The silent struggles of healthcare workers, often overlooked, reveal a disturbing reality of increasing violence in hospitals and clinics

During his Independence Day address, the Chief Justice of Telangana proudly announced that he had recommended a Protection of Advocates Act to the state government. The applause that followed made me think of the resident doctors marching through the rain in Delhi, gathering their courage to demand a law that protects healthcare professionals from the increasing violence in spaces that are supposed to be the safest.

In 2019, the draft Healthcare Service Personnel & Clinical Establishments Bill was introduced, seeking to penalise those who assault healthcare workers. However, the Home Ministry opposed it, stating that no separate law was necessary for doctors. A Right to Information (RTI) response from the Health Ministry later revealed that the draft Bill had been withdrawn. On July 26, 2024, the Health Minister further rejected the idea of a central law, asserting in the Lok Sabha that the newly enacted BNS and BNSS laws provided adequate protection for medical professionals.

Despite this, healthcare professionals’ anger is justified. Why doesn’t the public show the same solidarity as they did during the Nirbhaya case, where the horrific rape and murder of a physiotherapy student led to nationwide outrage? Even amid a national strike by the Indian Medical Association (IMA) over the rape and murder of a doctor in Kolkata, another tragedy was overlooked—the brutal killing of a nurse, a single mother, who went missing from a hospital in Rudrapur, Uttarakhand. Her body was found in Uttar Pradesh after she had been strangled and bludgeoned to death.

Similarly, in Gujarat in 2020, an Accredited Social Health Activist (ASHA) worker was raped while on duty. According to a study published in the *Journal of Global Health Reports*, 32% of ASHA workers face sexual violence, while 88% experience emotional and economic abuse. Disturbingly, 12% report sexual violence from their husbands, and 64% from beneficiaries and their families.

These incidents highlight the pervasive threat healthcare workers face. Last year, a doctor allegedly raped a nurse at a clinic in northeast Delhi. In another case, a Bhopal doctor was accused of confining and raping a 19-year-old patient. Just recently, at the same medical college in Bhopal, a resident doctor was suspended for inappropriate behavior with a cancer patient. Violence against healthcare workers also extends beyond sexual violence. Last month in Manipur, armed assailants attacked a children's hospital, and two weeks later, a patient was shot dead at Delhi's GTB Hospital due to mistaken identity.

These violent acts, whether committed against doctors, nurses, paramedics, or patients, must be addressed with the same urgency and seriousness. However, the IMA has yet to make a statement regarding the rape and murder of the nurse in Rudrapur. Have they suspended the membership of the Principal of RG Kar Medical College, implicated in the Kolkata case? Has the Indian Orthopaedic Association (IOA) taken action against its accused member?

A journalist recently tweeted during a doctors' protest, asking where the female doctors were in leadership positions. This raises a crucial point. According to a study published in PLOS Global Public Health, out of 46 professional medical associations in India, only 9 (less than 20%) are headed by women. Neither the Academy of Hospital Administration (AHA) nor the IOA has ever had a female president. This is despite women demonstrating remarkable leadership in healthcare—both my hospital and medical college are currently led by women doctors, and more than 50% of the heads of departments are women. Clearly, women are capable of leading in healthcare, but they remain underrepresented in top positions. Of the 64 individuals currently serving as presidents and secretaries of the 32 state chapters of the IMA, only three are women.

It’s time to move beyond token representation. Women doctorsmust be given more leadership opportunities. One of the most balanced and comprehensive statements on the issue of healthcare violence has come from Women in Global Health India. Their statement calls for an end to sexual violence in all healthcare settings, and it emphasizes that anyone—whether doctor, nurse, paramedic, or even political party member—who commits such violence must face severe consequences.

Eleanor Roosevelt, who played a key role in drafting the Universal Declaration of Human Rights, once famously said that human rights begin in small, often overlooked places. 

In the context of today’s healthcare system, that means the seminar room of RG Kar Medical College or the private hospital in Rudrapur—spaces where violence has occurred, but which remain untouched by reforms.

(The writer is director-professor at the University College of Medical Sciences and a disability justice advocate. Views are personal)