Extended Work Hours, Depression: The Math & The Aftermath of Doctors' Protests
The horrors of COVID, coupled with the lack of workforce, has left doctors with physical and mental health issues.
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"Pehle hum par phool barsaye, baad mein hum par lathh barsaye" is a slogan and a sentiment that defines the anger and anguish that resident doctors across government hospitals in Delhi currently feel. On Tuesday, 28 December -- a day after many were detained, and allegedly manhandled by Delhi Police for protesting -- The Quint spent time at the Safdarjung hospital, speaking to multiple young doctors about the need to expedite NEET-PG counselling, their long working hours, and crumbling mental health.
The hospital grounds reverberated with slogans such as "Sadda Haq, Aethhe Rakh' and "We want justice" even as armed policemen and security personnel stood guard.
Scores of these doctors had spent almost the entire day in a police station just a day before. They claimed they had been manhandled, dragged and thrashed by the Delhi Police while they were marching towards the Supreme Court a day ago to demand the expedition of the NEET-PG counselling that would pave way for the enrolment of a new batch of resident doctors.
(Photo: Eshwar Ranjana/TheQuint)
Some were also detained later in the evening on Monday, as they began their march towards Union Health Minister Mansukh Mandviya's office to protest against the alleged police brutality.
Around 12 pm on Tuesday, the protests swelled as it started raining.
A doctor, on being asked if there are any in attendance at the protest who had been detained a day ago, said, "Speak to anybody, almost all of us standing here were detained." He had spent the last few days protesting, and his voice had turned hoarse. This, however, didn't deter him from raising slogans.
The Anger Over Police Action
Dr Aarti Parashar, who is employed at GD Pant Hospital, was a part of the protest at Safdarjung hospital on Tuesday. She claimed that "several female resident doctors were manhandled and abused by male police personnel while they were marching towards the Supreme Court on Monday."
She added, "They detained us and abused us, it's shameful. On one hand, they pay tributes to us, call us 'COVID Warriors', shower flowers on us, light diyas and bang thaalis... But yesterday, they welcomed us with laathis and abuses."
(Photo: Eshwar Ranjana/TheQuint)
Dr Lovely Singh, a gynaecology resident at Safdarjung hospital, lamented about being at the receiving end of anger -- both of the system's, and the kin of patients.
Describing how Monday unfolded, she told The Quint, "Policemen started throwing resident doctors in a bus. Federaton of Resident Doctors Association (FORDA) President said that if some of them are being taken, we will all go because we are protesting as a team. When we started boarding the police buses ourselves, only then did they stop beating us up."
She claimed that it was, in fact, the police and not them who had blocked the roads.
The Math and the Aftermath Behind NEET-PG Counselling Delay
Dr Mahesh Mahajan, a neurosurgeon at the GD Pant hospital who came to show solidarity with the protesters at Safdarjung, explained the crisis triggered by the delay in NEET-PG counselling using simple math.
"To run a hospital, specific manpower is needed. There's a stratum -- first year, second year, third year, assistant, associate, senior, and so on, with all being assigned specific roles. If there's no first-year enrolled, their work gets distributed to second and third-year doctors leading to stretching of duty hours," he said.
Mahajan further added, "These are government hospitals. In India, a 100-bed government hospital will at least have 150 patients. Some hospitals even have floor-beds. If for a hospital like this, there are 20 doctors assigned but only 10 are allocated, there will obviously be mismanagement. Who will be held responsible? There have been so many incidents when they hold the doctors responsible and not the administration. So, the delay in counselling is absolutely unacceptable," he said.
To elaborate on Mahajan's point, Dr Singh explained how the residents at the hospital are having to tackle the workload of the new batch that is not being enrolled as well as the senior batches that are leaving after getting their degrees.
"Every year, NEET-PG counselling happens and new doctors are recruited. We were enrolled one year and eight months ago. Our senior batch has already left after getting their degree and no new enrolment has happened for a fresh batch. So, that has increased our workload. Now next March, one more senior batch will leave. So, after March, it will be three people handling 10 people's workload. What does the government expect? Are we machines? Do we not have to sleep or take care of our health? Should we just die working?" she said, angrily.
Dr Prashant, a neurology resident at GD Pant Hospital, said that the issue is not just extended work hours of the current resident doctors.
"There are over 40,000 potential resident doctors who are sitting at home because this counselling is not being carried out. That is a huge manpower that is sitting at home. We want them to be mobilised as soon as possible so that it affects the health system in a positive manner," he said.
'COVID, Extended Work Hours Triggering Mental Health Issues, Depression'
Several doctors narrated how the extended work hours not only take a toll on their health and their personal lives, but also put patients in jeopardy.
"Once I was supposed to assist a case in the OT (operation theatre) and I was on 24-hour emergency duty before that. I hadn't had two minutes of sleep but there was nobody to replace me. I was tired and sleepy. What would you say to a doctor who is in an operation theatre and is falling asleep on the table?" Singh said.
Parashar, who had similar stories to tell, described how the horrors of the second wave of COVID-19, coupled with the lack of workforce, has left many doctors reeling under mental health crisis.
(Photo: Eshwar Ranjana/TheQuint)
"Sometimes we cannot go home for 72 hours. During the second wave, we saw far too many people dying before our eyes. We are overburdened but we are still working. We can assure treatment to the patients but we cannot assure the quality of the treatment to the patients. We are humans, not donkeys," she said.
'Empathise With Patients Suffering Due to Protests, But...'
As the protest went on, a couple in an auto-rickshaw at the hospital's gate number 7, asked the security for directions.
She looked perplexed. The hospital had shut all gates for vehicular entry for security reasons.
"Andar kaise jayenge? Ye cancer patient hai, bhaiyya," she said pointing towards her husband.
On being told that all gates were closed and only emergency cases and ambulances were being allowed, the two decided to walk in the rain.
Priyanka (name changed) walked with her husband Brijesh to the cancer ward. "Cover your head, don't get drenched," she said to him anxiously.
"We have to come here every day, cannot miss a single day of his therapy," she said.
(Photo: Eshwar Ranjana/TheQuint)
Most of the patients and their kin, who would otherwise be seen waiting or walking around the premises, had taken shelter either inside the hospital or in the waiting rooms.
The guard at the Emergency Department, requesting anonymity, said that the protests that have been taking place since 9 December have disrupted emergency services to a large extent.
"Sometimes the administration directs the patients to other hospitals after preliminary treatment as they don't have enough people to carry on the treatment here," he said.
Asked about the sufferings of the patients while services are boycotted, several doctors said that it is the patients sake that these protests are being carried out.
"The third wave of Covid is around the corner. We don't want people to suffer because of lack of doctors. The protests are for the sake of patients and the health infrastructure," said Parashar.
The Breakthrough (Or Not)
On Tuesday, as protesters continued demonstrations through the day, Mandviaya met representatives of several Resident Doctors Associations (RDAs), including Dr Manish, President of FORDA at the Nirman Bhavan.
As he began to address the protesters upon his return around 5.30 pm, Manish suggested a reconsideration of the course of the protests following "certain assurances" given by Mandviya, leading to a brief displeasure among the protesters.
(Photo: Eshwar Ranjana/TheQuint)
A few minutes later, he addressed the media to disclose that Mandviya had given assurances on two principle demands -- a date to be declared for NEET-PG counselling, and a written apology by the Delhi police over the incident on 27 December.
Following the briefing, a meeting was held between representatives of various doctors' bodies in which it was decided to continue the protests despite Mandviya's assurances.
Each day, the story unfolds, the tussle intensifies, and the number one sufferers -- patients and their kin -- shuttle from one gate to the other.
(Photo: Eshwar Ranjana/TheQuint)
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