Stabbing renews debate over India hospital safety months after rape and murder of trainee doctor

By Esha Mitra, CNN

New Delhi (CNN) — A knife attack on a doctor in India has renewed an impassioned debate about whether enough is being done to protect medical staff in the world’s most populous nation’s often crowded and overstretched hospital wards.

Last week, thousands of doctors went on strike, shutting down private hospitals and clinics after a doctor was stabbed while on duty in the southern city of Chennai.

Oncologist Balaji Jaganathan was allegedly attacked by the relative of a patient who was unhappy with his mother’s treatment, local police said. The doctor survived the attack and remains in stable condition.

“How are we supposed to treat patients if we don’t know if we ourselves will make it out safely,” K. M. Abdul Hasan, president of the Indian Medical Association in the southern state of Tamil Nadu, told CNN, adding that more than 40,000 doctors went on strike on November 14 to demand safety in the workplace for health care workers.

Earlier this summer, thousands of doctors across the country took industrial action – and also spent weeks protesting – after a trainee medic was raped and murdered in the eastern city of Kolkata in July.

Their main demand then was a federal law, known as the Central Protection Act (CPA), to protect doctors and medical staff at their workplace. The stabbing in Tamil Nadu has once again emphasized the need for such a law, and stricter security measures to protect health care workers, doctors say.

Violence is ‘expected’

In recent weeks, CNN has spoken to nearly a dozen doctors who all reported a hostile work environment and lack of security. Several doctors work in the capital New Delhi, but they say things are much worse at remote health care centers.

A survey published in August in the wake of the trainee medic’s killing showed 78% of health care workers reported being threatened while on duty.

Another 63% said they felt unsafe while working a night shift, while those at government-run hospitals or community health centers felt more unsafe than those working in private hospitals. The survey had 1,566 responses from doctors, nurses and other medical staff across the country.

“Every doctor can tell you many incidents where they have been verbally abused or worse, it is expected for us,” said a doctor in a Delhi hospital who asked to conceal her name, fearing repercussions at work for speaking to the media.

In July, while the doctor was on duty in a Delhi government hospital, what was supposed to be a simple baby delivery turned into a complicated procedure, and the mother was imperiled.

As monitors beeped and a doctor rushed to resuscitate her, an older female relative began screaming. What happened next left staff traumatized, said the Delhi-based doctor.

Dozens of armed men barged into the delivery area reserved for patients and their female relatives as many women lay uncovered to give birth.

The men, claiming to be the patient’s relatives, began yelling, destroying equipment and assaulting the doctors. Despite the attacks, the team continued to try to revive the patient, until there was nothing more they could do.

“The doctors ran and hid in the duty room but they even broke into there,” said the Delhi-based doctor.

Doctors at the hospital subsequently asked for more security personnel and metal detectors, but their pleas have gone unanswered, said the doctor.

‘It could have been any one of us’

The Kolkata trainee medic’s murder took place while she was working a night shift and had shut her eyes for a short while in a seminar room at the R. G. Kar medical college and hospital.

A civic volunteer at the hospital has been charged with rape and murder and his trial in ongoing.

Indian laws require the identity of a rape victim to be protected. She has been given the moniker “Abhaya,” meaning without fear, and her case has become the latest to fuel surging anger in India over endemic violence against women.

But it also galvanized doctors to call for better protections.

“It could have been any one of us, we have no choice but to protest because if we don’t speak up now then when; it can’t get any worse,” said Anwesha Banerjee, a doctor from the same class of medical students as Abhaya, who also asked to use a pseudonym.

This incident brought doctors from all parts of the country to the street, united in their demand for stronger laws to protect doctors.

The Supreme Court of India opened a case on the Kolkata trainee doctor’s rape and murder and formed a national task force to recommend measures to improve security at hospitals.

However, the task force has disagreed with the doctors’ key demand for a new law, arguing India’s criminal code already has adequate legislation.

In the aftermath of the doctors’ strike in August, India’s Health Ministry set up a sub-committee to help the task force “suggest all such possible measures for ensuring the safety of health care professionals.”

The task force outlined measures to improve safety, such as installing more CCTV cameras, providing transport at night and better duty rooms for staff. But doctors say they want concrete action now.

“We need measures to actually be implemented, we need both state and central governments to act … guidelines cannot help until put into practice,” said Hasan in Tamil Nadu.

CNN has reached out to the Indian Ministry of Health for comment.

Hospitals ‘used to be ours’

Following the murder in Kolkata, the local West Bengal government issued a notification saying female doctors should avoid night duty.

But that sparked a rebuke from one of India’s top judges, who cited the country’s equality laws, and triggered fresh anger among doctors.

“Instead of protecting us and creating a safer work environment, if you restrict our ability to work, that only disadvantages us further, it goes against the very principle of what we want,” said Banerjee in Kolkata.

The Delhi-based doctor said while she lives not too far from her hospital, it is located in an area which is unsafe, especially at night.

“We don’t have transport provided for getting to the hospital and the hostels aren’t well maintained so we don’t prefer staying on campus,” she said.

The doctor to population ratio in India stands at one to 834, India’s health minister told parliament in February, citing the Health Ministry. That exceeds the World Health Organization standard of one to 1,000.

However, doctors say the problem is a shortfall of hospitals across rural India and second-tier cities. As a result, people end up having to travel long distances for treatment, and those hospitals bear the brunt of treating those with serious illnesses.

Those stresses were particularly acute during the coronavirus pandemic, when India was hit by a particularly devastating second wave.

The latest attacks on doctors have only added to that feeling that not enough is being done to protect them.

“With everything that’s happened, we have lost our sense of security, the hospital used to be ours, we owned it, that’s no longer the case,” said the Delhi-based doctor.

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