By Shree Baphna
How the RG Kar Case Resonates with Indian American Doctors
*Trigger Warning: Mentions of rape and abuse*
The medical community is experiencing shockwaves from India to the United States after the horrific rape and murder of a young trainee doctor in August at RG Kar Medical College Hospital in Kolkata, West Bengal. Since then, the case has become embroiled in controversy, with accusations of tampering with evidence, and corruption.
AsAmNews recently spoke to medical doctors from the Indian American community, who have been mourning their colleague and bringing awareness to the plight of doctors in India by organizing and staging protests. From these conversations, it soon became apparent that this particular case could very well be a symptom of a larger, serious systemic problem.
It is no secret that doctors in Indian government hospitals are heavily overworked, bearing incredibly high patient loads. Working multi-day shifts is not unheard of and often time call rooms- where doctors are meant to be able to rest between shifts- are overcrowded and unhygienic.
But why are government hospitals so crowded? Aside from having to deal with just sheer volume given how populous of a country India is, many of these issues stem from systemic problems within the healthcare system.
For one, government hospitals are free of charge and serve the majority of India’s population since most cannot afford to go to a private hospital. Beds are limited in government hospitals, resulting in overcrowding. People from rural areas, where healthcare is not easily available, also filter into more tertiary level government hospitals to avail of care which results in increased patient volume.
Dr. Dhrubajyoti Bandyopadhyay, a current cardiologist at Massachusetts General Hospital, Boston, USA recounted how the state of West Bengal had implemented a regulation that patients on state-sponsored health insurance could not be turned away from hospitals. Dr. Bandyopadhyay himself was a resident physician at RG Kar, where the recent attack on the trainee doctor took place. Due to this new policy, Dr. Bandyopadhyay stated, patients were admitted into the hospital regardless of there being enough beds. As a result, hospitals became overcrowded with patients waiting around for a bed, standing or sitting in any open space they could find.
“On paper, this is of course a great policy. However, there is no way to track patients because they keep moving around with nowhere to stay put if they don’t have a bed. It is a very chaotic system,” Dr. Bandyopadhyay observed.
Overcrowding and the inability to monitor patients also resulted in being unable to keep track of who was entering and exiting the hospital. Security was inadequate and strict vetting was not enforced. Owing to the increasing number of patients, doctors were made to work long shifts- but lacked the adequate facilities to rest. Dr. Bandyopadhyay made similar observations to Dr. Sharma about the state of the doctor’s call room, recalling how unhygienic and cramped it was.
Apart from political and infrastructure problems, Dr. Bandyopadhyay also highlighted corruption within RG Kar hospital as a chronic issue. He noted that many other government hospitals must also experience levels of corruption, but so far only RG Kar’s ‘medical mafia’ had come to light. At RG Kar, authorities charged the ex-principal of the medical school with money laundering.
“It is this nexus of hospital administration, politicians, and police that has really deteriorated the system at RG Kar”, Dr. Bandyopadhyay stated.
Furthermore, according to Dr. Bandyopadhyay, the trainee doctor’s case is but a symptom of this relationship. He says the way the police and RG Kar administration handled this case was completely bungled and has done nothing to shed light on the difficult conditions doctors are forced to navigate on the daily.
On the topic of better safety for doctors identifying as women, Dr. Poornema Ramasamy, an internal medicine practitioner in Columbia, SC., recalled her own fear for her safety back when she was a resident in training in India.
“We would pair off- one female resident to one male resident- during overnight shifts”, she recounted.
The hierarchical structure that exists in medical school and within hospitals in India does not create a conducive environment for the safety and learning of female doctors, according to Dr. Ramasamy.
When asked what she would like to see change with this damaging structure, Dr. Ramasamy stated that the medical teaching curriculum needed some serious overhaul. From the beginning, medical students should be taught the importance of respecting one another as colleagues, regardless of one’s gender identity. Furthermore, training should include awareness on workplace abuse, workplace safety, and violence against healthcare workers. To Dr. Ramasamy, education and not the law, would be the most transformational for the current system.
These past personal experiences bring out the emotional ties that Indian American doctors still feel with doctors back home in India. This has galvanized them to group together and raise awareness within their own communities. Dr. Ramasamy and Dr. Bandyopadhyay are also involved with a group of other Indian American physicians in composing a set of evidence-based recommendations that will be sent to a National Task Force being set up by India’s Supreme Court to address workplace safety measures.
Spearheading this consortium of Indian American doctors is Dr. Richa Sharma, an anesthesiologist in West Hartford, CT. In addition to the recommendations, Dr. Sharma has been instrumental in galvanizing 20 leaders across Indian American physician groups, in the US and Canada, and over 20 representatives from Indian medical college alumni groups to write letters to officials in India. She also helped convene on-the-ground advocacy in the United States such as the New York City India Day Parade, and a global protest which took place on September 8th.
With respect to their advocacy efforts, Dr. Sharma says it is important to do their best in “spreading awareness about the situation of lack of safety of our colleagues in India and supporting their well-being every way we can”. So far, Dr. Sharma has provided comments for the New York Times, Telegraph, and the Indian Eye in an effort to get the word out about the grueling work conditions doctors in India face.
“This is about being human, having humanity. We want to work to the best of our ability, but to do that, change is needed.” Dr. Sharma stated.
Although practicing doctors in the United States, it is clear to see how deeply this horrific incident at RG Kar has shaken the Indian American medical community. When asked what they wish for folks in the US to take away from this case, all three interviewees expressed a strong desire for solidarity and general awareness regarding the stark differences between medical professions in the ‘developed’ world versus the ‘developing’ world. At the end of the day, doctors cannot do their job if they feel unsafe in their place of work.
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