the personal is indisputably political in this case, the outrage of the moment runs the risk of sidelining some very grave systemic issues within the medical system at large. These are issues that must be addressed if our hospitals are to ensure safety for medicos and patients alike. Clearly, that is something which the system has historically failed to ensure.

Hospitals as vulnerable sites

Public memory is notoriously short-lived and not many perhaps remember Aruna Shanbaug. The nurse spent 42 years in a vegetative state after being brutally raped in 1973 by a ward attendant in the Mumbai hospital where she worked. But one need not even go back that far.

Let us look at the last few months alone.

In February this year, a young female patient undergoing treatment in the ICU of a hospital in Alwar, Rajasthan was sedated and raped.

On May 19th, a female doctor at AIIMS Rishikesh was sexually harassed by a nursing officer.

In July, police arrested a male nurse on charges of sexually assaulting a foreign national from Kazakhstan undergoing treatment at a Gurugram hospital. In July again, another female patient was allegedly raped by the director of a private hospital in Pratapgarh, UP.

The reason for listing these cases is just to keep ourselves from losing sight of the pressing need for reforms within hospitals, in order to make these the safe spaces that they should be.

Doctors’ protests in the past

The constant risks and threats to the life and limb of trainee doctors is something that has come up several times earlier. Doctors are often at the receiving end of public ire leading to physical and verbal abuse, being the first interface between patients’ kin and hospital authorities.  

In 2019, doctors protested for a safe work environment at Goa Medical College. Pic: Teena Kurian, CC BY-SA 4.0, via Wikimedia Commons

In 2019, junior doctors across the country had gone on strike after family members of a deceased patient assaulted a resident doctor at Kolkata’s Nilratan Sarkar Medical College and Hospital, leaving him grievously injured. Then, as now, the state, police and hospital management had come under fire for failing to protect doctors and take action against the perpetrators.


Read more: Why 3.5 lakh doctors in the country are planning to strike work this Monday (2019)


But in the years that have followed, nothing much has changed. There are headlines every now and then of doctors being assaulted at their workplaces.

Basic facilities missing

The lack of bare minimum facilities for staff and doctors and a general security protocol must also come under sharp scrutiny. Various medical professionals in the aftermath of the Kolkata incident have underlined how most hospitals, and government medical colleges in particular, have no designated resting areas for on-duty doctors. This, even when they have to work unearthly hours and long shifts at a stretch without any breaks. Worse, there are no separate washroom facilities for female doctors and staff.

A secure, monitored resting room could have so easily prevented the Kolkata tragedy.

There is unregulated access for any and all across wards and offices at government hospitals. Security staff are rare to come by. Not just hospital employees, but ex-employees, people from other departments and sometimes random strangers can walk in anywhere, even the female and maternity wards, without a question asked. In the present case too, the free, unquestioned movement of a civic volunteer in and out of hospital premises at 4 am in the morning, without any apparent reason, leaves a lot of questions to be answered.

Across much of the medical fraternity, therefore, the overarching question seems to be why, in the last 60 years, no attempts have been made towards basic structural reforms that would make workplaces secure and comfortable for doctors and staff.

Demands from Indian Medical Association presented to Health Minister J P Nadda

1. Hospitals across the country should be declared safe zones and law should define the entitlement of these safe zones
2. All major Government hospitals should have police camps and adequate security personnel
3. Similar security arrangements should be made mandatory in large private hospitals
4. CCTV cameras in vulnerable points should be made compulsory
5. A central legislation must be enacted to effectively stop violence in all forms against doctors and staff working in medical institutions.

Source: The Hindu

Treading a fine line

The state must undeniably answer for its consistent failure to ensure safety of women. The behaviour of the higher hospital administration has been suspect, to say the least. And the government’s sympathetic stance towards officials who are inefficient, if not actually involved in the crime, deserves public condemnation.

However, even as crowds demand justice for the victim and for heads to roll, it is critical not to lose sight of systemic failures that have persisted for decades in medical establishments. As a people, we have a delicate and difficult balance to achieve today: Indeed, press for retribution for every person culpable in this heinous incident; but in the frenzy of the moment, do not cloud out the demands for long term, sustained action that will make hospitals safe spaces for both patients and personnel. 

Hold authorities and states equally accountable for long overdue systemic and structural changes. In its absence, one can never be sure that a similar incident will not re-occur somewhere else, as soon as the current protests and marches lose steam. 

Also read:

Comments:

  1. Joy Sen says:

    Very well articulated. Very candid and brave too. Without clarity and bravery, truth behind the darkest of hours cannot be revealed.
    For your article, it matters for us, for citizens like us. 👍

  2. Anita Ganguli says:

    Absolutely

  3. Mohan Phani says:

    Satarupa, you have hit the hammer on the head. Long term changes in hospital campus security arrangement is absolutely required. Try getting into any good private hospital and you will understand what are the requirements that is being talked about here.
    It is taken for granted that cctv cameras should be everywhere but I am worried about the maintenance and monitoring of them in a government organisation. Such work must be contracted out to private companies with assured payment processes, else this will also be a failure.
    That we are all angry and want justice is without question. But our memories are short and protests are short lived. It is media who have follow-up and make sure something good happens and we do not have to experience another untoward incidence ever.

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