On the night of August 9, 2024, the sexual assault and murder of a junior doctor at RG Kar Medical College, sent shockwaves across the nation and abroad. Her tragic death ignited massive protests, uniting the healthcare community and the public in a powerful outcry for justice and safer workplaces. For days, healthcare workers (HWCs) and citizens marched with placards, their voices rising against the violence that has become disturbingly common in healthcare settings.
While the outcry brought temporary attention to the issue, the root problem remains very deep. This incident is a grim reminder of the alarming reality of workplace safety for healthcare professionals in India. How safe are those who dedicate their lives to saving others? Let’s explore the current scenario, drawing evidence from recent surveys and real-life incidents to shed light on the pressing need for a secure and respectful work environment for healthcare workers.
Violence against Health Workers
The tragic case of the junior doctor is not an isolated incident. Health workers are at high risk of violence all over the world. Between 8% and 38% of health workers suffer physical violence at some point in their careers. Many more are threatened or exposed to verbal aggression. Surprisingly, most violence is perpetrated by patients and visitors.
Across India too, violence against healthcare workers has become disturbingly common. In April 2020, a team of health workers in Indore was attacked by a mob while trying to conduct COVID-19 screenings in a containment zone. In May 2023, a junior doctor named Vandana Das was stabbed to death while on night duty, by a patient brought to casualty for medical examination by the Police in a Government hospital of Kerala. The incident sparked widespread outrage and protests by doctors resulting in the Kerala Government passing an ordinance to provide stricter punishment for violence against hospitals and healthcare workers.
The public’s high expectations and the belief that all services should be free exacerbate the issue. Additionally, unrestricted public access within government hospitals, combined with inadequate security measures, surveillance and mob-prevention protocols, significantly heighten the risk of violence.
The situation has left many medical professionals feeling disillusioned, with a growing sense of being unsupported and unprotected in an environment where their safety is perpetually at risk. This widespread insecurity is prompting some to rethink their careers, further worsening the already severe shortage of healthcare workers in the country.
What do Surveys Say?
A cross-sectional survey conducted by experts from Vardhman Mahavir Medical College (VMMC), Safdarjung Hospital and AIIMS, New Delhi, revealed a startling truth—more than half (58.2%) of healthcare workers feel unsafe at their workplaces. The survey, published in the journal “Epidemiology International”, paints a grim picture of the working conditions faced by India’s medical professionals. Over 78% of respondents reported being threatened while on duty, and 81.3% had witnessed violence firsthand.
The study, involving 1,566 healthcare workers from diverse medical institutions across India, highlighted significant gaps in the security infrastructure. The majority of participants worked in government-run medical colleges, where dissatisfaction with security measures was the highest. State government institutions fared the worst, with over 63% of respondents expressing unhappiness about the number of security personnel.
Harrowing Gaps in Security Infrastructure
The survey unveiled glaring inadequacies in basic security measures across healthcare institutions. Nearly 70% of respondents criticized the lack of effective emergency alarm systems, while over 90% of institutions failed to implement proper screening for weapons or dangerous objects. High-risk areas such as intensive care units (ICUs) and psychiatric wards were found to be particularly vulnerable, with 62% of respondents pointing out severe gaps in access control and surveillance.
Adding to the distress, nearly half of the healthcare workers reported that duty rooms, meant to provide respite during long hours or night shifts, were grossly inadequate. This subpar infrastructure not only compromises the safety of healthcare providers but also adds to their mental and physical stress.
The survey revealed stark contrasts between private and public healthcare institutions. Private institutions, with better funding and resources, have managed to implement more effective security measures, leaving public sector workers to bear the brunt of systemic shortcomings. This disparity highlights the need for targeted interventions in government-run facilities, which serve the majority of India’s population.
Addressing the Issue
Between 2007 and 2019, India reported 153 cases of violence against HCWs, a figure likely underreported but alarmingly high for a non-conflict zone. The violence rate against HCWs in India is far more than the UK and China, both of which have legal safeguard. The Epidemic Diseases (Amendment) Act criminalised such violence in 2020, with punishment up to five years of imprisonment and fines of INR 2,00,000. However, they were not very effective. A 2019 Bill had proposed stricter penalties but was turned down by the Ministry of Home Affairs.
The VMMC-AIIMS survey emphasies some critical strategies to enhance workplace safety in healthcare. These include a strengthening of security by increasing personnel and improved surveillance systems. Duty room conditions should also be improved. There needs to be clear violence-handling protocols, including confidential reporting and staff awareness. Regular security training to prepare healthcare workers for emergencies and drafting stricter legal frameworks are necessary to reduce incidences of violence in healthcare settings.
The Bottom Line
Ensuring a safe work environment for healthcare workers requires collective effort from institutions, policymakers and the community. Investing in security infrastructure, allocating adequate funds and enforcing legal protections for healthcare workers must become national priorities. The healthcare workforce is the backbone of any society and their safety is non-negotiable. The brutal case of Kolkata and countless others serve as a stark reminder of the challenges faced by India’s healthcare workers and a wake up call. It is time for us to take concrete steps to protect them. After all, the safety of those who save lives should never be in question.