violence – Dr. Vidya Hattangadi

Incidents of violence against doctors is growing in India

Dr Vidya Hattangadi — Mon, 13 Jun 2022 00:01:02 +0000

Incidents of violence against doctors is growing in India

Recently, in March 2022 a gynaecologist Dr. Archana Sharma aged 42, allegedly committed suicide by hanging herself, after an FIR was filed against her under section 302 of the IPC (murder) for the alleged death of a pregnant woman whom she was treating. A suicide note was recovered from the scene, in which the doctor wrote that the patient had died due to profuse bleeding in a caesarean procedure. The local MLA created a ruckus and influenced the police to charge sheet the doctor with murder. The patient died due to postpartum haemorrhage which means heavy bleeding from a mother’s uterus after childbirth. Postpartum haemorrhage is profuse bleeding than normal after the birth of a baby. About one in hundred to five in hundred women have postpartum haemorrhage. It is more likely with a caesarean birth. The saddest part is Dr. Sharma herself mothered two very young kids. She was a sincere doctor who was also a gold medallist.

Though every doctor gives his/her best to the patient they cannot avert surgical accidents. ‘No physician, however conscientious or careful, can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, blackmail or suit for damages….’ This famous quote is written almost 140 years back in a reputed Medical Journal from the USA, which is an eye-opener and also prophetic. In the last two decades, reports of violence against doctors, sometimes leading to serious hurt or murder, are making headlines across the world. Numerous such incidences have been reported even in India. Most of such incidents are not being highlighted adequately. Though of late electronic media highlights most of the news items but it needs to be given deeper assessment and attention.

Generally when a patient dies in a hospital the patient’s relatives due to the grief and anger target the treating doctor; they hold the doctor responsible. The World Bank has stated in one of its recent reports that up to 38% of health workers suffer violence during their careers. And a recent study by Indian Medical Association has stated that nearly 80% of doctors face violence in their workplace. Amid such circumstances, it is important that the purpose behind such acts of violence must be brought to light. There is no doubt that an assault on a doctor is intolerable in any civilized society.

According to an Indian legal firm’s report, kith and kin of patients have committed nearly 70 per cent of violence; nearly 50 per cent of such violence has been reported from intensive care units (“ICUs”) or post-surgery. Another biggest fact is the peak hours and the transfer of critical patients to other hospitals are most susceptible to violence.

Due to ignorance, people assume that any and every doctor has complete control over the biology of the patient, and therefore assaults them out of grief and anger when something goes wrong. Doctors are blamed for a variety of things, ranging from an incorrect diagnosis to faulty equipment in the laboratory, operation theatre, diagnostic equipment etc. It is hard for them to come to terms with the fact that, even when problems occur, the doctor carries out their work with the utmost sincerity. Each day, healthcare professionals across the country face threats, intimidation and assaults. While some cases are reported, several go unheard. When attacks on the medical fraternity happen, their morale takes a beating. They experience dejection as well as helplessness.

The doctor to patient ratio in India in 2020 was 1:1456. The WHO’s minimum recommended ratio is one doctor to between 400 – 600. India faces a shortage of an estimated 600,000 doctors and 2 million nurses.

The biggest fact is that healthcare professionals are also individual humans like us. Most of them suffer from insomnia, loneliness, sleep disorder, and mental depression as a result of the workload and related stress. They experience anxiety attacks as well as frustration because every case is different and presents a variety of challenges. Doctors and nurses face hardly enjoy privacy.

Glaring facts about the medical practice in India

In government hospitals, supply shortages are perennial in terms of availability of drugs including life-saving drugs, diagnostic equipment and their conditions and shortage of staff. These lead to additional costs as the patients go to private hospitals and diagnostic centres for getting the services. The staff shortage is never-ending which often shifts the burden of nursing on patients’ families. Patients and their families often complain about being constantly asked to pay for various facilities. Often, relatives do not have adequate amenities to rest and eat in public health establishments. This situation leads to irritability and contributes to conflict situations. Rising costs of healthcare have often led to dreadful health expenditures.

Young doctors lack empathy in clinical training. For instance, important aspects of clinical treatment such as explaining diagnosis, prognosis and duration of treatment and breaking bad news are not given enough attention in medical education and training which in fact is so necessary. Physicians with well-developed soft skills tend to form better relationships with their patients and staff which can enhance the flow of information and lead to better outcomes.

Doctors, especially in public health establishments, spend very little time with the patient due to overcrowded wards and OPDs, they face a shortage of time and facilities; in some hospitals sanitation facilities, canteen facilities and ventilation are awful. These shortages hamper the development of a meaningful doctor-patient relationship. Coupled with capacity constraints and high out-of-pocket expenditure patients’ families are not in a position to afford, such situations snowball into violence.

I conclude this article by saying that people must realise that doctors too are human. They are also somebody’s daughter, son, brother, sister, father and mother. Respect is the most important factor in the doctor-patient relationship. It helps to create a healthy atmosphere in which patients feel cared for as individuals, and the doctor also feels valued. Let us not overlook the fact that despite limited resources, Indian doctors provide one of the highest standards of care in the world this is according to the Harvard & Bloomberg research.

Are we really an independent country?

Dr Vidya Hattangadi — Mon, 13 Aug 2018 01:01:29 +0000

The 71^st Independence day will be celebrated this week, a thought is crossing my mind that is it enough being a constitutionally independent country? Are we living in a safe, liberated, clean, corruption free country? We freed ourselves from the clutches of British rule, but got into clutches ruthless, corrupt politicians who believe in dividing the country on the basis of caste and religion and are keeping us busy with blame game. Is 71 years a small time? Are we satisfied with our country’s progress?

Can we call it independence, when women and children don’t feel safe? They are not free from the violence. Do our students have the freedom to select the career they want? We have the reservation coming in way of admission in the educational institutions. The caste discrimination is ever increasing. We just don’t want to let go the discrimination of caste, because it helps the vote bank politics. So what if it creates communal tensions. In past 71 years we have failed to get freedom from corruption. We have politicians with criminal records, unqualified, non-deserving people who don’t deserve to sit in the parliament and make decisions for us. In 71 years we have not been able to solve poverty and unemployment problems. So again my question is 71 years is old or young? Are we independent?

Where independence mean self-government, we the people in India have to pay bribe to get a basic driving license, birth certificate/death certificate, marriage certificate, bribe the to a traffic police, bribe the clerk/peon in govt. office, to even get gas connection. Is this freedom?

Violence against women is increasing day by day. Rape, female feticide, acid attacks, domestic violence, dowry deaths, honor killings, forced abortion, human trafficking, sexual violence, forced prostitution and the list goes on and on. Sadly, the percentages of these crimes are increasing every day. According to an international report, every three minutes a woman is subjected to some kind of violence in our country.

The children are also not safe; they are not free from violence inside their homes, schools, streets, parks, school bus, school toilets. They go to schools to shape their future, and many of them are becoming a target of violence. We have so many cases, where teachers, principals, peons, bus drives, cleaners and washers have harassed and raped young kids. They are easy prey for human trafficking. Government data reveals that children are subjected to gross abuses in the very shelter homes that are made to protect them. This is so pathetic, its shame on us. So are we independent?

Corruption is on increase day after day. It has been adversely affecting our economy. We are immune to paying bribes; we have accepted it as a system. The judiciary, financial institutions, government offices, schools, colleges, hospitals, even temples everywhere we pay bribe to get our work done. The amount of scams is increasing. Forget the Public Sector banks; the private banks are also not clean. Major scams such as 2G spectrum scam of 1760 billion, 2010 common wealth games scam (700 billion), the Adarsh housing society scam, the mining scandal in Karnataka, cash for vote scam and many more. Wakf board land scam, AugstaWestland arms deal, Telagi scam, Coalgate scam, Fodder scam, Satyma scam, NIrav Modi scam…the list is big. The financial institutions and criminals are hands in glove. People have lost corers’ of money – their hard earned money in numerous scams.

Who is real minority? After 71 years each of independence, number of communities is marching for reservation as minority. While only 3% to 4% of the total population of India pays taxes, they are completely ignored by the Government. They are in fact minority. And the taxpayers are harassed the most.

We are not free from the illicit use of power of casteism, communal violence. National Integration is essential for any nation with socio-cultural, religious, linguistic and geographical diversities. Our country requires it and it is necessary. But a series of religious, communal violence in recent years just goes on to show we are not free from it.

To sum it up: after seven decades of independence that we achieved from clutches of Britishers, we are yet to experience freedom from clutches of poverty, unemployment, illiteracy, communal violence, corruption, vulnerability of women and children, pollution, perilous infrastructure, malnutrition, low standards of education, low standards of health care, inferior sanitation.

Why are we called a developing nation after 71 years? What is it that is holding us back from being the super power? We have the second largest world’s population. The question gets even more intricate when we start thinking about deeper meaning of independence.

Why there is a need for Zero Tolerance for crime against women

Dr Vidya Hattangadi — Wed, 11 Jun 2014 11:31:51 +0000

Violence against women in India is an issue rooted in hypocrite societal norms and women’s economic dependence. Biased practices are underlined by laws favoring men. Inadequate policing and sluggish judicial practices often deny female victims proper protection and justice. Though we also see female participation in public life and laws have been amended, India still has a long way to go to make Indian women equal citizens in their own country.

A zero-tolerance policy imposes automatic punishment for violating of a stated rule, with the intention of eliminating undesirable conduct in a society. Zero-tolerance policies forbid persons in positions of authority from exercising discretion or changing punishments to fit the circumstances subjectively; they are required to impose a pre-determined punishment regardless of individual culpability, justifying circumstances, or history. This pre-determined punishment need not be severe, but it is always meted out.

Zero-tolerance policies are studied in criminology and are common in formal and informal policing systems around the world. The policies also appear in informal situations where there may be sexual harassment or Internet misuse in educational and workplace environments.

Today when Asia’s third-largest economy is now in its longest slump for a quarter century, and has to face too many odds due to lethargic decision making culture, I think zero tolerance is the need of hour. Well, the new Narendra Modi Government’s pledge of zero-tolerance for violence against women, and requisite steps to strengthen the criminal justice system for its effective implementation is applauded.

India seems to have been plagued in the recent past with loads of horrifying incidents such as sexual assault and molestation; frequent news of gang rapes are a shame on our law and order. Women in this country are shaken to the core. Let’s stop making baseless arguments regarding our culture and ethos. Another issue regarding the size and diversity of our country is being dragged a bit too much.

Violence against women comes in variety of forms such as domestic violence, dowry deaths, acid attacks, honor killings, rape, abduction, and cruelty by husbands and in-laws. One of the key challenges is the dowry practice; the bride’s family giving gifts of cash and kind to the groom and his family. Many times the groom’s family ill-treats the bride if such demands are not met with. To protect women against this threat the Indian government had passed the Dowry Prohibition Act and the Protection of Women from Domestic Violence Act and cruelty under Sec 498A of the Indian Penal Code. In 2012, according to the National Crime Records Bureau (NCRB), dowry deaths – or murders of women by the groom or in-laws because of unmet high dowry expectations – constituted 3.4% of all crimes against women. In other words, last year in India on average 22 women were killed per day because their families could not meet dowry demands.

Legal experts point out that many rapes go unreported. Due to “family’s honor” many complaint files are withdrawn and in many cases the police do not give a fair hearing. Medical evidence is often unrecorded making it easy for offenders to pass scot free under prevailing laws. India’s societal changes have been engineered by women getting access to education and jobs. However on the ground regressive notions and crimes continue to halt women from getting out of their homes and joining the work force.

Many activists argue that the rising number of women parliamentarians and the presence of many high profile women in India’s political parties and public offices will act as only ornamental if effective laws and mindsets are not altered to safeguard ordinary women.

To prevent the crime rate further speedier delivery of justice will serve as an effective solution. From 1953 to 2011, rape cases all over the country went up by 873 per cent, the only way left is to deal with the problem efficiently, expeditiously and in a specific time frame. To drive home a strong message that the judiciary will respond seriously against all such crimes. Let’s hope for the best to happen with the announcement by Narendra Modi Government to strengthen the criminal justice system for its effective implementation.

“One in three women may suffer from abuse and violence in her lifetime. This is an appalling human rights violation, yet it remains one of the invisible and under-recognized pandemics of our time.” – Nicole Kidman