In 2020, the prime minister of India called upon all in the country to commend the frontline health workers who were risking their lives during the COVID-19 pandemic by slamming utensils outside their balconies as a display of gratitude. Yet that same year, the country witnessed a surge in workplace violence against health workers with over 2,000 reported cases — a significant rise from the 1,200 in 2017.
The landscape of healthcare is marred by distressing occurrences where dedicated providers are callously hindered in discharging their responsibilities, as highlighted by a tragic incident in Bihar. The unfortunate death of a pregnant patient sparked fury, culminating in an assault on a doctor and a compounder. A similar tale unfolded in Kerala, where a dedicated young surgeon lost her life to a senseless act of violence; being repeatedly stabbed by her patient underscored the danger that health professionals often face while striving to offer care and compassion. There have been viral videos of several incidents, one of which took place in the city of Indore, where two female doctors were hurled with stones as they went to check up on a patient who was suspected to be suffering from COVID-19.
With attacks like these, it is little wonder that the pandemic has had a profound toll on the physical and mental health of these indispensable professionals. Under the weight of countless losses — immense numbers of their patients, but also of likely thousands of their colleagues (by one count, nearly 1,600 doctors by September 2021) — many have endured grueling hours of service. These reprehensible acts have resulted in insufficient staffing overall, increased stress, and fear of retaliation amongst the medical community. India’s health workers endured terrible suffering as they sought to care for us. Now we must care for them.
One way to do so is to take forceful action to combat violence against health workers. Although legislation enacted by the central government in 2020 (“The Epidemic Diseases (Amendment) Ordinance of 2020”) made essential changes to the existing landscape of state laws in India to better shield health workers from violence and harassment, its temporary nature — it has ceased to be in force now that the pandemic has ended — left a void in the face of escalating violence against health workers.
Violence and attacks against health workers harm them and the entire health system. As a result of physical injuries and psychological trauma, violence in the sector leads to demotivation, burnout, and insufficient staffing — all affecting the quality and accessibility of healthcare. This predicament was further exacerbated in India during the pandemic when violence against health and care workers surged within health facilities and the community.
The inability to safeguard health workers from harm undermines India’s ability to deliver timely and quality healthcare. Fortunately, there has been a groundswell of momentum in their parliament. During the recent monsoon session, at least three bills aimed at safeguarding the rights of health workers were introduced in the Lok Sabha. The distressing trends of violence and harassment demand robust legislative measures. It is imperative that the Indian parliament pass one of these new laws to better shield health workers and facilities from violence, enabling them to provide care for the nation.
Currently, at least twenty five Indian states and union territories have policies or laws aimed at protecting health workers. However, these laws differ in punishment and degree of strictness. While some states have implemented measures to protect health workers, implementation itself has been weak. The current legal framework is not equipped to address the unique challenges and risks faced by doctors and other healthcare workers. A central law dedicated to protecting health workers and preventing future attacks that is linked to the Indian Penal Code and the Code of Criminal Procedure would lead to more effective state-level solutions. Ultimately, a framework proposed by the central government would set forth a uniform minimum standard for states to build upon with their own laws.
One such bill, introduced as a private member’s bill by Honorable Parliamentarian Dr. Mohammad Jawed, the “Healthcare Service Providers and Facilities (Prevention of Violence and Damage to Property) Bill, 2023,” is a monumental stride towards ensuring the protection of all “health service providers, including administrative, clinical, support, and auxiliary staff,” in accordance with human rights principles and international benchmarks. Before its introduction in this parliamentary session, experts at the O’Neill Institute, in collaboration with the Indian Constitutional Aid Association, reviewed and advised the member’s team on the bill’s content and the protections afforded by it.
If enacted, this bill will establish comprehensive measures for the prevention, intervention, and accountability of violence and property damage within health facilities, including new provisions in the penal code. But, in cases of minor offenses, such as situations where a health worker isn’t physically harmed, arbitration outside of the court can be pursued as an initial recourse for justice, in order to save the parties from the hassle of time-consuming litigation. This solution offers a streamlined and expedient avenue for resolution, alleviating the burden on the court system.
Furthermore, the bill would create stronger state health committees, ones that have responsibilities beyond those that currently exist in an advisory capacity. Under the proposed law, each state will have a separate committee tasked with collating comprehensive data on incidents and be empowered to prevent future acts of violence. To further address the aftermath of such incidents, the bill extends support for the well-being and recovery of health professionals. Adequate psychological support and counseling will be provided to affected individuals, thereby promoting job satisfaction and retention within the sector.
On its own, this bill is a worthy model that could be taken up even by the state governments themselves. The practice alone would create some consistency across India, which would be beneficial, especially in public health outbreaks. As evidenced by the multiple bills introduced this past session, ongoing debate, research, and solutions on the issue of protecting health workers from violence and harassment are needed.
By establishing a framework that precludes violence, champions victims, and holds wrongdoers accountable, the “Healthcare Service Providers and Facilities (Prevention of Violence and Damage to Property) Bill, 2023,” not only elevates the caliber of health services but also upholds the fundamental rights and security of those working in the health sector.
A policy answer here is imperative to forging a society wherein health providers can discharge their duties without fear and patients receive quality care in a secure environment. The time has come for India to take decisive action and accord paramount importance to the safety and well-being of its health workers, who consistently dedicate themselves selflessly to the service of others. It is a clarion call for the government of India to shield those who protect the ill and injured.
