Unsafe environments, no basic amenities: Lack of safety at govt hospitals a ‘direct threat’ to doctors’ lives

KOLKATA: On August 20, a critically ill patient was brought to the labour room at Sadar Hospital, attached to Sheikh Bhikhari Medical College in Hazaribag, Jharkhand. The patient urgently required a blood transfusion and was referred to Rajendra Institute of Medical Sciences (RIMS) Ranchi. “But before the patient could be taken, she collapsed in the ward. The patients' attendants and a mob of around 60 people attacked the hospital and we had to hide ourselves,” said Aansha Singh, who completed her postgraduate studies from RIMS Ranchi in 2023, and is now serving at the Sheikh Bhikhari Medical College.

But this is not a stray incident. Time and again, attacks and assaults on doctors and other health officials have made headlines. The brutal incident at RG Kar Medical College and Hospital in Kolkata on August 9, when a junior doctor was raped and murdered, has again brought to light the perilous conditions in which medical professionals in India operate – serving patients endlessly, even late at nights, at thousands of hospitals across the country. This tragedy has sparked a nationwide movement among doctors, bringing their long-standing grievances to the fore and prompting a Supreme Court hearing on the matter.

Dr Keerthy Varman M, general secretary of the Tamil Nadu Resident Doctors Association, said that security lapses are not just a local issue but a national concern. “Across India, government hospitals are marked by inadequate security, insufficient resources, and a lack of basic amenities for doctors, particularly female doctors.” This calls for the need to restrict the movement of people inside the hospitals.

Medical practitioners, doctors, and healthcare workers are demanding a safe environment to work in. Every state must develop policies to safeguard health professionals working in hospitals, they iterated.

“Every medical college should have a medical college protection committee, and the names of its members, along with their contact numbers, should be displayed everywhere in the medical college,” demanded Dr Varman.

Govt hospitals: Inadequate infrastructure, resources

Female doctors, in particular, face unique challenges. Many medical colleges and hospitals lack separate restrooms or changing facilities, forcing female doctors to go through uncomfortable situations or face unhygienic conditions.

Dr Abhishek Sharma, a third-year postgraduate resident at Nalanda Medical College and Hospital (NMCH), Patna, said that in his medical college, only the gynaecology department has a designated rest area, despite the presence of female students in other departments.

In some cases, female doctors have to leave the hospital in the middle of the night just to change their sanitary pads due to the lack of facilities at the hospital. “This is not only an inconvenience but a potential safety risk, as they have to navigate unsafe environments during these late-night trips,” said a professor of Stanley Medical College Tamil Nadu.

The situation is not unique. Across India, government hospitals suffer from the lack of gender-sensitive infrastructure. The absence of separate restrooms and changing rooms for female doctors is a glaring issue that needs immediate attention.

“The Vishakha Committee, which is supposed to address complaints of sexual harassment in workplaces, is often either inactive or its members are unknown to the staff, making it difficult for female doctors to seek redressal,” adds Varman.

Resident Doctors: Overworked, under-protected

Sharma said that the first and second-year residents often work 36-hour shifts with minimal rest, in conditions that are far from conducive to the high-stress nature of their work. While some departments provide basic amenities, most do not.

Security concerns further exacerbate their stress. Although some hospital corridors are monitored by CCTV, large areas remain uncovered, creating blind spots. “I will say that 60% of the area is covered and 40% has no camera surveillance. Our security should be improved.”

“This is in stark contrast with the controlled environments of other public institutions like police stations or district collectors' offices. This lack of control has led to numerous incidents of violence against doctors, with little to no legal repercussions against the perpetrators.”

Bond service, doctors’ struggles

In India, the government mandates that medical graduates who benefit from subsidised education must serve in rural or underserved areas for a certain period of time. This bond service is intended to address the shortage of healthcare professionals in these regions. However, for doctors like Singh,it comes with a lot of challenges.

Established in 2019, Sheikh Bhikhari Medical College is still in its nascent stages and the issues it faces are daunting. “The government is posting us in peripheral areas, but there is no security,” Singh added.

This lack of security is not merely an inconvenience — it is a direct threat to the lives of medical practitioners. The absence of reliable security personnel at night makes the situation worse. The fear of assault, or even worse, looms large making it nearly impossible for the doctors to focus solely on their duties, she said.

Also, the Sadar Hospital, which is attached to Sheikh Bhikhari Singh Medical College, is 2 kilometres away. Sadar Hospital is where the doctors serving the bond need to reach when there is an emergency.

To make the situation worse, there is a lack of essential medical supplies. Singh recounts the frequent shortages of crucial medicines, forcing her to request patients’ families to purchase them from outside pharmacies. “Despite raising these issues with local authorities, including the district collector, there’s been no improvement, leaving us to manage with whatever little we have. They come to check our attendance but do nothing to address our concerns.”

A system that needs reform

While the rape and murder of the junior doctor in RG Kar Medical College have sparked protests across the nation, the Supreme Court's involvement underscores the gravity of the situation.

One of the most pressing needs, as emphasised by Dr Varman, is the establishment of Medical College Protection Committees in every institution. These committees, which should be connected to local police and security agencies, would provide a direct line of communication for doctors in distress. This will ensure that help is available when it is needed most.

Again, the lack of essential infrastructure, particularly in rural and peripheral areas, hampers the ability to provide quality care. The shortage of medical supplies and essential drugs in government hospitals complicates the situation further. When a critical patient arrives at a hospital, doctors are often forced to send relatives to purchase medicines from outside pharmacies as the hospitals lack the necessary stock. This delay in treatment can have devastating consequences.

While urban centres often have better resources and infrastructure, rural areas are left with inadequate facilities and support. This disparity not only affects the doctors who are posted in these areas but also the patients who rely on them. The lack of essential drugs, security, and infrastructure means that rural populations often receive substandard care, Dr Varman said.