It has been a few days since Delhi was shaken by the violence that claimed over 47 lives. The city is reeling in the aftermath, and many reports have revealed the severe negligence of critical healthcare management in responding to the situation.
At a press conference organised by Jan Swasthya Abhiyan (JSA) on Monday, 2 March, the healthcare system’s faults - from failing to deliver timely emergency care to accounts of the police stopping ambulances - were laid bare. The conference detailed the findings of a JSA report that focussed especially in violence-affected areas of North-East Delhi like Ashok Nagar, Mustafabad, Jafrabad, Seelampur, Maujpur and Shiv Vihar to find a dismal failure of healthcare services to reach the ones who needed it the most.
Speaking to FIT, Dr Harjit Singh Bhatti, National President, Progressive Medicos and Scientists Forum, said,
“This violence has exposed the collapse in the Indian healthcare system. The state government likes to boast about their mohalla clinics but there were no hospitals or clinics for 8-10 kilometer stretches. But where are the functional clinics looking after riot victims in Shiv Vihar, Mustafabad or Jafrabad? We have been trying from 25 February till today, 2 March.”
Social activist and founder of Karwan e Mohabbat, Harsh Mander told FIT that “Even for ordinary health challenges for the poor, our public healthcare systems are appalling. But what is more terrifying is how people from minorities and Muslims are so scared and have lost faith in public health institutions. This communalisation of the public health system is the opposite of the Hippocratic oath.”
He added, “The tampering with evidence in the postmortem reports too is abysmal. Now we are seeing the medical profession scrutinised and it is time for them to introspect.”
According to the report, “far from providing healing from the trauma that victims have faced, the public health system itself has ended up inflicting secondary trauma through acts of commission and omission. Instead of being co-operative, hospitals have been withholding information and instead asking families to go from ward to ward, and room to room to check if their missing family members are admitted. ”
‘The Government Must Step Up’
The speakers told us first-hand accounts of healthcare denial, the lack of medical supplies in affected areas, mistrust in government facilities and more. JSA’s report recounts the challenges faced while accessing emergency healthcare and lists several recommendations for the government moving forward.
Dr Bhatti said, “The government’s duty is not just primary healthcare - that can be taken care of - but the follow-up healthcare is essential. The government needs to assure people they have made a separate facility or emergency setups for them, this will help them heal emotionally. Both the state and centre governments have failed.
Harsh Mander added that although the mohalla clinics did fill a gap in primary healthcare, they are woefully underequipped to deal with an emergency situation.
“An emergency situation requires an emergency response. We are living in Delhi and have the largest population of trained medical professions and the government could have called them to step in but that wasn’t done.”Harsh Mander
“What about diabetes patients? Everyday health gets magnified,” he added.
‘They Were Scared of Going to the Hospitals’
Social activist and co-author of the status report on the relief operations in the aftermath of the violence, Anjali Bhardwaj told FIT, “People were in great fear, they were not even accessing health facilities out of fear. There were people with serious injuries, one man with a badly damaged eye was refusing to go to the hospital as he said they were badly treated at government hospitals. People said they would rather lose my eye or a limb than go to the hospital.”
“There has to be a strong government response. Compensation and rebuilding of trust in the healthcare systems is needed.”Anjali Bhardwaj
‘Ambulances Were Stopped’
Dr Bhatti has been providing medical support to violence-inflicted areas and helped victims in the JNU violence late last year. He narrated stories of police interference that caused crucial delays in treatment to seriously injured people.
“The police were stopping our ambulances from reaching affected places. The mobs were attacking our drivers. We requested the doctors from affected areas to come up halfway to our vans and take the medical equipment since going there became impossible. We had to get permission from the courts and this resulted in an almost 8-10 hour delay in both delivering medical equipment and in rescuing victims who had serious injuries like bullet injuries and multiple fractures.”
Bhardwaj added, “People said that in the immediate violence, the response in terms of ambulances reaching there or of the treatment at hospitals, was abysmal. People were worried when filling up compensation forms, saying this might be an NRC exercise. They asked, ‘How do we trust anyone? No one from the government is here
Make Mental Health a Part of Primary Healthcare
One of the recommendationsOne of the recommendations offered by the JSA report was that of including mental health in the primary care given to victims. “There are people who have seen terrible violence. There are little children who have seen people enter their houses, mobs burn down shops, and this kind of trauma and loss, which is very evident in everyone we met, needs to tackled. There has to be sustained counselling,” said Bhardwaj.
“When your house is burned down and you’ve lost loved ones, of course you would need counselling. In the long run, the injuries on the one hand but the psychosocial trauma on the other will require a long time to heal.”Harsh Mander
‘Overcrowding, Diarrhoea and Infections: More Problems Ahead’
Going forward, Dr Bhatti said that “The government must have management systems in place to direct ambulances, give police instructions to escort ambulances, and set up temporary relief centres to deal with acute, chronic problems and rehabilitation and follow up work.”
It is important that sustained efforts are carried out systematically, as overcrowding in relief centers can lead to another host of health problems.
“ There is the risk of increased infection, diarrhoea, vomiting, skin infections, upper and lower respiratory tract infections and more.”