(First published in The Kathmandu Post )
Dr. Guna
Raj Awasthi, Medical Superintendent of District hospital, Baitadi was busy with
a line of patients in the hospital on June 5 when a group of women smeared
black soot on his face. It was later understood that they were incited by a
local Nepali Congress leader Ramesh Koli who badly wanted to settle scores with
this hugely popular doctor. Several weeks down the line, Koli is still at
large.
The larger story
In order
to justify their inhumane act, the assailants had this to say: the hospital did
not provide free ambulance service to Hira Bhul, a pregnant with triplet who
was referred from there to the higher centre. In contrast, the larger story
was: Hira was examined by Dr. Awasthi a couple of days before the incident and
as he found out that the condition of one of the fetuses was quite abnormal, she
was instantly referred to the higher centre where any ensuing complications
could be managed. In fact, upon learning that the patient was poor and helpless;
Dr. Awasthi even managed to collect the fund for them. He contributed Rs. 1000
from his side and Rs.1500 from the hospital committee. As for the ambulance, he
had personally requested ‘Dasarath Chand Pratisthan’ to avail it as the
hospital’s ambulance was out of the town.
It goes without
saying that this is a despicable act in its entirety and needs to be highly
condemned. But it has also provided us an occasion to introspect: Why are
doctors routinely facing threats and attacks in the workplace? Sadly, this
assault is far from an isolated incident and thus this news did not come as a
surprise. News of doctors being beaten, verbally abused and hospitals getting
vandalized are surfacing every now and then.
Besides, Nepalese doctors are not unique in facing this situation. Even
countries like China and UK are going through all this. Why?
There are reasons
aplenty. Doctor-patient relationship is at an all-time low. With the mushrooming
of private medical colleges, medical education has been hit hard and the
crucial ‘quality factor’ in the newly produced numerous doctors is under
question. The public can be blamed for their low health literacy but there have
been several occasions in the recent past when the failure in effective communication
with the patients has led to gross misunderstandings and subsequent unfortunate
incidents. With the continued commodification of healthcare, patient
satisfaction has sharply plummeted with doctors significantly losing their
trust. And if the state fails to regulate the medical education and leaves it
in the hands of Mafioso as in the present, one can only expect the cases of
medical negligence to rise. Add these all, and you get a sense of why the
incidence of violence against once highly regarded professionals is bound to
increase in the days ahead.
Now the question
is: Can’t this be averted? Of course,
yes. Dr. Govinda KC has been in the forefront of the campaign to reform the
health sector and if the citizenry backs him up to change this ugly underside
of medical education, things will definitely get better.
Omnipresent Impunity
However, if we try
to construct Dr. Awasthi’s case around the argument that negligence had
compelled them to do so, we are wrong. He is a doctor par excellence with
stellar track records, both on technical and humanitarian grounds. This is, no
doubt, a politically motivated pre-meditated attack. Unnerved about his growing
popularity, local party leaders with vested interests were seeking to transfer
this doctor elsewhere. It is against this backdrop that few relatives of the
patient were coaxed and provoked to manhandle him.
Under the
leadership of Dr. Awasthi, Baitadi has witnessed a remarkable progress in
health sector. In the health ranking done by Nepal Government based on various
health parameters, Baitadi was one of the 5 worst performing districts. But
once he assumed the office, it has now become fourth climbing up 65 positions. Even
a cursory look at the statistics will reveal how much he has worked for the
overall improvement in the health care delivery system of Baitadi. For this
outstanding performance, he has been already felicitated with the Health
Service Award. Among health workers, he has a reputation for endless service to
the people of rural areas and is thus seen as a constant source of inspiration
for scores of doctors working in the hinterlands.
In a nation where
the culture of impunity has been institutionalized, it is no wonder that the
party hooligans who orchestrate such attacks are offered political protection.
We have little hope that the culprit will be brought to book, because anyone
under the garb of political party is above the law in this land.
Until and unless we
end this culture of treating the politicos as more equal, medical reforms alone
will not bring about the desired working environment for medics. At least this
is what the Awasthi case has proved. Bringing more security guards in the
hospital is not the answer, strict enforcement of the law and ending the
omnipresent culture of impunity is.
Let us allow to
work with only the patients’ best interests in mind. By resorting to
hooliganism upon the slightest pretext, we are not only harming the health care
environment but also demoralizing the
bright young minds from choosing medicine as their career. We are pushing them
to the folds of the U.S and Australia.
It is high time the
general public understood the costs of unsafe working environment.
