'Attack on doctors will weaken the entire medical system', says IMA Kerala President

Dr Sulphi Noohu says the existing Act is toothless and demands stronger amendments

Kerala Dr Vandana Das Dr Vandana Das

On March 13, you posted on social media that a healthcare professional will soon be attacked and killed at the workplace. And, on May 11, that prediction became a reality when Dr Vandana, a young house surgeon was stabbed to death by a school teacher, while the latter was being treated by her at the Kottarakkara Taluk Hospital. What made you post such a prediction?

There are several attacks happening for the last so many years, almost one that had a minimum of one attack per week. There were 200 attacks in the last three years. So many times, doctors and other health workers escaped by a narrow margin. All kinds of sharp instruments are available in all hospitals. So many times, it was just because of luck that major injuries did not happen. So, I thought that it was going to be inevitable [that finally somebody would die]. That is why I wrote that Facebook post. Actually, I regret it. I feel bad talking about it now. But then this is a fact, a reality [that healthcare workers are being attacked].

There is the Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Act, 2012, indented to protect healthcare workers and healthcare properties. But do you think these are not doing what it is intended to do? 

Absolutely. That Act is toothless. So, we have demanded an amendment to this Act or maybe a new act. We have submitted a memorandum and concrete suggestions in line with the Epidemic Control Act. The government agreed in principle to implement that, but then it is not happening. That process is going at a very slow pace. 

What do you think is causing this delay?

I think the problem is the government is not feeling that urgency. They think that [this is a] routine thing. But they need to understand that it's an emergency situation. Previously, when COVID-19 came, this Epidemic Control Act was implemented. That ordinance came in no time—in less than maybe a few days. The government needs to give such importance and urgency to this Act also. This is a demand [in front of the government] for quite some time. I think this time the government will do the needful. 

One of your demands is to make hospitals protection zones. What are the other things that should be implemented at the earliest? 

We are demanding that in case of an attack against a healthcare worker, an FIR must be filed in an hour's time. The High Court of Kerala also has given such a direction. The second demand is that the police must complete the investigation in one month's time. And, if there is a lapse by the police officer, there should be action against it. There must also be fast-track special courts and the verdict must come within a timeframe of one year. 

Also, we demand punishments—imprisonment and fines for attacking healthcare professionals—must be increased. Also [hospitals must be] special security zones with security cameras in all places, not just in casualty. And also, there should be ample security personnel. Also, the hospital and 500 meters in and around the hospital must be declared as a specially protected zone. And there must be constant vigilance by the police officers to prevent attacks. 


When this unfortunate incident happened, the plight of house surgeons also came to the fore. They have to work late at night, with lots of pressure and fear.

We need strong rules and they must be implemented, that is where we are lacking at the moment. There is the 2012 Act, but it is not implemented properly. 

Regarding the doctors and their situation, I think the public also must take up this issue. See, if the hospitals are attacked like this, the doctors will try to do a defensive medical practice. They will avoid taking serious cases. For instance, if somebody develops a cardiac arrest, you need to intervene immediately. So instead of intervening immediately, they may try to look for their safety and they may refer that patient to some other hospital. Ultimately that patient will die. Such defensive practices will surely hit the entire health community. So the government and the public must come out strongly against hospital attacks. 

The Union government had a plan to enact separate legislation prohibiting violence against doctors and other healthcare professionals. But they withdrew the draft proposals. Do you think there is a need for a central act to protect doctors?

I think there must be a Central Act, and it must be a strong act. You cannot compare this profession with any other profession. The government sees that the other professionals also will demand their security. But it's totally different. Even in a war situation, the hospitals and health professionals of the enemy country are spared. So that principle must be applied here also. And there is a need for a Central Act. But the Union government sees that this is a state subject. And so, they said they are withdrawing the draft proposal. That was unfortunate. 

Could you please elaborate on your point on how the attacks against doctors would weaken the entire health system in the country? 

That itself is the main problem. These sorts of attacks will have a very high impact on the health systems of the entire country, not just in Kerala. Our best students must come to the medical profession. Unfortunately, these attacks are happening and many medical students are now thinking about leaving the profession. I'm not joking, this is a very serious thing. One lady doctor who was attacked three months back in Kerala had actually left the country—a postgraduate neurosurgeon. She was brutally attacked; she was kicked in the abdomen, and after that incident, she left the country. She came back, finally, after doing a lot of counselling and all. So, the general trend of the young, brilliant students of Kerala is that there is no point in taking the medical profession as such. So, brilliant people will take another profession. And maybe that is not good for the country.

Another aspect is that when a hospital is attacked or doctors are attacked, other patients are denied their actual treatment. When a casualty attack happens, it may delay treatment for many other patients who may require immediate medical intervention. Also, the situation demands that security surveillance must be increased in the hospitals. But when more security personnel and cameras are hired/installed, all these will reflect in the cost of the treatment also. All these expenses get added up because of the unsafe atmosphere in hospitals.

Did the IMA have a talk with the government after this incident? 

Yes. We met the chief minister today morning at 10am. He listened to our demands. And he's holding a meeting with higher health officials today. 

Did he promise you anything? 

No, he did not say a time frame for anything. But we are demanding a time frame because assurances were given earlier also. We need a time frame for the enactment of the law, the ordinance. 


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