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Who Will Heal The Healers? A Cure For Violence Against Doctors

03/02/2016 8:18 AM IST | Updated 15/07/2016 8:26 AM IST
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'Female doctor sitting in hospital corridor, side view'

Attending to patients who had arrived following a road traffic accident late at night, Dr Abhishek Kumar correctly identified that one seemed worse than the others. So he did the sensible thing, stabilising the patient before sending him for a diagnostic scan to rule out any hidden injuries. Unfortunately, the patient took a turn for the worse during the scan and passed away.

And just like that, the good Samaritans who brought the patient to the hospital turned from Dr Jekyll to Mr Hyde, mushrooming from five to 50. Abhishek's female colleague was rescued and locked up inside the operation theatre before the mob could get their claws on her. Abhishek was not so lucky. Brutalised, he lay in the ICU for over a fortnight with severe internal injuries, requiring dialysis at the age of 31.

When you resort to mob violence, more doctors become afraid to take up similar cases even though they are capable of saving the patient.

The same nation which rightfully stood up and said enough is enough when a group of six brutally raped a woman aboard a moving bus chose to ignore Abhishek's lynching. Just as it has been ignoring the consistently increasing incidence of violence (and even murder) of doctors over the last few years.

I wish I knew which word would trigger some emotion in you to care for him. Is it Modi or Rahul, Hindu or Muslim? Intolerance or beef, perhaps? Unfortunately, Abhishek's profession deemed him unworthy of even your basic sympathy. The doctor probably did something to deserve it, right?

Increasing medical expenses and patient expectations, a woefully understaffed medical system struggling to find the right balance between quantity and quality of care, poor health awareness, wavering ethical choices, loss of trust and of course, a readiness for violence against easy targets. These are the key ingredients that led to the breakdown of the hallowed doctor-patient trust.

Unlike us, China at least chose to acknowledge it -- the first step towards a course correction --- after nearly 40% of their health personnel admitted they planned to quit the medical field for fear of their lives.

We too need to talk about this, India. Now.

To the general public: End the cycle

When you resort to mob violence, more doctors become afraid to take up similar cases even though they are capable of saving the patient. Fear of you may prevent them from saving lives. Referrals to higher centres waste precious time and financial resources and still do not ensure a positive outcome.

Your anger at an untimely death and high costs forces you to lash out against what you see as a doctor who wronged you and a new cycle of violence and mistrust is born.

If you want more money spent on your own health by the government, demand it from your elected lawmakers instead of obsessing over about temples and reservations.

You need to end the cycle. There are black sheep in our fraternity whose actions leave us all ashamed. But violence is never the solution.

And yes, affordable healthcare is your right.

If you want more money spent on your own health by the government, demand it from your elected lawmakers instead of obsessing over about temples and reservations.

There are less than 10 documented countries with a smaller doctor: patient ratio than India and a handful who spend less (% of GDP) than us. And this is supposed to be one of the most influential countries in the world. How can you hope to progress while leaving behind the healthcare aspect?

2. To my fellow doctors: Speak out

Give up this "ostrich in the sand" attitude. Just because it does not happen in your city today doesn't mean you ignore it. Each act of violence that goes unpunished emboldens a new set of violent goons to carry it out in a new location.

Seniors, stand up for your juniors. The new generation of doctors need your support and voices now. Be heard.

Above all else, my fellow doctors, I need you to not allow the healer within you to grow cynical and join the dark side. Some have broken the long standing trust with their deeds. You can heal it with yours. For that is what you are -- healers.

3. To the media: It's time you step in

I know our numbers are too few to be ratings-worthy but I do hope you introspect. Every time you ignore an act of violence against us while magically appearing to showcase the harm done by doctors on strike protesting this violence, the disillusionment grows. Yes, we are flawed and will be found wanting at times but we are not killers.

Your absence is a key link in this chain of violence. We need you to step in.

4. To the hospitals: Take responsibility

By deliberately suppressing incidents and asking the doctor to suffer the brutality silently for the sake of your reputation, you come off no better than an archaic khap panchayat that forces the rape victim to accept 5000 rupees and a billy goat as compensation for unimaginable trauma.

My fellow doctors, I need you to not allow the healer within you to grow cynical and join the dark side.

Force action from the police instead of agreeing to compromises with violent criminals.

You needed us to work beyond our shifts on so many nights to make up the case load. We need you now to provide us with proper security and stand by us so that we can confidently give our best for you.

5. To the medical authorities: Don't do further harm

Your silence remains deafening to the ears of every doctor here in India, rest assured.

Even if you refuse to stand by your doctors, that's fine. But please do not do any more damage.

Cutting an abysmal healthcare funding by a further 20% with no justification whatsoever prompted even the Lancet to wonder what you were up to. Putting millions at risk by reducing aid to illnesses like tuberculosis and AIDS is going to be simply disastrous in the long run.

If you can, stand up now. Fight not for us but for the health of the country that is in your hands.

Undo the damage. Recall the three words that every doctor remembers in some form before he or she takes on a difficult patient. They apply to you more than ever now.

"Primum non nocere."

First, do no harm.

Today, doctors from the two most populated countries in the world sit disillusioned in the face of increasing mob violence.

We have reached a stage where the judicial hanging of a convicted terrorist is debated across all forms of media but the criminal lynching of doctors cannot elicit even a feigned paragraph of sympathy.

India cannot afford the luxury of losing either the skills or the willingness of present day doctors to this violence.

Already it has started to take a toll on the medical community in China with over 76% of doctors openly stating they would not want their children to join the profession.

India - with half the doctor:patient ratio of China - cannot afford the luxury of losing either the skills or the willingness of present day doctors to this violence. We cannot afford to have more Dr Abhisheks lying in the ICU wondering what they did wrong.

You need to join the dots and identify the impending train wreck that is coming so that we can change course and avert this disaster.

You need to introspect, India.

Before another healer gets scarred for life.

The unabridged, angrier version of this article can be found at Godyears.

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Pranab Mukherjee

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