Horrific RG Kar Rape – Murder of Young Doctor Turns Into A Killing Ground.

New Delhi: The horrific brutal rape and murder of a 31-year- old female trainee doctor at Kolkata’s RG Kar Medical College has sent shockwaves through the nation. Her body found half-naked and bearing severe injuries in a seminar hall where she had retired after a grueling shift, her death has ignited a firestorm of outrage and grief. A hospital volunteer has been arrested in connection with the crime and further investigations are being done by the CBI.

Forensic evidence and post-mortem report has shown that her body bears multiple signs of trauma
suggesting she was sexually assaulted in the pre-dawn hours. 150 ml of semen were collected from her private parts.
Healthcare professionals across India have also launched nation wide strikes, demanding stricter laws to protect them.

Indeed, this incident raises wider questions about safety measures for women performing night duties in any sector. The incident has once again underscored the pervasive issue of violence against healthcare workers, particularly women, who make up a significant portion of the medical workforce. Despite constituting nearly 30% of India’s doctors and 80% of nursing staff, they face disproportionate risks. Official data reveals a troubling increase in crimes against women, with rape and assault being alarmingly prevalent.

It is quite disheartening and pathetic that despite 12 years of sensitisation since the Nirbhaya rape, establishment figures hold fast to the belief that feeling fatherly is sufficient, just and convincing. The Kolkata incident is yet more proof that little has changed in the reality of rape in India since the Nirbhaya horror in 2012. Incidents of rape have only increased from 24,900 in 2012 to 31,516 in 2022, an increase of over 25 per cent.
Police records show that 86 rapes occur in India every day but the country by and large sleeps untroubled by the odium of being ‘the rape capital of the world’, a statistically inaccurate but sentimentally apt description. Added to that we now have the phenomenon of rape followed by murder, as has happened in the Kolkata case. Since the National Crime Records Bureau started maintaining data on this new metric in 2017, there have been more than 220 rape-murders of women each year.

The murder at the Kolkata hospital has exposed the alarming security lapses in many of India’s public healthcare facilities, leaving women particularly vulnerable.

The cruelty lies in how the political and judicial systems have responded to past incidents of violence and continue their inefficiency in delivering justice.

Safety to healthcare professionals at the workplace should be a given. However, people in most workplaces are denied this necessity. People working to alleviate the suffering of others like healthcare professionals (HCPs) deserve a workplace that protects them from violence. Working long hours and in poor living conditions is by itself, quite stressful. Adding to that, the ill-treatment of HCPs by patients and/or their acquaintances can significantly harm their mental health. Indian doctors can easily relate to the threat of violence that looms just behind their doors.

Most healthcare professionals have faced violence at work and have not received help when they needed it. The mob in the emergency room, the violent patient’s relative, the accusatory look, the threat on the phone, the endless trolling on social media.
It is a sheer shame to note that violence sneaks into the daily lives of healthcare workers and has been normalized to the extent that it is joked about.

The danger of normalizing serious social problems like violence is that rooting them out becomes even more challenging.

There are several reasons why violence against healthcare professionals is commonplace in India. At the core, however, are three main issues:

(1) Poor Infrastructure: Due to inadequate funding or the underutilization of available funds, healthcare facilities continue to be unsafe for patients and HCPs. Amenities like a safe space for HCPs to rest, a security system, and a central control room with CCTV monitoring are rare.

(2) Poor Trust: The widespread hate of the public towards the healthcare fraternity stems from (perceived and real) malpractice and high costs of healthcare.

When incidents of violence against HCPs surface in the media, there is a section of society that feels “they must have been negligent/ must have ‘fleeced’ the patient and hence they deserve it.”

(3) Inequity in healthcare: Inequity plagues the health system in India. The distribution of HCPs in rural-urban areas is skewed. The quality of healthcare improves considerably based on the patient’s gender, paying capacity, position in society, and ‘influence (who the patient is connected to’).

‘VIP (a very important person)’ is a common tag used for patients who are treated better (clinically and more humanely) when they are known to or are in positions of power. Most perpetrators of violence get away without any accountability and this can encourage continued violence.

It is hence pertinent to be aware of the laws that prevent such acts of crime. In 2020, during the pandemic, when the country needed its HCPs the most, the central government passed an amendment to the Epidemic Diseases Act. This amendment provides that acts of violence against HCPs would be cognizable and non-bailable offenses. Health, law and order are state subjects. Nineteen (19) states of the country have laws to prevent violence against healthcare professionals, however, implementation is poor.
While there are several laws to hold the HCP accountable like the Clinical Establishments Act, the Consumer Protection Act, PCPNDT Act, etc. the same is not the case in penalizing the perpetrators.

The need to ensure safety at the workplace cannot be overemphasized. A mechanism to restrict entry into healthcare facilities is a simple step that can prevent heinous crimes like the one in Kolkata. Standard operating procedures, mock drills to deal with violence, staff training in communication, and delivering evidence-based high-quality healthcare are some measures that HCPs can take to protect themselves. Of course, implementing safety measures like CCTV monitoring, employing security personnel, etc. will need financial investment, however, this is not enough. The strong patriarchal and aggressive milieu we live in needs to be uprooted and this will require radical change in the way we grow, educate, and parent as a society.

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*Dr. Naresh Purohit-MD, DNB, DIH, MHA, MRCP(UK), is an eminent Epidemiologist, Advisor-National Communicable Disease Control Program of Govt. of India, Madhya Pradesh and several state organizations.  Dr.  Purohit is also Principal Investigator for the Association of Studies For Kidney Care.

He’s also Executive Member of the Federation of Hospital Administrators.