Doctors can be super-heroes 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?
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.
Doctors can be super-heroes 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?
Resident doctors at KEM hospital protest at KEM hospital, Mumbai, March 23, 2017(Bhushan Koyande/HT)
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 super-heroes 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. The old idea of ‘respect’ for the doctor is gone, says former AIIMS professor of medicine Anoop Misra, now in private practice. Thirty years ago when he was a resident, physical assault was simply unheard of. 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.
When a significant proportion of women say they want to stay home, the message is clear: Gender stereotypes about unpaid care work and a woman’s place in it remain prevalent
A woman makes fresh spices for her family of seven at a slum, Noida, Uttar Pradesh, India(Burhaan Kinu/HT)
Fifty-nine years ago when my mother, a full-fledged lawyer with a fledging practice, got married, she declared that she would no longer work. In her worldview, careers and marriages were simply incompatible.
Just how much has changed — or not — became clear with a new survey that finds that while many women want both careers and time at home, a significant number only want to stay home.
The first survey of this magnitude — some 149,000 men and women across 142 countries — looks at attitudes to work. The largest numbers (41%), want a paying job and time at home, finds the study by the International Labor Organization and Gallup. But only 29% of women globally want full-time paid jobs while 27% want to stay home.
The findings tie in with India where 30% want paid jobs. But the numbers who want to stay home are significantly higher at 41%, with only 22% who want both.
The survey comes at a time when India’s female labour force participation has been steadily declining from 35% in 1990 to 27% in 2014. Ironically, the number of girls with more than 10 years of schooling has been steadily increasing from 22.3% in 2005 to 35.7% in 2015.
The statistics are grim. Among G20 nations, we hover above Saudi Arabia with only 27% of women aged 15 and older in the workforce, finds an International Monetary Fund paper. And 25 million women have left the workforce in the past decade finds data analysis website IndiaSpend.
You would imagine that unprecedented economic growth post liberalisation, not to mention greater educational attainment, would result in more women in paid jobs. In fact, the opposite has happened.
It’s a mystery that has vexed economists and policywalas, and while there’s no definitive answer, there are several theories.
In October, a team of Harvard faculty researchers questioned single, rural women aged between 18 and 25 to find that family and marriage were cited as the biggest constraints to paid work.
Balancing paid work with family life is a challenge all women face. But only in India, found a survey, do women spend 298 minutes a day cooking, cleaning and looking after kids and parents, compared to a pathetic 19 minutes a day spent on similar work by Indian men.
When the burden of unpaid care work falls so disproportionately on women, is there any time to work outside the house? If anything, rising family incomes are likely to result in women opting out of the workforce so that they can “take better care of their homes”.
There are, of course, other reasons: Not enough flexi-time options, for instance, or unsafe public transport and harassment at the workplace. Existing gender pay gaps are also a deterrent. The latest Monster Salary Index report finds that Indian men earn 25% more than women. The biggest gaps are not just in traditional sectors like manufacturing but also in newer sectors like information and communication technology.
Unequal pay for the same work tells us how we as a society value men and women. But the benefits of getting more women into paid work accrue not just to GDP but to women themselves: If she’s viewed as a productive economic asset, her prestige increases and so does the investment in her education and health.
Yet, nothing will change unless we first change social attitudes to unpaid care work.
So, while increasing paid maternity leave from 12 to 26 weeks is a laudable step, it also reinforces the stereotype that child-rearing is a woman’s job (those who say men cannot breastfeed have clearly never heard of a breast pump). In fact, some activists fear that giving women six months off from work will become an obstacle to their career advancement.
When a significant proportion of women say they want to stay home, the message is clear: Gender stereotypes about unpaid care work and a woman’s place in it remain prevalent. My mother grappled with this 59 years ago. The fact that her grand-daughters still have to, should be deeply troubling.
A woman makes fresh spices for her family of seven at a slum, Noida, Uttar Pradesh, India(Burhaan Kinu/HT)