Away from the hustle of outside traffic, the bustle inside a hospital provides a familiar cocoon of safety for its staff. Darkness descends, but the clock does not stop ticking, nor do the duty hours.
“It’s not our second home, it’s our first,” says a lady doctor (unwilling to be named) on the long hours spent there, shuttling between treating patients, explaining tragic developments to patient-family members and taking some time for a delayed meal or much-required rest. That non-stop, imperfect semblance of order has been shaken again, with the violent death of a young doctor at Kolkata’s RG Kar Medical College — bringing protesting doctors, nurses and civil society onto the streets, saying “never again”.
Healthcare practitioners want a Central Act to ensure hospitals are safe zones — something the Union Health Ministry is reportedly not keen on, as State laws are in place. As discussions get underway, more news on violent attacks on doctors and nurses (inside hospitals and outside), get reported from other parts of the country. And these are only the ones that get reported, say doctors, leaving unsaid, those afraid to report incidents.
“Never again” was an anguished call from medical circles when nurse Aruna Shanbaug was brutally raped at Mumbai’s KEM Hospital (in 1973). Years later, she passed away in the same hospital, with the nurses caring for her till her last breath.
Shanbaug came in for mention by the Supreme Court, when it looked into the case involving the RG Kar incident. The Apex Court instituted a task force to make recommendations to ensure safe work places for healthcare practitioners, among other things. Central authorities interacted with medical associations and State administration, including the police, to ensure basic measures are in place (24/7 control room, quick response team, CCTVs, better lighting etc), till the recommendations of the taskforce come in.
Hospital attacks
In a recent letter to the Union Health Minister, the Indian Medical Association (IMA) called for the draft “The Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill, 2019, to incorporate the amendment clauses of Epidemic Diseases Amendment Act, 2020, and Kerala’s Code Grey Protocol, and be proclaimed an Ordinance. Kerala’s Code Grey protocol, along similar lines as systems in developed countries, is an alert if someone is dangerous or combative. Karnataka is reported to be looking at similar systems.
IMA President Dr RV Asokan explains, a Central Act is necessary to ensure that action is uniform and effective.
Countering the argument that other professionals may seek similar special protection, he says, it is wrong to compare them with “people saving lives and working among the people,” when a situation of sudden death may occur and people think it is right to attack the attending medical staff or hospital. Doctors also seek “airport-type” security — but will that make it difficult for ordinary people to access healthcare, as those with power and wealth will continue to wield it?
“The ask is for a safe environment to work in,” says Harjit Singh Bhatti, National President, Progressive Medicos and Scientists Forum. At night, doctors are vulnerable as they are fewer and people (sometimes agitated) walk directly into duty rooms, he says, adding it can be “intimidating”. A Central Act brings in clarity in implementation, he says.
Firm laws, if implemented, will also keep out hangers-on that loiter around hospitals, preying on vulnerable patients by promising appointments with doctors etc, says Singh. Often, local power brokers, claiming political connections, seek immediate attention from the medical staff for an innocuous ailment, when the doctor may be attending to a serious medical case — leading to attacks on doctors, says one who has witnessed a similar incident in Delhi.
Former Maharashtra Director General of Police and former Commissioner of Police (Mumbai) D Sivanandan says, hospital safety is the management’s (Government or private) responsibility — to put in place technology support, quick response teams and undertake police verification of security personnel employed at the institution. This needs to be done periodically, he says, to pick up unreported behavioural aberrations. Some hospitals may undertake home drops, after a late shift, but Sivanandan urges people to be aware, carry a non-lethal weapon (pepper-spray, small knife), keep a quick dial number on the phone, and train in basic skills to react in the face of bodily harm. Changing times require tough measures, agree senior doctors, recalling with sadness a time when “doctors were respected and given right of way”.