Doctors’ Dictum : DUTY First

Dr Sanjay Kumar Bhasin
Hippocrates; a Greek physician, once said, “Extreme times call for Extreme measures”. During COVID-19 times, this phrase so aptly be perceived as entire world including India underwent the extremities of this malady.
As a matter of professional conduct the doctors, nurses and paramedics suo motto assumed the role of frontline warriors controlling the situation world over in an exceptionally selfless manner. They even forgot their own right to health. In India, right to health encompassed in Article 21 is derived from the Directive Principles of State Policy. The Supreme Court held right to health, an integral part of the right to life and the Government has a constitutional obligation to provide health facilities to all the citizens including frontline warriors. During pandemics, they are the ones subjected to the highest amount of risk and it is of paramount importance that they remain in pink of health. Unfortunately, insufficient measures were taken for their safety and protection during COVID times. But these frontline workers worked with full dedication and devotions risking their own lives to save the lives of the commoners as well as the VVIPs. In JK UT also the healthcare professionals took the lead role and tried their level best to curtail this deadly epidemic to minimum possible level.
Problems faced by the frontline warriors
Dearth of protective gear: Medical staff across so many parts of India in the initial phase of pandemic management faced inadequate supply of protective gears such as the PPE kits, N95 masks, hand sanitizers, gloves and so on. These were the basic amenities required to boost the confidence of healthcare professionals vis s vis treating the COVID positive patients in both private and public hospitals. Death of nearly 3000 patients in Wuhan, China in Dec 2019 could have been wake up call for all the governments to start garnering as many PPE kits, N95 masks and gloves as would suffice in fighting the unprecedented situation. But it could not happen and healthcare professionals had to work initial under compromised circumstance giving lot of mental trauma to them. In extreme situations sometimes doctors had to skip the scene with apprehension of succumbing to the contagious coronavirus and subsequently jeopardizing their family members. Inadequacy led to almost 83% of all doctors quarantined in Maharashtra at one or the other times, followed by 11% in Delhi and 6% in Karnataka. Many hospitals in Maharashtra, Delhi, Karnataka, West Bengal and Tamil Nadu were partially or completely shut down due to the reason of their staff being quarantined after their exposure to Covid-19 patients. Subsequently, the situation improved.
Abuses on frontline warriors: in spite of facing extremes of situation including risks to their lives while treating patients, they faced abuses coupled with media propaganda unnecessary escalating workplace situations. On so many occasions the family members or the attendants of the coronavirus patient admitted in the hospital rolled up their sleeves to pick a fight with the doctors. A lot of verbal abuses used to be hurled on frontline workers which eventually fuelled up into physical assault and the media further fuelling them and giving negative image of the institutions as well as profession. Additionally, plethora of incidents of stone pelting on ambulance, assault and manhandling of a woman doctor by attendants are on record. Apart from this, many of our frontline warriors have faced ostracisation from their very own communities and were evicted from their homes by the merciless landlords or hostile society members. Cremations and burials of many of them or their relatives had been a hard nut to crack for their families. Instead of praising and supporting the warriors the public almost considered corona warriors as untouchables.
Sensing gravity of the situation, the Union Government promulgated Epidemic Diseases (Amendment) Ordinance, 2020, whereby; Attacks on doctors, paramedic staff and ASHA workers have been made non-bailable and cognizable offences with imprisonment from 6 months to 7 years and fine of 1-5 lakhs. There is provision of completion of police investigation within a month and the final judgment to come within a year. Furthermore, those found to be damaging the private clinic or a vehicle belonging to a doctor will be asked to pay compensation amounting to twice the market value of the damaged property or assets.
Pay & Perks of Corona Warriors
While these frontline warriors were working day and night to treat the COVID patients with full strength yet many a state like Karnataka, Odisha, Delhi, Maharashtra and many others failed to provide the deserved salary to these warriors leave aside added incentives. Doctors threatened to leave the job and ultimately in June, the Supreme Court had taken serious note of the non-payment of doctors engaged in Covid-19 duty and asked the States to settle the issues soon.
Death of Corona Warriors: while treating COVID patients 31 doctors had died getting the infection by May 2020 in India. In September, IMA published list of 382 doctors who died of Covid-19 and demanded martyrs status for them. Number of Doctors dying due to COVID while treating patients rose to 500 by October ending. The government denied of any authenticated data of Doctors death available with them and the IMA stated that it amounts to “abdication of duty and abandonment of the national heroes who have stood up for our people”. Happily, the death rate amongst Corona warriors decreased from November onward probably due to better understanding and management of the disease and its decreasing trend in the general population.
Huge Mental Pressure Returning Home: These warriors faced huge mental pressure while returning home after duties and joining their ailing parents and small children. Most of the times they remained confused how to balance but they did it bravely and technically. Few did transmit disease to their kiths and kins.
People across the world including India largely remained confined to their homes with businesses and all educational institutions remained and are still shut down in an attempt to contain the virus. Contrary to that, these sleep-deprived hero doctors and all health-care workers with thermometers, stethoscopes, and ventilators as their weapons led the battle against COVID-19 from the front with selfless determination putting their own lives at risk for the sake of saving humanity. These real heroes of challenging times must be appreciated to the fullest for putting their own health, families, and most importantly their own lives at risk. Befitting tributes must be paid to the dead corona warriors. Million dollar question especially for Indian system is, What if another pandemic appears on the horizon? Surely our response should be governed by science and strategy and overseen by experts? We must reassess the value health-care workers hold in our lives and the kind of treatment they get from us. Among the several lessons this coronavirus pandemic has taught us, the biggest one is to find ways to sufficiently invest in the better and more efficient medical fraternity and give medical professionals the respect, compensation and infrastructure that they truly deserve once this crisis is over. Moreover, the world needs to work towards advancement in medical research and technology. Nothing will be a greater tribute to the health-care workers than this.
Preservation of human life and right to live with dignity are of paramount importance.
(The author is Honorary Secretary JK Chapter of Association of Surgeons of India Member Secretary Institutional Ethics Committee, GMC Jammu)