A strike or extortion?

The recent strike called by the Resident Doctors forcing hospitals to turn away the patients, thereby depriving them of emergency medical services has raised many issues. Firstly, violence of any sort on anyone is not condoned. The attacks on the resident doctor at Dhule should be condemned. After which there were few more attacks.
Before presuming all patients and relatives coming to public hospitals are aggressive and should be blamed, one needs to understand a few facts. The resident doctors are studying in colleges where usually NOT anyone gets admissions. Moreover they get the best of experience at these government hospitals, where these very poor come to get treated. The conditions are pathetic, poor are denied the basic medical care, 1000 times the number of patients come, while there are dedicated beds for only a few. All the hospitals run on the resident doctors. Everyone knows that and acknowledges it. But now starts the problems.

They have come to these medical colleges to get best of medical education at affordable fees and avoid capitation fees. Their education is subsidized and taxpayers like us are funding their education. They forget this fact the minute they become doctors. There is no indebtedness to the society. Then they become money-making machines. Many a doctor and their families are out to make up for the expense of their education, which is by far more affordable had they studied abroad, and the aim is to have a flourishing practice.

Fact number two -The very government that has denied the security and protection to doctors has denied more rightful and basic a service, health care to the millions of poor. The level of frustration that the poor have to experience I am not sure anyone of us can even imagine it. The resident doctors are primarily middle-class, upper middle class and the rich. Each has at least one vehicle in their families. They have no clue of long distance travel in public transport borne by patients The patients often do not have the knowledge of their illness, worse they do not have money to afford. For them doctor is a miracle performing person or may be even god. That however was an image even perpetuated by many doctors. It is now in the last 5-8 years that educated patients, media pressure that doctors do not get offended when asked questions. Otherwise how much was an interaction? Patients are discouraged from asking questions to the visiting doctor on their rounds. Why? Who is s/he, god? They are answerable and the patient has to know progress of treatment and status of their illness. Things are changing now, but it is nowhere near than what it is in progressive countries.

Fact three – The hospitals have plans and rooms as per these plans. The doctors are paid fees as per these plans. Now begins the racket. The doctors fight (and I have witnessed it, has happened with my own father’s case), when the patient has to be given discharge, the visiting doctor insists it is done beyond noon in private hospitals. Now it is not for nothing they say it helps to know a doctor. Thankfully my cousin and his wife, who are our family’s medical in-charge literally had cautioned me of this and pushed me to go to the cashier before noon. It was shocking that my father’s doctor threw a anger tantrum. My father has not forgotten it till today and once when he was to come home to administer him an injection, called him and told him off. He refused and said he will not take it from him. The doctor realized my father’s predicament and the fact here was one intelligent man asking him far too many questions. But that is how it should be. Poor do not have these sensibilities because they are not aware, deprived of education.

Fact four – the distances in small towns and villages are far too long. As I said, the poor often do not know what is happening to them, the doctors at the public health clinics make rare visits, if at all. Tell them off, give some pills. Once they bring them to the first government hospital they wrongly expect the doctors to drop everything for them. Moreover they expect miraculous effect. Now in Dhule the doctors told the patients relatives of the fact which they refused to accept. Because we also need to understand this time the doctors were right, but it has happened in cases the doctors do not encourage patients admissions at nights or early mornings. It has been reported. That definitely does not give patients or relatives right to beat them up.

Fact five – there is lack of security measures and facilities. Again, the government has denied these. But here the deans of these hospitals have a role to play. The resident doctors need to tell their authorities of these lacunae. If not provided then have the guts to stand outside the minister’s bungalows and demonstrate. Shout slogans there, but no. They will not do such. When we media asked them to do so and said we will extend support if they do this, they told us they can’t do so. They need the help of the government. If this is the stand they are taking and then resorting to extortion of depriving those very patients who are angry with them, then they are to be blamed for this situation. This is not the way to protest or raise pertinent issues.

Fact six – you sow what you reap. Have people witnessed the bullying by seniors on the junior resident doctors? Last year I visited my niece in Nagpur, who is studying MD and was traumatised. Both her parents are MDs and as I said, my family’s medical in-charge. The stories she told me of the harassment she was put through by her lazy seniors was not shocking, it only angered me. The seniors insult the juniors in the ward, they speak to them rudely and in the case of my niece they slapped a file on her face. As a result, expectedly, few patients and their relatives began speaking to her rudely. The others took pity on her and said she needed to give back. I had to grill her to raise these points with the dean, who had been asking my niece why she lost the smile on her face. I finally gave an ultimatum, told her if she did not, I would do a sting and tell the dean I am a senior journalist and will expose them. This is the harsh reality. These doctors perpetuate such behavior and they are closely observed by the patients. If they fail to understand these multi0-layered issues which are highly influenced by socio-cultural and political factors then it is a huge mistake.

Fact seven – the politics of this issue is deep. The obvious is depriving the poor of essential health services, mutli speciality services and give proper health care. Worse is the mutual benefit racket that exists between the deans, doctors, government, media and the rich. Many who can afford modern medical treatment take favours and get treated by the top doctors of the city in these government hospitals, to save their money. The politicians use their muscle and pull. Then these politicians have used the uneducated poor to provoke them in the name of the ‘sons of the soil,’ ensure they remain the disruptive elements in the society and are used accordingly. The idiot poor do not realize the ramifications of their action. The media too sometimes plays a crucial role. There is a very senior Marathi journalist, who still works for a Marathi newspaper. He was THE one who provoked the Shiv Sainiks at Thane to go and destroy the Singhania Hospital at Thane. When the Sena leader Anand Dighe died, the doctors had given one last shot to save him. And when they got angry and protested, this so-called political journalist told them, “Baghtay kay, jaa jala/toda hey hospital.” The sainiks went on a rampage and the hospital was forever destroyed, patients were injured and a child even died in this violence.

Any violence should be condemned. But when politicians and certain political parties have specialised in using violence as a means for bargaining and getting their demands fulfilled then sorry, the followers and population is going to do exactly just that. This whole situation of beating doctors and their strike is rather complexed and multilayered. Sadly like today’s young journalists, the young doctors do not know of these complex issues. The number of players, the manipulation of their own senior doctors and deans and then they would care. Such things most youngsters wish to stay away from and are encouraged by their families too. But if they do not care to understand, I agree with what CJ Chellur says, holding poor to ransom will only further intensify their emotions. They will go a step further to beat. The doctors have a bigger role to play in putting an end to this whole issue. The standoffish attitude needs to be replaced by more sensitive one.

Dr Binayak Sen -fighting charges of sedition

The medical practice is the only profession in our country (atleast i know India) that has to take an oath. The docs are not supposed to be profit oriented and more so, since diligent tax payers like me file returns & pay taxes, their medical education is highly subsidised. So they are supposed to take an oath of serving 1 yr in rural villages & be committed to public. That is the main reason for subsidisation of this otherwise expensive studies.

One such diligent medical professional & gold medallist is the man in the picture above. Dr Binayak Sen. Who has a wife, Ilina & 2 daughters. Today the family is scattered thanks to Govt of Jharkhand, GOI & High Court that has ordered him to life imprisonment.

Dr Sen went on to Chattisgarh which was once part of Bihar before. Sen dedicated his life to the poor, mostly those who can’t afford to eat even rice twice a day, forget 3 times. And they are totally deprived from absolute basics like food, opportunity to earn living, basic education & will to survive. Most of us will never be able to identify with that. So let’s be honest about this fact.

Sen gives them medication, helps them to live, ensures the women don’t die while pregnant, at the time of delivery, lack of nutrition,  don’t die after delivery due to lack of iron or blood. He ensures the children in that region don’t die due to malnutrition & starvation. This i am sure is of most significance. He also treats them for diarrhoea, cholera, malaria & they get medicines free of cost.

People in cities may never know the importance of these things. It is so vital to have healthy, normal citizens who are not a burden on our economy. Ill, disabled deprived population adds burden to the economy, Which the governments should be reducing, but play politics with it. This most valuable difference is so vital. Even more when we realise he’s made a difference in an area where govt has never bothered to reach or never will.

In the interim period. The Communist Party of India (Maoist) reached in these remote, tribal areas of India. The cadre & workers mostly educated, rich, who left their comforts & warm environments came to dedicate their lives to the betterment of these poor tribals. Well they never will get medals for sure. Yet someone was acknowledging them, someone valued & cared for them. The fact that the tribals would never forget. Soon many felt frustrated, the lack of governmental intervention has its limits too. The cadre also began feeling it. They realised things & systems are not changing & soon we saw the rise of extreme Maoist, Naxal activities of their cadres resorting to violence.

Killings took place -till now mostly of the officials, administration of those who were key players of our corrupt systems. Till then most felt, “Its ok, the govt calls for trouble if they don’t change & get to the grassroots.” the govt never has done it & will never do. So then anger, frustration drove many to guerilla war fare. The naxals began attacking civilians. However the tribals never diminished their support to the naxals. For the reason that they survived indifferent death.

Dr Sen meanwhile dedicated his life to serving these poor tribals. His wife & children lived in Wardha & would frequently visit him in Raipur too. their lives took a change for sudden. Dr Sen was arrested. The last 7 years he is fighting all sorts of charges put on him forcibly, for which there is NO evidence at all.

OK, tell me when you go to visit your personal doctor how do you like your dr to be? Detached, Impersonal, straight up, come to the point Ms/Mrs/Mr so & so. Or at least i like my dr to smile, laugh, relax, be warm welcoming & i want to tell him something personal -my illness.

May be its an Indian trait or what i don’t know, we don’t stop here. We patients know about the doc’s life, more so he knows lots more about ours. We feel nice if our doc enquired about our spouse, gf/bf, children, their progress, our personal problems, etc. The usual appointments of docs go on for a while.

We tend to consult the doc see him as a guide & in a country like India, Doc is equated with GOD. Whoever, whatever there may be. Many of us want our parents or kids to listen, follow certain course of medication, diet we ask our doc to do so. We request him to have a talk with our family members, because we are confident they will listen to the doc. Its understood. The doc doesn’t simply ‘passes on our message’ goes beyond & convinces the individual. So we want the doc to be our advisor, counsellor or communicator, to get some work done.

Imagine this situation a tribal area. It’s far more intensified. The families who may know nothing about medication, treatments & illness in the first place. Besides imagine the activists who lived here, leaving behind their families in cities while they lived in remotest corners. Now take this further. Some of these got arrested. Not all have worked in arms training or imparted arms training or even picked up arms. Some really went there to teach -educate the children/adults.

The informal non-religious, non-formal and absolute socialist form of education. So what. At least they informed poor, illiterate tribals of their rights, schemes, funds available that they can use. As a result, many who got arrested and have been sent on rotation from 1 jail to another do have families. Some have multiple families. Some have really tiny kids. In fact one alleged Naxal saw his kid last when he was just born! They feel lonely. They too are human concenred of their families & more so the academic progress of their kids. They are given crap food, with worms, stones, etc. Most have been beaten. You can make out after their releases interim ones though.

These Dr Sen types have been languishing in jail for like 7 years plus. So while they are in jail they also would to reassure their wife, kids, daughters especially how to cope with these circumstances. They want to tell their children to not fall for loose talk, taunts NOT to get emotionally vulnerable. Also words of caution, ask them to be careful.

This is NORMAL. I’d have done or communicated lot more. Remember the arrested naxals are denied all rights. NOT even allowed to write letters to their families. What if they have sent encoded messages you know!

So the Chattisgarh govt of BJP stepped up its anti-naxal activities. & while they wanted to arrest the violent Naxals, whom they couldn’t zero down upon, they simply arrested Dr Sen. He got bail after 7 years and trial began. Unfortunately during the trial most media IGNORED the issue. in this interim period i happened to write a piece on children of few naxal leaders. I spoke to Pranhita.

“When rumours of Binayak’s Sen’s arrest were doing the rounds in Raipur, where he lived and worked, his family was on edge. Pranhita was at the time studying in a college in Kharnagar, a few hours from Raipur. Her life changed after Sen was arrested on May 14, 2007. She started getting threats.  Leaflets would be slipped under my door, saying ‘they’ knew I lived alone she says. I am now scared to talk to people. Even when you messaged me for this interview, I felt nervous. Free Binayak Sen campaign, and is the cinematographer for a documentary the People’s Union for Civil Liberties is making on the case. Working for the campaign has also helped Pranhita appreciate her father’s work. ” At the same time, she says she holds no grudge against the neighbours who shut their doors and windows when a posse of nearly a hundred policemen arrived to take her father away. “They called my father a terrorist and shut us out. But calling him names does not make it true.”

The daughter & other children have to live with these tags like “terrorists”. The Chattisgarh court has charged Dr Sen with ‘sedition;’ The definition – “actions or speech urging rebellion against the authority of a state  or ruler.” So to treat the poor, live among them. To pass on messages if the cops are to be believed, is this a crime? More over to prevent illnesses, death of women & premature babies, immunise them is going against the country.

Do we not always communicate, send messages to one another? what’s social networking i wonder? Now if Dr sen has sent messages of these arrested in Jail to their family members, it becomes sedition? This is maths gone wrong. Bcoz the police aren’t doing thorough investigations, they have failed to catch real culprits. They can’t put an end to Moaism so they catch the person doing some good work there. Sure some good work this is.

Instead of calling for other NGOs, calling CPI (M) cadre to talk, taking schemes to the poor in those remote areas, ensuring even if there’s 1 child he gets to study, instead the govts send para military troops, naxal combat teams to finish the activists, people? the real problems remain unsolved.

But the truth is those who know less about the movement, about Maoism, Communism in this country, will draw their own conclusions. Worse still, since most do not have family doctors who take the extra effort, charging pittance & helps to prevent disease, we will never believe Dr Sen is only pracitising medicine. Dr Sen has at no time propounded, promoted or supported violence & killing in the name of maosim. To call him naxal in itself is wrong. Actually they are driving nice people towards it. Worse still they’ve called Dr Sen as terrorist? Who exactly has given us the right to call this med doc such names?

People also say, “what’s the truth, he was a naxal na?” He helped the naxals, maoists, so he is anti-national . On what basis are these allegations being made? Read what i’ve written. Ask ourselves the basic questions we have read. Draw your conclusions based on it. Else find a better family doctor yourselves.