Hospital basics, that's what junior doctors are asking for

Aiema Tauheed, Kolkata

JUNIOR doctors have called off their agitation in West Bengal on the promise that the state government will hold talks with them on their demands, but right through the Durga Puja festivities they were on hunger strike. It was no small sacrifice which won the hearts of citizens who showed up, some with their families, to support them.  

It was the brutal rape and murder on August 9 of a young junior doctor, on night shift at the government-run R.G. Kar Medical Hospital, that shocked her colleagues. The slow response of the government coupled with abysmal working conditions at the hospital compelled junior doctors to begin a movement demanding justice.

They began their hunger strike on October 5, following nearly 50 days of ‘cease work’ in two phases. Currently, seven junior doctors are on strike, with many in urgent need of medical attention.

They have placed 10 demands before the West Bengal government. These include justice for the R.G. Kar Hospital victim, the immediate removal of Health Secretary N.S. Nigam, improved workplace security, a centralized hospital referral system, a bed vacancy monitoring system, and basic infrastructure like on-call rooms, CCTVs, and proper washrooms.

Dr Sayantani Ghosh Hazra from the West Bengal Junior Doctors’ Front (WBJDF), pale-faced and determined, was on Day Nine of her fast when we met her. “All our 10-point demands pertain to justice. Justice for Abhaya and creating an environment so that another Abhaya does not recur,” she reiterated. “Our demand for a digital bed vacancy system or transparency in the West Bengal Recruitment Board are all related to justice. Any scope for non-transparency creates a situation where we doctors,  especially junior doctors who are at the forefront, face mental and physical assault.”

Dr Alolika Ghorui

Dr Alolika Ghorui of Calcutta National Medical College, weary and soft-spoken, and on Day Three of her hunger strike, said violence against doctors stems from a flawed healthcare system. Before joining the protest, she spent her days taking care of other doctors on hunger strike.

District hospitals refer patients to medical college hospitals despite having the facilities to treat them. Patients, frustrated by repeated referrals, delayed ambulances, and lack of guidance, often cannot contain their fury when a bed eludes them at the overcrowded hospital. Junior doctors, who are typically the first to face such patients, bear the brunt of this tension. Trained security personnel are essential to prevent such volatile situations from escalating.

The government has belatedly announced a central referral system. But other serious issues are still pending.

Dr Parichay Panda of Shishu Mangal Hospital, on the third day of his hunger strike, underlined the need for urgent security measures — such as proper deployment of police personnel, including female officers. He also stressed the importance of regular patrolling and installation of CCTV cameras.

“Simply placing a CCTV camera won’t do. Monitoring is required. There was a CCTV camera in Abhaya’s case, but we all know how much footage was actually uncovered by the CBI and Kolkata Police. So, monitoring is essential,” said Dr Ghosh Hazra.

They were joined by Dr Bipresh Chakraborty, a Doctorate of Medicine (DM)  Gastroenterology resident at IPGME&R (Institute of Post Graduate Medical Education  and Research) and SSKM Hospital, who arrived after working a gruelling 36-hour shift in his hospital.

With horror and disgust, he recounted a brutal assault that had taken place the previous day at the IPGME&R and SSKM Hospital, when 10-15 goons had stormed the premises and viciously beaten a patient’s relative and son. “This attack happened right in front of CCTV cameras and police personnel,” he said, clearly appalled. “The state government must ensure that these security systems are both implemented and enforced.”

“Having the tools but not using them is just as bad as not having them,” he pointed out.

The doctors had already shared their recommendations. These include proper CCTV installation as well as adequate and well-trained security personnel who aren’t just silent bystanders. He also said there was need for a panic button for doctors so that help could reach them immediately. It is not possible for hapless doctors to stave off violent attacks on their own. 

Dr Bipresh Chakraborty

Dr Chakraborty said government hospitals were steeped in an all-pervasive threat culture, backed by impunity. “A culture of threat is fostered by those who know that powerful individuals will protect and guide them. That is why they feel no fear.” This posed a threat to not just doctors but patients as well and needed to be addressed, he said.

Another pressing issue is the poor quality of medicines supplied, a matter that needs urgent attention. There should be no compromise when treating patients, particularly the quality of medicines and implants, emphasized Dr Chakraborty. He stated that corruption, of any kind, at any level, should not interfere with a patient’s health or a doctor’s duty.

Another gaping hole in government hospitals is the shocking lack of basic amenities compromising health and hygiene. “This is a hospital,” said Dr Panda. “People are performing surgeries, checking patients, transfusing blood, and handling emergencies. If basic amenities are not provided to doctors, the well-being of both doctors and patients suffers, leading to the collapse of the entire system.”

And for women this lack of basic facilities is doubly distressful.  

“When we are on our periods, it is especially difficult. In our five-storied hospital building, there is only one properly functioning women’s washroom. Until this movement started, we didn’t even have a female rest room. We always felt the need for one, but we thought, ‘This is a government hospital, what more can we expect?’ We are trying to break this mindset. There is a budget and a functioning government. If they want to, they can make these changes,” said Dr Ghorui.

Dr Sayantani Ghosh Hazra

Washrooms and safe resting spaces are essential for women’s safety. “Abhaya had to go and sleep in a room where seminars are conducted. That is not a place for us to seek refuge,” emphasized Dr Ghosh Hazra.

Dr Chakraborty said, “It is a very sad state of affairs that in the 21st century we still have to request for these basic amenities.” The exhaustion from his long shift in the hospital was visible on his face. He spoke with deep disappointment of the bare expected minimum that is not provided to doctors. “In the past 36 hours, I had to use the washroom in my duty room. The sanitation system doesn’t work. The flushes are broken, and there’s no soap. We’re not fighting for this right now, but this is the bare minimum.”

Even a basic healthy meal eludes doctors working long shifts. The canteen situation varies across medical colleges. Some have 24/7 canteens, while most do not. In her college, said Dr Ghorui,  the canteen is particularly bad. “They don’t even stay open 24/7, so we have to order food with our very limited salary.”

The government must recognize that shifts lasting 24 to 48 hours for doctors in residency are inhuman. The doctors see an overwhelming number of patients during these hours, which is also unacceptable. “More and more medical seats must be created,” said Dr Panda. “The system needs a solid structure. With the country’s large population and the limited number of doctors available to serve them, a complete structural change is necessary. This is a long-term requirement.”

Despite such trying work conditions, junior doctors still attend to patients and have not complained about their inhuman working hours.

“We’re used to the shifts, which is why most of us don’t even complain about them,” said Dr Ghorui. “There is a continuation. We can push ourselves up to 36 hours and still make sound medical judgements. But beyond that, it becomes dicey. We need rest to make proper judgements.”

There was some criticism around the junior doctors’ agitation. It was said that because of their ‘cease work’ the healthcare system was in a shambles and that the lack of junior doctors on duty had led to patients suffering greatly.

“We are postgraduate students. We are supposed to study and learn, not be the backbone of the healthcare system. But if such is the situation, it exposes the shortcomings of the WB Health Recruitment Board, the WB Medical Council, and other bodies regarding manpower,” said Dr Ghosh Hazra.

She expressed her gratitude to the senior doctors who had stepped in to take over their duties so that they could continue to protest, but she questioned the need for such a situation to arise in the first place. The ‘cease work’ wasn’t a ploy to shirk work but to debunk the notion that students are the sole upholders of the healthcare system.

Junior doctors are also paid poorly. West Bengal probably pays the lowest stipend in India to its hardworking junior doctors.

“We are underpaid, but that is not the purpose of this movement,” said Dr Panda. “Our movement is not about salary.”

Dr Chakraborty added, “The stipend we receive in West Bengal is very low. There should be a uniform stipend scale across India to ensure that residents are neither overworked nor underpaid.”

This year, Goddess Durga was welcomed with a cry for justice and recognition of the determined spirit of the young doctors. “I celebrate from Mahalaya itself. Even if I am on duty, I wear a sari to celebrate each day,” said Dr Ghorui. “But since this incident, it just doesn’t feel right. Ma Durga shouldn’t come to this place. That’s how we feel.”

It was also astonishing to see people from all walks of life and every religion and gender, from silver-haired elders to children with schoolbags, sitting at the site in solidarity. “I do not know how long we will have to fast,” admitted Dr Ghosh Hazra,  uncertainty in her voice. “I’m ready to stop fasting as soon as we receive affirmation of our 10-point demands,” she said, as people who had joined them burst into loud chants, demanding justice.