Hindustan Times (Patiala)

Heroes in white coats

We complain about the state of government hospitals. Doctors don’t show up or turn up late. Medicines are in short supply and diagnostic machines don’t work. Doctors aren’t to blame for lousy infrastruc­ture. The least they need is a guarantee of personal

- NAMITA BHANDARE

Here’s what they don’t teach you in medical school: Self-defence. Perhaps they should. After all patients, or more accurately their relatives, are known to beat up doctors who bear bad news.

Think I’m exaggerati­ng? Watch the YouTube video of the assault that landed Dr Rohan Mhamunkar of Dhule in the ICU. The doctor’s suggestion that a patient with severe head injuries should be taken to another hospital since his didn’t have a neurologis­t, provoked an attack by some 25 relatives. As the doctor falls back on an empty bed, you can see one of them repeatedly stomp on him.

The Dhule attack is one of four in the span of a week in Maharashtr­a. In Nashik, three doctors and a nurse were assaulted after a patient they brought in died of swine flu.

At Sion Hospital, Mumbai, relatives of a patient who died of chronic kidney failure beat up a first-year resident. The most recent attack on a senior woman pediatrici­an, also at Sion Hospital, took place after 4,000 resident doctors had already gone on strike, ironically, to demand protection.

“We’re only asking for safety measures,” says Dr Parthiv Sanghvi, secretary of the Indian Medical Associatio­n’s Maharashtr­a chapter. Specifical­ly, the striking doctors want security, action against the culprits and restrictio­n on the number of relatives accompanyi­ng patients.

“Exemplary punishment,” adds Parikshit Tank, a doctor in private practice who is supporting his colleagues in government hospitals, “Would be a strong deterrent.” Right now, of the 53 cases of assaults on doctors in the past three years in Maharashtr­a, there have been zero conviction­s. “The message is, assault a doctor and get bail,” says Tank.

We constantly complain about the state of government hospitals, often with good reason. Doctors don’t show up or turn up late. Appointmen­ts can take forever. Medicines are in short supply, diagnostic machines don’t work and unethical practices, including the demand for bribes by hospital staff are why 67% of people said government hospitals are corrupt in a 2007 Mint survey. Yet, the view from the other side, while seldom seen, is equally compelling. Doctors aren’t to blame for lousy infrastruc­ture. They work despite it. With one doctor for every 2,000 patients (the World Health Organisati­on recommends one for every 1,000), our doctor-patient ratio is worse than Algeria’s. Doctors can be superheroe­s in white coats. Last year they wrote about their working conditions — long shifts, short sleep, bad food — to the state Human Rights Commission. Shifts in a stressful job can stretch to 48 straight hours. But when you’re short of five lakh doctors in the country, what choice do you have?

The AIIMS outpatient department sees 10,000 patients a day. Some, particular­ly if they’re from outside Delhi, could be accompanie­d by five-six relatives to help with appointmen­ts, medicines and food.

Overworked doctors simply don’t have the time to allay patient anxieties. Patients feel doctors are rude and brusque. Now, a fraught situation, with nerves on edge on both sides can lead to, heated exchanges, or worse, even in private hospitals.

Increased security including CCTVs could help. So could the new health policy, announced last week, that raises the health budget from a miserly 1.2% of the GDP to 2.5% -- still far below the global average of 5.4%. If some of those funds go to infrastruc­ture and to additional primary hospitals and health centres, it might ease the burden. But none of this will happen overnight. Until then, the least we can do is assure our doctors that we will not tolerate any sort of assault against them. In Dhule, there are reports that Dr Mhamunkar might lose sight in one eye. Surely, no doctor signs up for this.

Namita Bhandare writes on social issues and gender. She has edited books and features in a documentar­y on sexual violence @namitabhan­dare

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