'Systemic Failure': Medicos Demand Action After Kerala Doctor Stabbed to Death

Doctors allege that over 200 attacks have taken place against doctors in Kerala in the last three years.

(Trigger Warning: Descriptions of violence and murder. Reader discretion advised.)

"There can be little doubt that the killing of a doctor by a person in custody of police, be that as an accused or in any other capacity, points strongly at a systemic failure [sic]."

Kerala High Court

For 22-year-old house surgeon Dr Vandana Das, 10 May would have been like any other day at Kerala's Kottarakkara Taluk Hospital – until she got trapped inside a hospital room, where nurses were treating 42-year-old Sandeep, who was in police custody.

In a matter of seconds, Dr Das was allegedly stabbed six times on her head, neck, and spine by Sandeep. While police personnel and others managed to get out of the room, Dr Das could not escape death.

Doctors across the state, backed by the Indian Medical Association, have taken to the streets after the shocking incident – demanding punishment for the accused, reiterating their concerns about the safety of healthcare professionals, and stressing the need for a strict law.

'Failure of the Police, State'

Dr Binny John, chairman of the Kerala chapter of the Association of Surgeons of India, told FIT, "The accused, who had a drug abuse problem, was brought for first-aid care. He was not handled properly by the police. He was not handcuffed. We have protested many times against the violence against doctors in Kerala but no action has been taken."

Dr Sulphi N, IMA Kerala chairman, concurred, alleging that over 200 attacks have taken place against doctors in Kerala in the last three years. He said:

"It is the duty of the government and hospital authorities to protect doctors. We want a new Act to be brought in since the 2012 Prevention of Violence in Healthcare Institutions Act is unable to protect us."

Dr Sulphi also told FIT, "We met with the Chief Minister and Health Secretary and demanded an ordinance for our protection that should be issued urgently. We've also asked for an investigation, special prosecutor in the case, and that the new law to be named after Dr Vandana."

This is not the first time that doctors were forced to protest against assaults on medical professionals. The Kerala unit of the IMA also took to the streets in March this year after a cardiologist was physically assaulted in Kozhikode.

Irresponsible Statements by Politicians Instigate Attacks

Doctors also feel that "irresponsible comments" by political leaders instigate violent attacks against doctors.

Two months ago, Pathanapuram MLA and Kerala Congress (B) leader KB Ganesh Kumar had said in the state Assembly, "Some doctors need to be beaten up, in my opinion." He said this while speaking about alleged cases of medical negligence. 

Kerala Health Minister Veena George's statement about Dr Vandana's death on Wednesday, 10 May, also irked doctors. George had said:

"The doctors who were present at the hospital when the incident took place tell us that the girl was not experienced, and therefore, she got scared when such an attack happened."

Dr Syed Faizan Ahmad, national vice-president of the All India Medical Students' Association, told FIT, "We have 19 subjects in 4.5 years of MBBS. If the government can't protect us, just add one more subject on how we can protect ourselves and learn self defence. This happened only because of the laxity of the police."

Dr Pooja Tripathi, a public health specialist, agrees with Dr Ahmad. She said:

"The Health Minister gave an unfortunate statement that she was not prepared enough to handle the attack. Anyone in a political, leadership role should not make such comments. How can you expect a doctor to be prepared for such an attack?"

Dr Tripathi went on to add that as someone working in emergency care 24*7, it is not on the doctors to protect themselves, but on the institution to ensure their safety. 

However, George later said that her words had been twisted. "People who know me will know that I am not someone who reacts insensitively about such a tragic incident."

Dr John feels that if attacks or violence against doctors continue, people will be deterred from pursuing the field. He said, "India should think about what will happen to healthcare in future because bright young minds would not want to join the medical profession if attacks like this continue."

State Government's Purview

Dr Sulphi says that protesting doctors want the Centre to bring in a law to safeguard doctors – but health is actually a state subject. The Centre had in 2018 introduced the Prevention of Violence Against Doctors, Medical Professionals And Medical Institutions Bill, but nothing came out of it.

In 2022, the Union Ministry of Health and Family Welfare issued guidelines, stating:

"Violence against healthcare professionals is a criminal offence and needs to be dealt suitably by the State /UT Governments under provisions in Indian Penal Code (IPC)/ Code of Criminal Procedure (CrPC) so that doctors/clinical establishments discharge their professional pursuit without fear of violence."

'Shut Down Hospitals if Doctors Cannot Be Protected'

The Kerala High Court division bench of Justice Devan Ramachandran and Justice Kauser Edappagath, during a special sitting hearing the case on Thursday, 11 May, said, "This is a gruesome incident which should have never happened."

The court has ordered protection for medical interns, postgraduate students under the Kerala Healthcare Service Persons and Healthcare Service Institutions (Prevention of Violence and Damage to Property) Act, 2012.

The previous day, the court had said: "If doctors can't be protected, shut down all hospitals. You have failed this girl. This is a case where you brought a man from your custody. The police should have maintained continuous vigilance."

A bench of the Kerala High Court had said in February this year that in cases of violence against doctors, anticipatory bail could lead to "dangerous situations."

In fact, a division bench of the court had in December 2022 ordered the state police to file a First Information Report within an hour of receiving any complaints related to attacks on doctors. The bench had said that the increasing number of cases of violence against doctors was "distressing."

Discrepancies in the FIR

On Thursday, the police also drew criticism for discrepancies in the First Information Report that was filed.

• The FIR mentioned that the police received information about the incident at 8:15 am on Wednesday even though it happened at 4:30 am in the presence of police officials.

• Murder charges were not added in the FIR.

The FIR was filed under the following sections of the Indian Penal Code:

• 341 (wrongful restraint)

• 324 (causing hurt by dangerous weapons)

• 333 (causing grievous hurt)

• 307 (attempt to murder)

The Kottarakara police said that the FIR was filed based on inputs by an eye-witness.

On Wednesday, the ADGP (law and order) M R Ajith Kumar had told The Indian Express:

"Sandeep behaved normally when he was brought to hospital for treatment. After examination, he was taken to the dressing room, where he first turned violent on the dressing table. Jumping out of the bed, he kicked a relative named Binu. He took the scissors from the room and stabbed a home guard (who was accompanying the police team). Sandeep then turned against a policeman on duty at the hospital and another person. While all others in the dressing room managed to get out, Dr Vandana could not. Sandeep then turned against the doctor and stabbed her multiple times."

What Doctors Are Demanding

The doctors' demands, among others, include:

• CCTV cameras and police booths in medical setups

• Punishment to the accused in this case

• Compensation to the victim's family

• Investigation against the erring police officers

• Amend the Hospital Protection Act

The Resident Doctors Association of Bhopal's All India Institute of Medical Sciences also demanded that self-defence training be given to doctors.

Dr John said, "The culprit should not be given bail. The court should come down forcefully on the accused. The law has to be changed so that people are deterred from attacking healthcare workers."

If these measures are brought in place, Dr Ahmad feels that they won't just help healthcare workers but also patients whose treatment is often hampered whenever violence erupts in hospitals.