A Chennai doctor, Simon Hercules, died of COVID-19 on April 19. He was denied even basic dignity at the time of his death as a mob attacked his friends and family with sticks and rods when they were transporting his body to a burial ground.
This incident has, yet again, cast a worrying spotlight on the health and safety of our frontline soldiers in the collective fight against COVID-19. How do we, as a people, go from clapping hands on our balconies and rooftops as a gesture of gratitude for healthcare workers to heaping the kind of abuse we witnessed in Indore, Moradabad and Bengaluru?
An eminent Noida-based doctor told me that doctors have been subjected to attacks for quite some time in our country. He contracted COVID-19 while treating an asymptomatic patient, and is currently in self-isolation in a hospital, separated from his family. He said the news of him testing positive for coronavirus had spread like wildfire. His driver, who had not come for work since the lockdown on March 25, was not permitted by his neighbours to enter his house unless he produced a negative coronavirus test certificate.
According to a 2017 study by the Indian Medical Association, over 75 per cent of doctors have faced violence at work and 56.5 per cent had thought of hiring security at the place of their practice.
Nineteen states in India have passed Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage or Loss of Property) legislations in the past decade. But most complaints were not registered by the police.
Less than a year ago, doctors and medical professionals in Kolkata launched a massive protest after a doctor at a government medical hospital in the city was beaten and left with a fractured skull over the death of a 75-year-old patient. This sparked nationwide protests over violence against doctors, leading to a Healthcare Service Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019, being proposed by the government.
In light of such recent attacks on doctors and healthcare workers across the country, the central government, on April 22, introduced an ordinance to amend the Epidemic Diseases Act, 1897, to make attacks on doctors and healthcare workers a cognisable, non-bailable offence: The offence shall be punishable with imprisonment ranging from three months to five years, and penalty ranging from Rs 50,000 to 2 lakh. In cases of very serious attacks, the imprisonment may be for a minimum period of six months, and a maximum of seven years, with the penalty ranging from Rs 1 lakh to Rs 5 lakh.
The doctor’s Hippocratic Oath is, historically, taken by physicians who swear to uphold the highest ethical standards in the practice of medicine. If doctors, out of their strong sense of personal duty, are willing to make huge personal sacrifices by risking their health, and by living apart from their families, then why can’t we ordinary citizens treat them with the dignity that everybody deserves?
Consider the fact that the World Health Organisation (WHO) has framed guidelines on the rational use of impermeable suits, protective shields and goggles — generally referred to as personal protective equipment (PPE). The donning and doffing of PPE is a cumbersome process for which a strict protocol is mandated. A doctor at Lok Nayak Jai Prakash Narayan hospital told me that, “once you zip up you are sealed in for six to seven hours. You pass dark urine because you cannot drink water. Because of the impermeable fabric, it becomes suffocating and your sweat does not evaporate”. A junior resident at Ram Manohar Lohia hospital, Delhi, narrated how his colleague fainted due to dehydration while wearing the PPE.
Significantly, the PPE is for one-time-use: Due to shortages in supply, the healthcare workers fear substandard products have flooded the market. A well-known doctor from a prominent private diagnostic laboratory in Delhi said that the PPEs provided are often found torn and damaged.
Apart from the constant risk of pathogen exposure, medicos face continued psychological distress. And despite great personal sacrifices made by our doctors, nurses and healthcare providers, landlords have dispossessed medicos from tenanted premises since the COVID-19 pandemic began.
The Supreme Court on April 8 directed that testing of COVID-19 in private labs be made free for the economically weaker sections of society who are unable to afford the fee. Later, on April 13, it further clarified that the benefit of free testing can be availed only by those eligible under the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana, as implemented by the government, and any other category of economically weaker sections in society, as notified by the government for free testing.
The doctor associated with the same prominent private lab in Delhi, mentioned above, pointed out that though there’s a perception that Rs 4,500 for a test is expensive, the actual cost to the labs exceeds that amount by a much greater margin. If all overhead costs are factored in, the lab will incur serious losses. Despite all this, when healthcare workers from the lab visit patients and are “frequently subjected to physical violence”, it is deeply demoralising.
Such interactions with doctors reveal some stark contradictions within our society. We deify doctors as life-givers on the one hand but don’t refrain from attacking them in times of desperation, on the other hand. We repose our lives in them as though they are god, but we forget that doctors are also human, and fallible.
This article was first published in the print by the title ‘Let’s help the healers’ on Aprli 29. Kapila is a Delhi based lawyer and writer