India doctors take up self-defence amid rising violence from angry relatives

Doctors from the All India Institute of Medical Sciences (AIIMS) learning taekwondo at a park in the hospital campus in New Delhi, India on May 15, 2017. Mustafa Quraishi for The National

DELHI // Hell hath no fury like a person who’s told by a doctor that the hospital has no bed for a loved one.

Working in India’s premier and busiest hospital – the All India Institute of Medical Sciences in New Delhi – can be dangerous for medical staff who sometimes face the wrath of relatives told the patient will have to wait a long time for a bed.

Having travelled in a smelly train compartment for two or three days to bring the patient from a remote village to a hospital, the news is enough to push relatives over the brink.

“They are desperate and can lose control because they blame the doctor, not the hospital,” said Dr Vijay Kumar, 32, senior resident at the department of geriatric medecine at AIIMS and president of its Resident Doctors’ Association.

A survey carried out by Maulana Azad Medical College in the capital recently showed that 75 per cent of the doctors surveyed complained of verbal abuse and 12 per cent of physical violence.

In the five years he has been at the state-run hospital, Dr Kumar has seen many incidents of violence but it was a brutal assault on a doctor at a government hospital in Maharashtra in March – which left the doctor blind in one eye – that prompted him to organise self-defence classes for AIIMS doctors.

Last month, doctors at the hospital started a three-month self-defence training by two taekwondo black belts.

“This training will be useful,” said Dr Harjit Singh, senior resident in the geriatric department, who was recently jostled by the relatives of an elderly man who had kidney failure.

Dr Singh had to ask the family to take the patient, who was admitted for a week, to another hospital because AIIMS has a limited number of dialysis machines and the bed was needed by another critically ill patient. The family got furious.

“Violence by relatives is rising because we can’t cope with the number of patients. We are the victims of this poor infrastructure. With this training, at leaset we can protect our vital organs. I’ve learnt how to protect my face, my chest and how to push someone away,” said Dr Harjit Singh.

While AIIMS has many security guards, Dr Kumar said they were useless.

“They run if they see something happen. Forget helping, they’ve had no training, they possess no equipment, their salaries are paltry and they aren’t even physically fit,” he said.

The idea of self-defence came to him when he saw his young daughter getting ready to go to her taekwondo class.

“I thought yes, that’s it. Why should doctors be sitting ducks when they can learn to keep assailants at bay?”

While he does not have scientific evidence, Dr Kumar said the attacks have been increasing not just at AIIMS but also at other smaller government hospitals in the Indian capital.

An indicator of the rising anger of doctors was demonstrated in March when AIIMS doctors went to work wearing helmets.

The crux of the problem is that the hospital is overwhelmed by the wave of patients who surge through its gates. The outpatient department sees around 10,000 patients every day.

Given that poor Indians never go to hospital without a few relatives accompanying them, the actual number of people coming every day is probably about 50,000.

The hospital, set up in 1956, has a doctor-patient ratio of 1:2,000. Owing to the appalling state of healthcare in the country, there are no facilities near poor Indians who develop a serious illness; no government hospitals with qualified doctors to diagnose or treat them, nor medical equipment for testing and treating.

Many eventually get on a train to reach AIIMS, a name that every Indian knows. Once there, many sleep, eat and live on the grounds of the hospital and on streets outside.

An appointment for cancer patients could take days. Neuro-surgery patients with months to wait before their operation and with no money for a guest house, much less a hotel, huddle on the streets.

“My father has kidney disease and heart problems. He’s so sick I was barely able to bring him here,” said Anil Singh, who had travelled from a remote village in Banka district in Bihar, about 1,500 km from the hospital.

Mr Singh has been waiting two days, sleeping on the road with his frail father, to see a doctor.

“I don’t know if he will survive if we don’t see someone soon,” he said.

Dr Kumar says the waiting time for neuro-surgery is two years. “We doctors here do the best we can but what can we do if the infrastructure is collapsing?” he said.

The government is pushing for the early completion of four new AIIMS hospitals in other cities by 2019 to help relieve the monumental pressure on the one in New Delhi. When prime minister Narendra Modi assumed office in 2014, he promised “an AIIMS in every state”.

Dr Kumar concedes that self-defence training is only a temporary solution. “The real solution is when India starts spending more than one per cent of its GDP on health. That’s the day I’m really looking forward to,” he said.