When trainee doctor Aditi Ghosh (not her real name) goes for her evening rounds at a state-run hospital in India’s eastern state of West Bengal, her mother and sister call her phone throughout the night to check on her safety. Ever since a 31-year-old trainee doctor was raped and murdered inside a Kolkata hospital earlier this month, they worry about her safety constantly.
“Many times I am unable to take their call because I am attending to patients. My mother gets really upset and has often asked me to quit the job,” she said, adding that security for trainee doctors had barely improved despite outrage among the medical fraternity.
Anger over the Kolkata doctor’s death led to a week-long national strike by the Indian Medical Association, which officially concluded on Sunday, as well as widespread protests.
Some doctors have remained away from duty, but it is hard to stay away from work for long, especially for those working in private hospitals, medical professionals say.
Resigning from her position before the end of a mandatory three-year-traineeship programme would require Ghosh to pay a sum of 3 million rupees (US$35,800) to compensate for her state-subsidised medical college education, which her family can ill afford.
But her mother is now willing to pay the sum because the 24- to 36-hour work days that she regularly puts in are likely no different from the workload of the trainee doctor whose body was discovered in the seminar room of Kolkata’s R G Kar Medical College.
India’s medical fraternity and civil society groups are up in arms demanding justice over the horrific case. Many doctors say they are feeling increasingly jittery about the poor safety conditions at hospitals, where they are often attacked despite trying to save lives.
A three-judge bench of India’s Supreme Court has taken cognisance of the case on its own and scheduled a hearing for August 20.
Many of the trainee doctors in state-run hospitals, however, say that official concerns about security are superficial and only raised after a grave incident occurs, after which things fall back into their old routine with little regard for their personal safety.
Few state-run hospitals have designated rest areas and doctors have to sleep in makeshift places such as chairs and tables, seminar rooms and even on the floors of operating rooms. Relatives and friends of patients, who might be agitated, are often able to access deep inside hospital premises, doctors say.
“Small incidents happen every day. Only three days ago, the relatives of a patient attacked an orthopaedic surgeon in a Kolkata hospital,” Ghosh said.
Junior doctors are the ones who often handle the initial treatment of patients in the overcrowded hospitals. During the Covid-19 pandemic, hundreds of doctors lost their lives after succumbing to infections while caring for patients, but there is little improvement in working conditions.
Doctors are now demanding duty rooms, proper security and for hospitals to be declared “safe zones”. Millions of people joined doctors last week in a protest march in Kolkata, with the movement spreading to the financial capital of Mumbai in western India.
Ghosh said her friends and colleagues had since been told by local police that they would not be given any security cover if they joined any protest.
The Kolkata case is now beginning to resemble a December 2012 gang rape and murder incident, commonly known as the Nirbhaya case, involving the rape and fatal assault of a 22-year-old physiotherapy intern while she was travelling with her male friend in a private bus.
The incident sparked candlelight marches, protests and clashes with the police, and was a principal cause for the Congress party-led coalition to lose power from India’s federal government. The Trinamool Congress, the ruling party of West Bengal state, is now battling ever-growing protests from across India as well as groups in cities such as London and New York.
“Many people have come together and are protesting. This is a very significant and spontaneous protest. But we have still to see whether the whole thing will shape up as a movement,” said Ritu Sen Chaudhuri, sociology professor at West Bengal State University.
Niket Arora, a consultant doctor at a Kolkata-based private hospital, said there was hardly any security for medical staff. “Incidents of physical violence happen every month or so. Grave issues or incidents happen once or twice a year and verbal arguments happen on a weekly basis,” he said.
Arora said he and his wife, a doctor at a private hospital, had been feeling jittery since the Kolkata case.
“Earlier, I would speak to my wife when she was on her way until she reached the hospital [to make sure of her safety],” he said. “But nowadays, we no longer feel [even the hospital is a safe area].”
Arora had previously worked in a cooperative hospital in western India’s Maharashtra and said it was common for doctors to sleep in narrow and cramped spaces, with some even making do with the floor of the operating theatre.
“In government hospitals, the security of doctors is the least concern for authorities,” he said.
Medical professionals said it was common for a junior doctor to be sleeping in a seminar room like the victim, who had seemingly followed a routine practice.
“The very fact this incident has happened has shaken me up. The doctor was on duty. You are physically exhausted at the end of duty and this is when the doctor was attacked,” said A Kumar, a surgeon who shuttles frequently between India’s capital New Delhi and Rajasthan’s state capital Jaipur.
Kumar said while she did not have major security concerns during her traineeship despite the late hours, there was now an “element of feeling unsafe” should her daughter or sister work similar hours.
“What really saddens my heart is the way the deterioration of society has happened,” Kumar added.
Healthcare professionals say while work conditions in private hospitals are better, a reform of the entire medical system is needed, given that state-run infrastructure still forms the foundation of even private hospitals and those in remote areas.
“How can you ask a lady doctor to sleep in the seminar room?” said Sudhir Kalhan, a senior consultant at Delhi’s prestigious Sir Ganga Ram Hospital, referring to the Kolkata doctor victim. “There has to be security round the clock and when women doctors have to go somewhere, they have to be escorted.”
He cited the example of a pregnant woman doctor at his hospital who is provided with sufficient breaks and nutrition.
Kalhan, who sits on the advisory panel of the National Accreditation Board for Hospitals and Healthcare Providers, which certifies hospitals in India, called for mandatory legislation for the safety and well-being of doctors.
Young trainee doctors were particularly vulnerable to exploitation, he said. “If you work for eight hours, you need a bed and nutritious food, and it should be in a secure place.”
