This post has been self-published on Youth Ki Awaaz by Healer&Poet/HindustanHumSeHai/ReclaimOurRepulic. Just like them, anyone can publish on Youth Ki Awaaz.

Opinion: Are Resident Doctors Covid-19 Warriors Or Cannon Fodder?

This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

Trigger warning: mentions of death and other traumatic instances related to Covid-19

The teaching hospitals and medical colleges of this country are practically the only public-funded and government-run, tertiary medical centres in this country. Thus, they become the only sources of expert medical care for the vast majority of the population of India.

The strategy to fight Covid-19 in India was not only exploitative of young doctors, but also discriminatory towards the poor of this country And, its architects were senior bureaucrats and senior hospital administrators, with the latter being too eager to please the former.

Resident doctors protest against the postponement of NEET PG counselling in Guwahati.
Resident doctors all over the country have been protesting against the postponement of the NEET postgraduate counselling. Photo credit: ToI.

In decent and just societies, battles demanding high technical skills are fought by the most experienced veterans of special forces, and not by new recruits who are still learning the ropes. The trainees are preserved, to fight in the wars of the future. But, the opposite of that happened in India.

These centres of medical education that were supposed to be the last bastions of defence, their: postgraduate (PG) students, resident doctors, interns, and even MBBS (Bachelor of Medicine and Bachelor of Surgery) students, were pushed to the frontline.

Disproportionate Distribution Of Covid-19 Workload

Much of the seasoned workforce, which is maintained and also paid for by the government, comprising of doctors who had already completed their specialist training long before, only saw proven Covid-19 positive patients, from a safe distance.

Alternatively, they sat in their homes with their stethoscopes gathering dust, fighting the Covid-19 war online, dispensing their orders via internet messages on WhatsApp, and taking virtual consultations on Zoom.

The modern Hippocratic oath only guides us to help and do no harm, it doesn’t ask us to sacrifice our lives like soldiers. What young doctors in medical colleges did during Covid-19 was beyond their mandate and duty. It was heroism.

What was precisely unethical about it was the extremely disproportionate distribution of workload and risk, across the hierarchy, as compared to non-Covid-19 times.

Delayed Admissions Of PG Students

Also, now that we have only have one third of the PG residents that we had at the beginning of the pandemic, the situation is worsening. The delay in NEET (National Eligibility cum Entrance Test) PG admissions is also responsible for the same.

During Coronavirus times, medical educators forgot that their pupils have paid the fees for, and enrolled in postgraduate courses in: anaesthesiology, dermatology, surgery, psychiatry, orthopedics, ophthalmology, pathology etc.—and not for a Master’s or a diploma in a single disease called Covid-19.

 

View this post on Instagram

 

A post shared by Youth Ki Awaaz (@youthkiawaaz)

Hospital administrators forgot that the oath they took in their youth was to heal and comfort patients suffering from all diseases, not just those caused by the Coronavirus.

Together, with the bureaucrats, they bid their time in their pristine offices, behind polished desks—roleplaying as armchair generals in a very real war, the kind of which they have never fought as soldiers in the field themselves.

Public Health System Collapsed

During the Covid-19 crises of 2020 and 2021, when the entirety of the burden of Covid-19 was thrust, and unfairly so, upon the shoulders of these young heroes; and the centres of medical learning they work in were relegated to the singular purpose of Covid-19 management, the whole infrastructure of specialised healthcare delivery to the common Indian citizen collapsed.

They called us resident doctors the “Covid-19 warriors”, but the truth is: we were never more than cannon fodder and the people of India were just the acceptable collateral damage.

The allowable blood loss; the unimportant, invisible, forgotten, unaccounted, rotting, smelling, casualties of this war against Covid-19, strewn across the banks of the rivers Ganga and Yamuna.

And, it is the people of India who are bleeding again… not just due to lack of platelets in their blood, but also due to a lack of PG doctors in their hospitals.

Resident Doctors’ Degrees Held As Ransom

Between the two extremes of healthcare i.e., Anganwadis and medical colleges, nothing much was functional in a meaningful way.

The latter wasn’t even available for patients who might have been very sick from other illnesses, but weren’t Covid-19 positive, as almost all apex and tertiary centres where medical education takes place, were turned into dedicated Covid-19 centres.

Where else could policy makers have found such an easily exploitable, concentrated pool of bonded labourers called resident doctors, if not in the teaching hospitals and medical colleges of India. Our hospital adminstrators were only too happy to oblige.

With their degrees held hostage, resident doctors were an army of slaves. Technically, this was not so different from how construction companies in the Middle East withold the passports of migrant labourers as ransom, to extract their labor.

Poor Policy Making To Blame

This was the easy way out, because building disaster management capacity ground up, by strengthening primary and secondary healthcare infrastructure would have been hard. The right thing to do always is. It was a strategy that was bound to fail.

In my opinion, it was never the plan of ruling class to actually resist the spread of Covid-19. It seems like they only intended to wait it out in safety. There were hardly any elected representatives or bureaucrats available to face the people who had voted for them, and paid their salaries (via taxes)… Except on Twitter and Facebook, where they were just angling for VIP beds.

People were seething with anger and demanding answers, and rightfully so. They weren’t subjects of a despot, but were citizens of the world’s largest, democratic state. A state that abandoned them in their most desperate hour.

Any sign of the republic of India ceased to exist, except for the resident doctor standing in a makeshift ICU (intensive care unit), drowning in the sea of death surrounding them. We became the lone target for all the misplaced anger and rage of the breathless masses, hungering for oxygen.

Doctors Have Lost People Too

It became clearer than ever that if these medical institutes form the bones of the ailing, but still relatively functional body of public funded tertiary health care in India, then the resident doctors are its very flesh and blood.

In the aftermath of Covid-19, what we are left with is a tertiary health care and medical education system, which is now more cachexic and anemic than ever before, because of delayed admissions of incoming PG candidates.

 

View this post on Instagram

 

A post shared by Youth Ki Awaaz (@youthkiawaaz)

We are without new blood to reinforce the ranks of our valiant Covid-19 warriors, who now are physically and emotionally exhausted from the stresses of this plague, at both professional and personal fronts.

We too, have lost loved ones or have loved ones who have lost their livelihoods, as happened to people from other walks of life. And, we haven’t had the luxury of paid staycations and work from home, to recuperate.

Where Was The Time To Learn?

It wasn’t just the hard work and isolation. Some of these residents made the ultimate sacrifice: death.

And, those who survived their martyred peers, have already sacrificed the most important time of their academic career to Covid-19, i.e., one and a half years of PG training, during which they were supposed to acquire skills and knowledge necessary to earn their livelihood as specialists, for the rest of their lives.

The lack of juniors to train, has not only left them overworked, but also disrupted the flow of medical education the way it happens in a medical college, at the patients’ bedsides, from senior to junior, every generation.

Not everything can be learnt from the books, or else medicine could have been a distance learning or correspondence course. This has compromised the only tertiary health care delivery system that is accessible to common man for many years to come.

Why Are Doctors Speaking Up?

Why are the residents and the poor patients they treat, being made to suffer for the complacency of bureaucrats, indecisiveness of the judiciary, as well as the personal ambitions of politicians? Why is the politics of this nation is devoid of any semblance of policy?

And, why are the poor excuses for policies we do have, devoid of any sensitivity towards the the weakest, poorest and most vulnerable sections of the same society we claim to be a part of?

 

View this post on Instagram

 

A post shared by Youth Ki Awaaz (@youthkiawaaz)

For all the mistaken and false equivalences between doctors and soldiers, this one is actually true: it is in such times of exhaustion, desperation and injustice, that soldiers rebel against their generals.

Conviction in the hour of crisis and courage in the face of doom are admirable. But, callous stubbornness against the righteous will of the people just for electoral gains, is abominable. This can only happen when checks and balances that operate in a polity before and after elections fail, when a society has got its priorities and values wrong.

Mandir-Masjid Is Secondary, Health Ought To Be Primary

We have got enough mandirmasjids, what we need is more resident doctors working in our medical colleges, because we know from the previous Covid-19 waves what is actually useful when a calamity hits.

We know from the farmers’ protest that democracy is about more than just the right to vote, it’s the duty to be defiant against injustice.

A medical college, without a new generation of doctors to educate, defeats the very purpose of its own existence. What is a teacher without his pupils, after all?

One and a half year later, when the pandemic seems to be finally receding, our medical educators have got no pupils to train, while the ailing masses suffer, hospital administrators and their bureaucratic overlords are still sitting in their ivory towers, glued to their seats of authority and power, while the  capital city burns in the fires of dengue.

Many People Died During The Pandemic

From the windows of their high castles, the policy makers, the decision makers, have thrown all notion of accountability into these flames. Maybe, from such heights, bodies on burning pyres look like the inviting, warm embers of bonfires on cold, December nights.

Indifferent or ignorant of the reality, they are contently soaking up its warmth without any sense of alarm.

Inside their gated colonies, the privileged might be insulated enough not to feel too much heat from the resident doctors’ rebellion, but power and money don’t guarantee safety from the burn of the Omicron variant.

This delayed-counseling crisis might not be on purpose, but it is an unintended consequence of disastrously poor, policy implementation.

One thing is certain: it was not anybody’s priority. Before the residents started their protests, how many heads of these prestigious institutes had dared to raise their voice, or wrote letters demanding expedited NEET-PG counseling to their political masters?

Support Resident Doctors

We ask our teachers and mentors to find the courage to do so and join the protesting resident doctors, not just in words but action. Resident doctors have taken up this movement on their own so far.

We ask our directors and deans to be part of the fraternity, and not just heads of their institutes, if they really care about medical education, patient care, or still have the faintest memory of what it meant to be a doctor.

__

The author is a resident doctor in a medical college. They think of themselves as a healer and a poet.

Featured image is for representational purposes only. Photo credit: Wikimedia Commons.
You must be to comment.

More from Healer&Poet/HindustanHumSeHai/ReclaimOurRepulic

Similar Posts

By Sumbulkhan Khan

By Saloni Mamodiya

By Charkha Features

    If you do not receive an email within the next 5 mins, please check your spam box or email us at actnow@youthkiawaaz.com

      If you do not receive an email within the next 5 mins, please check your spam box or email us at actnow@youthkiawaaz.com

        If you do not receive an email within the next 5 mins, please check your spam box or email us at actnow@youthkiawaaz.com

        Wondering what to write about?

        Here are some topics to get you started

        Share your details to download the report.









        We promise not to spam or send irrelevant information.

        Share your details to download the report.









        We promise not to spam or send irrelevant information.

        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.

        Read more about his campaign.

        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.

        Read more about her campaign. 

        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.

        Read more about the campaign here.

        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.”

        The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

        Read more about the campaign here.

        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.

        Share your details to download the report.









        We promise not to spam or send irrelevant information.

        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.

        Sign up for the Youth Ki Awaaz Prime Ministerial Brief below