On the occasion of Doctors’ day of, 2021, the honorable Chief Justice of India, Justice N. V Ramana called doctors as “living gods and goddesses” and “heroes without the cape”. Yes, indeed. They are. Not only them, but also every single one of the people coming under healthcare profession. They have been selflessly and tirelessly serving the humankind since the very beginning of their career.
Ever since the unprecedented Corona Pandemic struck, the healthcare workers have been working as the front line warriors guarding millions of lives, while putting theirs at risk. When the whole world was baffled due to the fear and anxiety that the pandemic created, they have been un-reluctantly trying to save the world from this havoc. When we complaint about the un-comfort in wearing a mask, they have been giving their best efforts to save lives, wearing PPEs for hours, deprived of food, sleep, and rest. More than 1500 of them died in this battle, while protecting others’ lives.
Do they have a family? Yes, they do. They have their own flush and blood to care about. They have their own folks and loved ones to hang together and console each other. But, they have been upholding their responsibilities and working for the welfare of the world. When others enjoy the privilege of staying home and staying safe with their loved ones, the healthcare personnel have been cutting themselves off from their families and loved ones. iD food company’s advertisement which made us all emotional is just a small reflection of this. The eyes of that doctor simultaneously reflects, the sadness of missing her family, tiredness by her hectic working schedule, sorrow by the dying patients, and more than any of these, the gratification of healing patients.
Bearing all these things in mind, we can say that, what healthcare personnel are expected to receive is a huge respect and consideration from our side. But, in reality, what do they get? Apart from the ‘banging plates’ and ‘showering petal’ things, do they receive what they are expected to deserve?! No; a big solid ‘NO’. Instead, they are subjected to attacks and violence.
Violence against healthcare personnel is not new, and is not exclusively to the COVID-19 pandemic. But in recent times, it has grown in epidemic proportion and garnered media. Healthcare personnel across the globe have been facing may difficulties during this calamity, like shortage of PPEs,hectic and extensive working hours, fear of catching the virus and transmitting it to others etc. The increasing incidents of violence against them is adding to this already existing burnout.
According to the WHO framework Guidelines (2002), “Workplace violence is defined as the situations where staffs are ill-treated, intimidated or attacked in conditions linked to their workplace, including commuting to and from the workplace, involving an explicit or implicit challenge to their safety, well-being or health”(1).Compared to all other workers, workplace violence seen in healthcare workers is four times higher(2).It can be physical violence or psychological violence or a combination of both. It can be in any form like assault, abuse, bullying, mobbing, harassment either sexual or racial or psychological, threat, etc. According to the report of Indian Medical Association, over 75% of doctors across the country have faced at least some form of violence(3). The statistical study by Indian Critical Care Medicine(4) also reveals that violence against health care personnel is not new, but had existed before the pandemic as well.
During the pandemic, the violence against healthcare personnel has increased and it grabbed the media’s attention. In June 2021, a video of a young doctor being brutally attacked in Assam surfaced on the internet. The young doctor was mercilessly attacked by the relatives of a Covid patient, who had died due to oxygen shortage(5). This disturbing visuals caught on camera is only one among the many cases of such barbarism. Doctors assaulted by the relatives of a dead patient in Hyderabad(6) and Mumbai (7) are another examples from the list of many others.
In various cases of violence against healthcare personnel courts pointed out that country is going through a national calamity and healthcare personnel are the strength of the nation and their interest should be protected . In Azra Usmail and Others v. Union Territory of Jammu and Kashmir(8), Jammu and Kashmir High Court pointed out that, such violence would have dangerous consequences like the spread of infection, and Court observed that “the professional engaged in the treatment of COVID-19 patients and prevention of the infection would be working beyond the call of their routine duties and also overtime. In order to ensure full attention of the professional addressing the COVID-19 issues, it is necessary that they are kept free of any personal tensions and needs”. During the judgement of Jerryl Banait v. Union of India (9) wherein doctors were faced stone-pelting, Supreme Court observed that “The pandemic which is engulfing the entire country is a national calamity. In wake of calamity of such nature all citizens of the country have to act in a responsible manner to extend helping hand to the government and medical staff to perform their duties to contain and combat the COVID-19. The incidents as noted above are bound to instill a sense of insecurity in Doctors and medical staff from whom it is expected by the society that they looking to the call of their duties will protect citizenry from disease of COVID-19. It is the duty of the State and the Police Administration to provide necessary security at all places where patients who have been diagnosed corona virus positive or who have been quarantined are housed. The Police security is also provided to Doctors and medical staff when they visit places for screening the people to find out the symptoms of disease.” In another case, Sanpreet Singh v. Union of India(10), the High Court of Karnataka directed the Karnataka Government to ensure proper nourishment and necessary care to the healthcare professionals and the Court also directed District Magistrates to look into the grievances of these workers. These judgements show the importance of ensuring the safely of healthcare workers in India. Healthcare workers are the real warriors of COVID-19 and the public health would remain uncertain as long as the barbarism against them continues.
The questions to be discussed is ‘whether India has the appropriate legislation to tackle this situation?’; ‘whether the existing law is enough to protect the lives and property of the healthcare workers?’. Even though the violence against healthcare personnel is not an exclusive COVID phenomenon, but has been a crippling practice for years, there has been a lack of provisions explicitly dealing with such offences. It’s a fact that the Protection Of Medical Service Person and Medicare Service Institutions (Prevention to Violence and Damage to Property)Act,2008 (11)has been enacted by approximately 23 states in India, but it continues to be a futile act. It has still not been integrated to the administrative machinery, and since it is not a part of IPC, seeking assistance from this act is pointless.
So there has been an urgent need for a stringent legislation, exclusively for the protection of healthcare personnel. Prior to COVID-19 pandemic, the primary law to regulate healthcare emergencies was the Epidemic Diseases Act of 1897, which was enacted to fight the bubonic plague in erstwhile Bombay. The 123 year old legislation had only four sections where the word ‘healthcare personnel’ hadn’t even mentioned. That act included only provisions relating to control of the epidemic.
Now, faced with an unprecedented health emergency, Government issued an ordinance adding new provision to this basic legislation in order to fight the deadly Corona virus and also to protect the healthcare workers from abuse. In September 2020 the President gave assent to this bill and now it is in force as The Epidemic Diseases (Amendment) Act, 2020. It is highly relieving that the health care personnel have given proper consideration under this Act. Section 1A of this act defines who is healthcare personnel and it defines ‘act of violence’ as the acts committed by any person against the healthcare service professional serving during an epidemic as one, which may cause, harassment, hurt, injury, a hindrance to services, damage to property or documents in custody. Section 2B provides that no person shall indulge in any act of violence against a healthcare service professional or cause any damage or loss to any property during the epidemic. Under this act any act of violence against healthcare personnel has been made punishable, with imprisonment for acts causing grievous harm ranging between six months and seven years, and a fine that could be anywhere between Rs. 100,000 and Rs. 500,000. These violent acts are also classified as cognizable and non-bailable offences.
This amendment is intended to ensure that during any situation similar to the current pandemic, there is zero-tolerance to any form of violence against healthcare personnel and damage to property. Even though the amendment act has been criticized in various aspects, the strict implementation of this act would certainly helps to curtail the violence against healthcare personnel. Healthcare personnel are the warriors of the country to fight with such a dreadful health emergency. Violence against them would annihilate the whole healthcare system. As WHO rightly said, “during the COVID-19 pandemic more than ever, protecting the health and lives of health care providers on the frontline is critical to enabling a better global response”(12)
In the background of a lame healthcare infrastructure, the healthcare workers have been trying relentlessly and selflessly to protect each individual’s lives. Cutting themselves apart from their family, risking their own lives, they are fighting the battle from the front. They truly are the heroes in this challenging time. So instead of such barbaric violence, it’s our duty to safeguards them, and the least we should do is appreciate their efforts and sacrifices, and respect them.
In solidarity with healthcare personnel. Huge love and respect to them.
(1) Framework guidelines for addressing workplace violence in the healthcare sector. [Jun;2020 ];https://apps.who.int/iris/bitstream/handle/10665/42617/9221134466.pdf Geneva. 2002 3:1. [Google Scholar] [Ref list]
(2) Bureau of Labor Statistics (BLS). Non-fatal occupational injuries and illnesses requiring days away from work. [Jun;2020 ];https://www.bls.gov/news.release/archives/osh2_11082012.pdf 2012 [Ref list]
(4) Sharma S, Gautam PL, Sharma S, Kaur A, Bhatia N, Singh G, et al. Questionnaire-based Evaluation of Factors Leading to Patient-physician Distrust and Violence against Healthcare Workers. Indian J Crit Care Med 2019;23(7):302-309, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686582/
(6)Hyderabad: doctors at Gandhi Hospital protest, block road after kin of COVID-19 patient attacks colleague [Internet]. India Today, Hyderabad. Updated 10 June 2020. Available https://www.indiatoday.in/india/story/telangana-hyderabad-gandhi-hospital-doctors-protest-coronavirus-patient- family-attack-1687654-2020-06–10 (accessed 27 Jul 2020)Google Scholar
(7) Shocking! COVID-19 patient’s relatives stab doctor in Maharashtra’s Latur [Internet]. Mumbai Mirror, MO\U. Updated 30 Jul 2020. Available
https://mumbaimirror.indiatimes.com/coronavirus/news/shocking-COVID-19- patients-relatives-stab-doctor-in-maharashtras-latur/articleshow/77256055.cms (accessed 22 Aug 2020) Google Scholar
(11) https://www.google.com/urlsa=t&source=web&rct=j&url=http://18.104.22.168/billstexts/rsbilltexts/AsIntroduced/medicare%2520service%2520XXXVIII.pdf&ved=2ahUKEwiE0tyKobfzAhWF6XMBHehJB7UQFnoECA8QA Q&usg=AOvVaw0qgBtqjd8a8mAR-24ZZUU3
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