“Incidents every day”: India’s doctors complain about lack of security and rest areas after rape and murder case

Some doctors have stayed away from work, but it is difficult to stay away from work for long, especially for those working in private hospitals, medical experts say.

If Ghosh were to resign from her post before the end of the mandatory three-year training program, she would have to pay three million rupees ($35,800) as compensation for her government-subsidized medical studies, which her family can barely afford.

But her mother is now willing to pay the amount because the 24- to 36-hour workdays she regularly does are probably no different from the workload of the aspiring doctor whose body was discovered in the seminar room of the RG Kar Medical College in Calcutta.

India's medical community and civil society groups are outraged and demanding justice for the horrific case. Many doctors say they are increasingly nervous about poor security conditions in hospitals, where they are often attacked despite trying to save lives.

A three-judge bench of the Supreme Court of India has taken independent cognizance of the case and scheduled a hearing for August 20.

However, many residents in state hospitals say that official safety concerns are superficial and are only raised after a serious incident. After that, everything goes back to business as usual without their personal safety being a priority.

Few government hospitals have designated rest areas and doctors have to sleep in makeshift places such as chairs and tables, in seminar rooms or even on the floor of operating theatres. Relatives and friends of patients who may be agitated can often retreat deep into the hospital, doctors say.

“Small incidents happen every day. Just three days ago, a patient's relatives attacked an orthopedic surgeon in a hospital in Kolkata,” Ghosh said.

In overcrowded hospitals, it is often junior doctors who provide initial patient care. During the Covid-19 pandemic, hundreds of doctors lost their lives after succumbing to infections while caring for patients. However, working conditions have hardly improved.

Doctors are now demanding office rooms, adequate security measures and the declaration of hospitals as “safe zones”. Millions of people took part in a protest march by doctors in Calcutta last week, and the movement has now spread to the financial metropolis of Mumbai in western India.

Ghosh said her friends and colleagues have now been informed by local police that they would not be provided with security if they took part in a protest.

The Kolkata case has become similar to a gang rape and murder incident in December 2012, commonly known as the Nirbhaya case. In that case, a 22-year-old physiotherapy intern was raped and assaulted while travelling in a private bus with her boyfriend.

The incident sparked candlelight marches, protests and clashes with police and was one of the main reasons the Congress-led coalition lost power from the Indian federal government. The Trinamool Congress, the ruling party of the state of West Bengal, is now battling growing protests 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 to wait and see whether this develops into a movement,” said Ritu Sen Chaudhuri, a sociology professor at West Bengal State University.

Niket Arora, a consultant doctor at a private hospital in Kolkata, said there was little security for medical staff. “Physical violence occurs about once a month. Serious problems or incidents occur once or twice a year and verbal altercations occur every week,” he said.

Arora said he and his wife, a doctor at a private hospital, had been nervous since the Calcutta incident.

“I used to talk to my wife when she was on her way to the hospital. [to make sure of her safety]”, he said. “But today we no longer feel [even the hospital is a safe area].”

Arora had previously worked at a community hospital in Maharashtra, western India, and said it was common for doctors to sleep in small, cramped rooms; some even had to make do with the floor of the operating theatre.

“In government hospitals, the safety of doctors is the least of the authorities’ concerns,” he said.

According to medical experts, it was common for a resident like the victim to sleep in a seminar room and apparently carry out routine practice.

“The very fact that this incident happened shocked me. The doctor was on duty. At the end of the shift, you are physically exhausted, and then the doctor was attacked,” said A Kumar, a surgeon who frequently commutes between India's capital New Delhi and Rajasthan's capital Jaipur.

Kumar said that despite the late working hours, she had not had any major safety concerns during her training, but now there is an “element of feeling unsafe” if her daughter or sister had to work similar hours.

“What really saddens me is the way society has deteriorated,” Kumar added.

Although working conditions in private hospitals are better, a reform of the entire health system is necessary, say health experts. Private hospitals and those in remote areas still rely on state infrastructure.

“How can you ask a doctor to sleep in the seminar room?” said Sudhir Kalhan, senior doctor at the prestigious Sir Ganga Ram Hospital in Delhi, about the Calcutta doctor's sacrifice. “There must be round-the-clock security and if doctors have to go somewhere, they must be escorted.”

He cited the example of a pregnant doctor in his hospital who was provided with sufficient breaks and food.

Kalhan is a member of the advisory board of the National Accreditation Board for Hospitals and Healthcare Providers, which certifies hospitals in India. He called for mandatory laws on the safety and well-being of doctors.

Young medical students are particularly vulnerable to exploitation, he said. “Anyone who works eight hours needs a bed and nutritious food, and that should be in a safe place.”