KOCHI: The recent rape and murder of a second-year postgraduate female trainee at R G Kar Medical College and Hospital in Kolkata area have sent shockwaves across the country, especially among the medical community. The incident has once again sparked a concern about the safety of healthcare professionals.
Reportedly, the victim, working night duty on August 8, was found dead the next day in a seminar hall of the emergency building. After the initial autopsy, the police suggest that circumstantial evidence points to her being murdered before being raped.
A suspect named Sanjay Roy was arrested on August 9. He was brought in for questioning based on the torn remains of a bluetooth earphone retrieved from the crime scene.
Junior doctors across hospitals and medical colleges in Kolkata have called for a halt in services to protest against the alleged lack of safety on hospital premises. In Kerala, doctors, postgraduate medical, and medical teachers have joine d them in solidarity.
The Kerala Government Medical College Teachers’ Association (KGMCTA), spearheading the protests says the safety of women doctors has always been a matter of concern in the state, too.
“It is the responsibility of the respective governments to create a safe working environment so they can work fearlessly,” says a statement released by the association.
It is not the first time safety has become a cause for concern for Indian doctors. A 2015 study by the IMA shows that 75% of the doctors in India had faced some kind of violence at their workplace, with 12% being physical attacks. Kerala doctors too have witnessed a fair share of safety concerns.
It was in 2019 that a woman doctor from General Hospital, Ernakulam, filed a complaint against a senior, accusing him of sexual assault during her house surgency period that year. But it was after the Vandana Das murder case, where a patient stabbed the doctor to death, that a safety issues became a talking point.
A study after the incident revealed that while complaints are often filed, they are frequently withdrawn due to pressure, fear of jeopardising their careers, or concerns related to their age.
According to Dr Rosenara Beegum T, state president of KGMCTA, after the murder of Dr Vandana, an ordinance amending the Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Act, 2012, was passed. The government had also decided to carry out security audit every six months in all hospitals.
Other decisions included several safety measures across hospitals in the state such as setting up police outposts in medical colleges, district hospitals, general hospitals and women’s and children’s hospitals. Full police surveillance was also promised in other hospitals. Establishing closed-circuit cameras in hospitals was another point.
However, the pressing question is whether these measures have been effectively implemented or if gaps remain.
Given the slow pace of progress, the doctor says, the organisation has now resolved to conduct its own security audits and present the findings directly to the government, with support from associations such as the house surgeons association, postgraduate association and student unions.
“The security issues faced by women doctors manifests in various forms — from harassment to physical attacks,” explains Dr Rosenara.
“The priority must be to create a safe environment for all doctors so they can voice their concerns and report issues,” she says.
“In the study, students will identify shortcomings from their perspective, while faculty members can address issues from their end. The KGMCTA will represent the audit. As educators, it is also our responsibility to ensure safety,” she says.
Attack against doctors
According IMA officials, violent cases of patients or bystanders attacking healthcare professionals are mostly reported from intensive care units or post-surgery units. The death of a person would be the most common trigger for such attacks.
In a recent incident, Dr Merry Francis Kallely, a neurosurgery resident at Government Medical College in Thiruvananthapuram was kicked in her abdomen by a bystander. The trigger was the death of a 49-year-old patient with a brain tumour who had undergone surgery by the neurosurgery team. Though Merry wasn’t part of the surgical team, she informed the patient’s husband about the death. In response, the husband reacted violently and kicked her. A complaint was filed and an FIR was registered, but no further action has been taken in the case.
“Some people have attempted to justify his actions by attributing them to emotional turmoil. However, allowing attacks based on emotion would mean that one could justify any form of violence,” says Dr Rosenara.
IMA says, so far, none of the perpetrators have been convicted.
As per the ordinance, in case of any attack, the trial procedures should be completed within one year. It also says that the government with the consent of the High Court would designate a special court in every district for trying cases under the 2012 Act.
“So far, no such changes have been implemented,” says Dr Joseph Benaven, president of the IMA Kerala Chapter. IMA has now designated lawyers in every district to monitor such cases and help the doctors concerned.
“The ordinance is our only saving grace so far,” says Dr Joseph. “However, our urgency was recognised only when a young doctor had to pay the price with her life,” he adds.
The amendment also brought paramedical students and staff, security guards, managerial staff, ambulance drivers and helpers in hospitals within the ambit of the Act. The punishment has been increased to imprisonment for not less than six months to up to a maximum of five years and a fine ranging from `50,000 to `2 lakh.
Any offender who commits serious physical violence against a healthcare worker will be punishable with imprisonment not less than a year up to a maximum of seven years with a fine up to `5 lakh.
Dr Sulphi Noohu, past president of the IMA Kerala Chapter, agrees that the amendment has brought a sudden decrease in violence against doctors.
“Now, the general public and police are vigilant. Doctors are also trained to handle situations. Before, at least one attack would happen a week, leading to 70-100 cases a year. Now, it has come down to three attacks in two-three months,” he says. However, he warns, “a constant follow-up of the system is required or else the situation can go back to how it was earlier.”
Need robust security system
But the ordinance is not enough, say several officials. There are still many additional measures that need to be implemented, especially since the installation of CCTV cameras remains incomplete in many areas.
“Only a few hospitals have these facilities, including police surveillance systems. In peripheral areas, such as Taluk hospitals, these security systems are still lacking,” explains Joseph.
The resident doctors in the hospitals say there has been only a slight improvement. “Thiruvananthapuram medical college lacks hostel facilities within the campus. So 80 per cent of the PG resident doctors stay outside,” says Dr Unni R Pillai, Kerala Medical Post Graduate Association state president.
He adds that the recent cases of suicides occured among those who reside outside, in isolated spaces. “There have been cases of failed attempts as well. If a facility with the campus is provided, there’s a scope of sharing their issues with those in the same profession.”
Lack of duty rooms
The shortage of duty rooms is another key lapse in Kerala hospitals, many say.
“Only a few departments have duty rooms, and those often lack necessities such as attached bathrooms, telephone connections, and systems to communicate with security personnel,” says Dr Sulphi.
According to another doctor, even now there are instances of doctors sleeping in their cars due to a lack of duty rooms. “They consider their cars to be safer,” says the resident, who wants to remain anonymous.