Rabin Gautam
An elderly lady is brought to the emergency department at 10 pm accompanied by his son. He complains his mother is unable to speak for an hour and having weakness on one half of the body. I look around to see my emergency room colleagues, who are busy with two critical patients bein given cardiopulmonary resuscitation. Although I was working in the medicine department and was present in the emergency room that day to admit one of the patients to the ward, seeing my emergency room colleagues busy,I visit the son's mother who was sitting in one of the bed.
On reaching my patient, I take her vitals along with some basic history from her son and perform examination regarding her illness and conclude that she has a stroke and needs a CT scan. Unfortunately, CT scan on that particular day is not functioning, in otherwise a hospital which is run very efficiently and I mention the same to the patient's son. I request him to wait a while till the emergency formality and transfer to another hospital is made when he suddenly becomes aggressive and latches over my white apron, looks my name, calls it loud and says "if anything inappropriate happens to my mother I will come to this hospital again and won't spare you". In the meantime, he abuses me verbally and there is nothing I could do rather than stand at the intolerance. His furiousness seemed due to the referral of his mother to another hospital and some waiting time for ambulance to arrive. As a medical doctor attending the patient, I had not made any error in performing my duties.
This was the first time, my confidence was shattered when I was just beginning my medical career. For a few days, it left me a traumatizing experience unable to concentrate on my work. Despite the stress of working long odd hours, I always felt I did best to my patients not only with treatment but also appropriate counseling whenever I saw them.
A few weeks later another verbal abusive incident happened to one of my colleagues in the inpatient ward. After that incident, I still remember how angrily he said "it's no point being a doctor in this country. The people simply take all our efforts for granted when we sacrifice so much for the health of theirs". In my two years stay at the hospital, I saw and heard several attacks to my colleagues, seniors, and nurses whenever any untoward accident occurred to patients. These attacks were mostly verbal and sometimes physical as well.Most verbal abuse never got attention, neither there was a system in place for such reporting and action.Twice there was the physical property of the hospital being damaged.
It has been nearly a decade since that incident, instead of things improving, it has rather deteriorated. Just a few days back a doctor was beaten up in a medical college, despite the presence of security officials. The CCTV footage is apparently deleted. This comes at a time when the nation is facing its worst nightmare in battling the COVID-19 crisis, where the health workers are one of the key people on the frontline. At a time when health workers are already demotivated, because of lack of personal protective equipment, inappropriate working conditions, low salary wages, these abuse to them is further going to impact negatively.
It is at this critical juncture where we, the health professionals, look up to the state and the Ministry of Health to act proactively. The Nepal Medical Association has repeatedly taken up the issue to the concerned body but little has been done so far. The government so far seems to have half an ear to the issue. The formality of bringing the attention of concerned authority has continued every time with little action so far.
This is not to say that, health workers do not make errors. Medical error and medical negligence are two separate entities often put into the same basket in Nepal by the media and common people. The talk about this will be a separate issue for discussion. What is worrying is that in every death that occurs within the hospital premises, the culture of looking at medicos with suspicion has risen sharply. It would be appropriate that whenever such an incident occurs they are best left to decide on the hands of the independent professional bodies. Most incidents occurring within the hospital premises are rather taken care with either an apology or some financial bargains.
It is now time for the government to take strong decisions against such cases, going as far as a "Jail without Bail" for those who attack health care workers. It will always be difficult to work in a condition where health care workers are always insecure. Changes in law and strict enforcement aremuch needed.
We are already having closure and sealing of hospitals after COVID-19 cases were seen among the hospital staff. On top of these, physical abuse to the health workers may be another reason for the hospitals to be closed at this critical juncture. The medicos picture in social media recently has changed with one line on it which reads "if white coat turns red, country will turn into grave". It's a very harsh message, but the message is also a reflection of how little attention they have been given by the state. The government needs to take a bold step to protect these medicos from being traumatized and health institutions from being vandalized time and again.
