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A Doctor’s Plea To The Patients And Their Families Who Resort To Violence

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Lately, there’s been a lot of heat in discussions about the doctor-patient relationship. Many views from both sides – ranging from sympathetic to vindictive – have surfaced on several media platforms. The integrity and ethics of the treatment provided by doctors have been questioned; the behavior of the aggrieved has been scorned. The remarks of the judiciary and the legislature have been ‘interesting’ (to say the least) and have only added fuel to the fire. In the aftermath, questions have been raised about the hypocrisy of the judiciary over various past rulings. Several videos have gone viral with the media proving fundamental in shaping the perception of the masses to the same.

I often sit back and wonder what provokes such actions and what has led to this loss of trust of both the care-giver and care-seeker. Unless we diagnose where this malice stems from, we won’t really be able to fix it. All knee-jerk actions will only offer ‘band-aid’ solutions.

Being a resident doctor in a busy trauma centre at a government hospital for the past three years, I have had the unenviable opportunity to see a lot of grief. Along with my colleagues, I have managed huge numbers of patients – battling through the insane work-hours, often without basic amenities. We have saved numerous lives – but we have also occasionally failed. We see a lot of pain and hurt and the occasional loss of life despite the best of our efforts.

It affects us all very deeply – but as the saying goes, ‘the show must go on’. And so, as a defense mechanism we develop an unavoidable perceived detachment towards human suffering – something we are infamous for. It is this detachment that enables us to not be preoccupied with the grief of a previous loss. It also helps us discharge our duties consistently, unflinchingly and save lives. This is an intangible feeling that can’t really be expressed in words.

But when I put myself in a patient’s or their attendant’s position, I feel the immense pain and despair they do. I have tended to my ailing mother for a year at a stretch – so I would know about this. The loss is irreplaceable and the situation hopeless. It’s a natural tendency for one to find someone or something to lay the blame on. It’s not done actively – but it’s happened to all of us and probably will continue to do so. This grief cannot be put into words.

The point that I want to stress here is the word ‘grief’. Grief is said to have five stages – denial, anger, bargaining, depression, and lastly, acceptance – all in that order. We all go through these stages when we experience any form of grief. The only difference is the pace at which one progresses through the various stages and deals with each of them.

Denial is probably the most profound period, when the news hits or the realisation dawns. It’s the time when the mind goes numb and one can feel the cold sweat as the veil of grief engulfs them. Then comes the stage of anger. This is where an already-bad situation goes south, rapidly. It’s at this point that the mind becomes deaf to the sound of reason and impulse takes over. The response at this point is purely instinctive, regardless of the consequences. How one reacts here depends mostly on how they have learnt to function in life.

As clinicians, we are sometimes so focused and preoccupied with our work that we neglect handling the patient’s/relative’s emotions at this crucial juncture. It is at this point that communication becomes key – and it is at this point that we clinicians probably lack the most. It’s imperative to take a few moments to convey to the patient and their attendants that we do care and understand – and that whatever we are doing is to the best of our ability and available resources. This point has to be effectively conveyed, period! If done properly, most people do understand and see the logic and reasoning.

But then, there are few people who have a rather abrasive way of handling this stage. They tend to look to shift the blame elsewhere. Since it’s the doctor who’s the most gullible and at hand, they become the recipient of the consequences of this blame game. This is probably not done with intent, but rather, out of pure, raw instinct. What follows is a distasteful altercation which often leads to violence with a mob mentality. The several videos and clips are perhaps proof enough. The instinct may be without malice and intent – but the actions are not. They are just not acceptable. Violence, in words or actions, should not be the chosen vessel of expression.

So, how do we find a middle path? Do we enforce stringent laws to act as a deterrent? Do we tackle this show of force with force, or do we stop offering treatment altogether? What can be done to address the insecurities of the care-giver that they feel at being so vulnerably exposed at such precarious moments? What can be done to appease the aggrieved and to prevent the violent outbursts that have become the norm? At this point, your guess is as good as mine.

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Featured image used for representative purposes only.

Featured image source: YouTube
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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