The battle for survival and good health is led by the army of doctors around us. India celebrates National Doctors’ Day on 1st July every year to honour the most eminent physician and the second Chief Minister of West Bengal, Dr Bidhan Chandra Roy who was also awarded the Bharat Ratna. On this day, we pay our tribute to all the medical professionals and workers for their persistent and diligent service to the society. They have treated and served the people against all the odds. This year, we have greater reason to pay tribute to and thank our medical professionals for their service in the battle against the COVID19 pandemic.
Presently, as the world is experiencing an unforeseeable pandemic crisis, a crucial challenge stands at the doorstep of our health workers, doctors and physicians. They have the responsibility to fight the unrelenting onslaught of the Coronavirus. In any other treatment process, the lives of these health workers are at a relatively lesser risk. However, this time, the deadly virus carries great risk to their lives. They are the frontline workers in the battle against the epidemic. Their efforts and contributions have been the reason behind a significant number of recoveries with over 2 lakh patients becoming COVID-free in India. Our only hope to overcome the disease is with the help of these health warriors.
Challenges in fighting Covid 19
India, having a majority of the rural population (being 65.97% of the total population), is under major strain to maintain and provide adequate health services for everyone. The inadequate healthcare facilities, lack of staff and medical homes and inaccessibility to health-related resources create a severe health setback in our country. Hundreds of doctors, nurses and paramedics have come down to treat thousands of patients on a daily and sometimes, even on an hourly basis, across all affected states. The doctors are under the constant obligation to attend to the infected patients, and many of them have to work overtime. The COVID-19 virus is highly infectious, making some people having a pre-existing health condition even more vulnerable to infection. While attending to COVID-19 patients, medical workers are required to wear Personal Protection Equipment (PPE). The PPE comes in a kit consisting of clothing suit, mask, gloves, goggles etc.
Short supply of PPE kits
A major problem in the current situation is the short supply of these PPE kits, which is the most important protection equipment against this hazardous disease. In addition to the shortage, the expensive price per kit which comes at Rs.1000- Rs.2000 per set is also an impediment in procuring them. Additionally, the kits have a utilization capacity of being single-use only. To overcome these complications, doctors have taken up raincoats and motorbike helmets as an alternative protection measure.
The doctors and nurses are also seen working continuously for straight 6-7 hours at a stretch, without breaks. Many times overwork and pressure lead to headache, fatigue and dehydration. Further, with each day, the number of patients has been increasing rapidly but the number of doctors to treat them is the same. Some medical staff have minimized their consumption of water to avoid washroom breaks and have instead taken to wearing diapers. Switching off ACs and fans in hospitals to prevent the spread of the virus is causing susceptibility to heat, and also causes a skin infection called hyperhidrosis due to excessive sweating.
There is a huge lack of medical resources with an inadequate number of beds and a low hospital to patient ratio. The lifesaving equipment such as ventilators and oxygen cylinders are absent in hospitals or are available in lesser quantities than required. The drawbacks and inadequacy in the hospital infrastructures is a serious concern at the moment. An already shabby healthcare system in India is now overburdened by the rising number of patients and a shortage of protective equipment.
How has Coronavirus affected health workers across the country?
According to the latest report in May, the virus has affected around 548 health workers, which includes doctors, nurses and paramedics. There has been no investigation on the root cause of their catching the virus. But the low maintenance and hygiene of the healthcare facilities have exposed them to a maximum risk of contracting the infection. As of May, around 31 doctors and 3 nurses have lost their lives due to being infected by COVID. It is saddening that the frontline saviours are being knocked down by the virus due to overexposure and a weak medical system. As a result, several cities are closing down hospitals to contain the further spread of the virus among other medical staff and patients.
Apart from their professional duties, long hours of having to cater to COVID-positive patients forces them to stay away from their families and their homes for days together, and many of them are also forced to go into self- isolation. In an article about the emergent situation, the European Respiratory Journal mentions that the medical workers are going through a time where “the doctor is subjected to a number of competing duties: 1) a duty to patients; 2) a duty to protect oneself from undue risk of harm; 3) a duty to one’s family; 4) a duty to colleagues whose workloads and risk of harm will increase in one’s absence, and 5) a duty to society.”
The list of hurdles goes on adding up as the other patients of critical diseases such as AIDS, Cancer, etc. are left with no options for treatment due to the shutdown of many clinics and therapy services. Door to door immunization vaccines have also been halted in states like Bihar, Karnataka, Kerala, Rajasthan, and Uttar Pradesh.
Attacks on Medical Workers
The struggles of doctors don’t end here. Despite their round-the-clock dedication towards curing people infected with the virus, a wave of social stigma and public violence against them has started attaining intolerable proportions. In various cities like Indore and Bengaluru, the health workers have been publicly attacked while on duty. The widespread fear of contracting the virus among the people has caused many to undergo mental distress and has caused them to take the frustration out on the doctors.
In an incident in Indore, where the doctors went on tracking a suspected COVID case, a denial for providing information and misbehaviour by the person was witnessed by many. Immediately, a bunch of around 100 people surrounded the medical team, pelting stones and other objects at them. Such similar incidents of attacking doctors have been taking place in other cities as well. “We are not scared of infections; we were mentally prepared for that as an occupational hazard. But getting beaten up, that wasn’t something we mentally prepared for. That’s not an occupational hazard we signed up for” reports Nirmalya Mohapatra, a senior doctor at a public hospital in New Delhi.
Doctors face discrimination
There has been a rising number of cases where doctors are facing discrimination in their neighbourhoods. They have been forced to stay out as they might be a carrier of the coronavirus and infect the surrounding people. It is disheartening how the doctors have to suffer from both professional and personal hardships contributed by the insensitive nature of many people around them. Some instances have also come to light where doctors have been threatened with disconnection of electricity and water, and have been forced out of their homes.
The ongoing struggle against the novel coronavirus can only be won by the help of our powerful fleet of healthcare workers. They should not be the ones paying the price for the defaults in our healthcare system. In India, the ratio of doctors to population is 1:1800, which is much less than the WHO prescribed standards. Thus, it is important to protect every healthcare worker who is helping to fight the infectious virus by providing their services. Their physical, mental and personal sacrifices have to pay off. The government should expand its purchasing quantities of the PPE kits and ensure that every doctor has access to protective gear. Basic sanitation and disposal facilities have to be provided in every hospital to lower the chances of exposure. These health workers have the right to a safe and secure medical environment for treating infected patients.
The Prime Minister has promised a bulk import of PPE kits from South Korea and China to cover the shortages. Regarding the violence against the doctors, the government needs to implement stricter rules and penalties to protect them. Recently, on 22nd April, the government has introduced an ordinance on amendments to the Epidemic Disease Act, 1897, making the attacks on doctors and health workers a cognizable and non-bailable offence. The amendments make the offence punishable with imprisonment from three months to five years and a fine of ₹ 50,000 to ₹ 2,00,000. In case of serious attacks, the imprisonment ranges from 6 months to 7 years and the fine charges range from ₹ 1 lakh to 3 lakhs.
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The doctors are making huge sacrifices to protect us and maintain our health. Therefore, it is important that we treat them with dignity and respect their service towards our society. The fight and difficulties in their profession will become bearable with our support.
We all need to remember – “People pay the doctor for his trouble; for his kindness, they still remain in his debt.” ― Seneca (4 B.C. – 65 A.D.)