Reflections on the responses to the sexual violence at RG Kar Hospital
Reflections on the responses to the sexual violence at RG Kar Hospital
And how the IMA continues to be unable to read the room
I was a student at a medical college in Pune in the mid-2000s. An early lesson we learned there — as 19, 20 and 21-year-olds — was to refrain from speaking up against lecturers and professors, even if they engaged in such egregious behaviour as sexually harassing women students, or normalising the harassment. Of course the lesson was implicit. We learned it as part of the college’s ‘hidden curriculum’: some brave fellow students who spoke up were rewarded with fail grades and had to spend the rest of their time at the college six months behind their peers. Then a few years later, when I was working as a practitioner at a public hospital, a colleague was found inappropriately touching a teenage girl during a routine pre-recruitment exam for government employment. The ‘punishment’ that the hospital administrators deemed appropriate for this man was a temporary transfer to a different health centre, not too far, until the public’s “tempers cooled down”.
Objectification and sexualisation of girls and women, and the pervasive acceptance of that as routine and normal, are inherent in public cultures across India, even uniting the generally vastly different North and South. It was a shocking moment for me when I realised, late in life, that while almost all the mainstream movies I grew up watching took care to minimally portray the physical aspects of human love and romantic relationships, many showcased sexual harassment and violence in extensive detail: we were fine with rape scenes, but we cried “indecent” if we saw a kiss on the lips.
The tragic rape and murder of a doctor at R.G. Kar Medical College and Hospital in Kolkata on August 9 has met with varied types of responses from different individuals and groups. Many, including women who almost daily face misogynistic microaggressions and sexually offensive behaviour, have asked us to focus on the systemic factors behind what can arguably called the ‘rape culture’ all around us in India (subtly exemplified by the incidents mentioned above). Prominent doctors’ organisations have renewed their longstanding demands for protection of doctors through ‘strong’ Parliamentary legislation. Many other healthcare practitioners and groups have drawn attention to the pervasiveness of such violence across the health system and across categories of healthcare personnel. And, well, a lot many others have continued to engage in misogyny, objectification, and microaggressions all the same (a man in a Whatsapp group of Ivy Leaguers I’m on, e.g., had this to say: Men will be men! But why don’t these men do these things in Singapore, Dubai or Saudi Arabia. They don’t fear the law here whereas there they do. Education, awareness, sensitisation can do only as much. The fear of God has to be driven into them).
In this write-up my primary aim is to highlight the responses, mostly from healthcare groups in India, which I have found helpful, ethical, and educational. Since there’s been a huge barrage of information, opinions, misinformation, and political propaganda, I thought it would make sense to have some of the more important and useful stuff in one place. Needless to say, this is a non-exhaustive list, coming mainly from my immediate friend circles and social media circles.
As usual, the Indian Medical Association (IMA) and similar doctors’ organisations have been very vocal these past weeks. It is unfortunate, though not surprising, that the IMA has failed to recognize the systemic and broader nature of the problem of sexual violence against women, and instead has chosen to primarily frame this as a ‘violence against doctors’ issue (after, it seems, some initial toying with a ‘violence against health workers’ frame). It is also unfortunate that in any issue pertaining to doctors and healthcare in India, the IMA most often speaks over and louder than other, more grounded organisations and groups of healthcare professionals.
In contrast to the IMA statements and demands (a sample here), the statement from the Women in Global Health’s (WGH) India chapter is worth reading (“drafted by Abhiti Gupta and Shivangi Shankar with inputs from members of WGH India”). Some excerpts below:
[A key ask] Safety, not surveillance: No restrictions on women’s working hours, no residential/hostel restrictions and activities
[A key ask] Commitment to and operationalisation of the WHO Global Health and Care Worker Compact, 2022 to ensure safe, dignified and decent work for all health workers
Institutions must commit to gender parity within the workplace. This includes providing safety to employees. The recent case also highlights the complete lack of worker rights for healthcare workers. We believe healthcare workers are human and have human rights- clean water, clean toilets, spaces for healthcare providers to rest/take breaks, work hours that allow for sufficient sleep, and appropriate protective equipment. Marginalised groups again suffer more indignity from the lack of basic amenities. Difficult access to washrooms and spaces for rest creates more unsafe situations.
Here’s the statement from Jan Swasthya Abhiyan (People’s Health Movement — India). Excerpts:
We like to point out that the current incident cannot be seen in isolation. Continuous sexual violence and harassment of patients as well as the health personnel within the premises of hospitals, wards, OPDs often go unnoticed. The vulnerability extends beyond patients to all healthcare workers mainly women — including doctors, particularly junior doctors, interns, nurses, paramedical staff, lab technicians, administrative staff and frontline health workers like ASHAs, Anganwadi Workers. All of them are susceptible to sexual violence at the workplace often perpetrated by other doctors, colleagues, other employees and outsiders. [all sic]
Recognising the pervasiveness of sexual violence, the National Medical Commission (NMC), under the Directives of the Supreme Court, issued directives in 2023, to all healthcare institutions mandating the formation of committees within each institution, to investigate allegations of sexual harassment lodged against any employee. Furthermore, the directives ensure compliance with the provisions of the Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013. We demand that the PoSH Act be implemented to address sexual harassment at all workplaces, including hospitals, healthcare settings and medical colleges and institutions. [all sic]
Finally, here’s the statement from the more-than-fifty-years-old organisation Medico Friend Circle. Excerpts below:
We have seen several reports of students and juniors being harassed sexually by their professors and their complaints being ignored. These survivors are being forced to continue suffering silently. We demand the immediate implementation of Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act and Rules in all colleges (medical and others) across the country.
The pervasiveness of sexual violence especially against women and people of non-heteronormative gender identities indicates the distance to be traversed towards achieving gender justice in our country. These struggles are shared by women in various other settings outside the healthcare system as well. The unsafe working conditions and toxic environments are indeed a product of deep-rooted issues of caste, patriarchy, capitalism, and other ways of oppression and marginalisation. The specific case of violence against healthcare workers also need to be seen as a symptom of the disruption of doctor-patient relationship and breakdown of trust, as a consequence of the perception, no matter how false, of a healthcare system that is not pro-people, perhaps as one of the violent consequences of the deficiency of investment in health in the country.
In contrast to these statements and demands, the Indian Medical Association has (once again) misused their prominence to make this all about doctors. Here’s, for example, an all-over-the-place statement by the IMA President, which manages to include the line “Doctors are a class apart in sacrifice”. It must also be noted that the IMA is insisting on bringing new legislation that they imagine will help curb violence against healthcare services personnel, even as so much of relevant existing legislation (like the ones cited in the statements of WGH, JSA, and MFC above) remains unimplemented or poorly implemented. Finally, not one of the statements, letters and tweets coming from the IMA has bothered to touch upon the structural and institutional factors which pave the path to sexual harassment and violence, especially those within the medical profession. To quote Siddhesh Zadey, an epidemiology doctoral student: “If women students, docs, & nurses open up about their experiences & if the society takes them seriously, my hypothesis is that India will lose 20% of its clinician workforce in a day. From deans running colleges to final year stud[ent]s running boys hostels, everyone will lose sleep.”
Apart from this, there is the crucial issue of how the mainstream media in India, in collaboration with the so-called middle class as a group, decides to be particularly outraged over only some rape crimes and not others, and the major role that caste plays in this selectiveness. For example, this Twitter thread by Khushbu Sharma was enlightening. Excerpts: Can these sudden & occasional middle-class outbursts of rage or whatever be trusted? These protests r always couched in a vocabulary that talk of a ‘perfect victim’ … this middle class outrage was in deep sleep when every day dalit & adivasi women r raped & murdered. It was conviniently sleeping when a little girl from Gurjar Bakarwal community in Jammu was raped by ‘saviours of religion’ & nation. It was calm when Hathras happened. It remained unprovoked when rapists of Bilkis Bano were set free by a constitutional court. Nobody came out reclaiming the night when Kuki women in Manipur was paraded naked. Because, the caste society denies them honourable bodies.
Journalist Sukanya Shantha wrote about the despicable Mumbai incident of Bahujan women from a demolished slum site being forced by high-rise residents to leave a “Reclaim the Night” march: For 22-year-old Reshma, the experience at the protest site was “just as brutal” as losing her home to the demolition. “It was an open call for protest, organised in a public space. That’s why we joined them. But they made us feel that only one kind of woman and her safety matter. Our safety and concerns are not seen as gender issues by them.”
In all of this, it needs to be remembered that India today, courtesy the BJP, RSS, and their numerous offshoots, is the world’s largest (and most relentless) producer of fake news and heinous propaganda. Next to the class and caste prejudice mentioned above, it is sanghi/bhakt prejudice that dictates the prominence (or not) that any particular incident receives in the mainstream discourse. Ophthalmic surgeon Raghuraj Hegde hit the nail on the head when he recently wrote:
We as a society are not moved when in Hathras, a Dalit rape & murder victim is forcefully burned in the dead of the night by the police against the wishes of the family. We just watch our TV screens without reacting, when Olympic medal winning wrestlers who had everything to lose stood by the victims of sexual molester [and BJP member] Brij Bhushan Sharan Singh protesting against him. We did not care when the police manhandled our elite athletes who were protesting peacefully. There were several doctor colleagues of mine who were sharing WhatsApp messages on doctor groups of how the wrestlers’ “agenda” is anti-national and all are falsely accusing [Singh,] the WFI chief. These same male doctors are now shedding crocodile tears going on marches on the streets yesterday during IMA strike.. Our collective conscience was not affected by the molestation, rape and parading naked of the Kuki Manipuri women and that the Prime Minister of the country has not moved a finger to stop the violence there which has continued unabated for more than a year. Just this last week, a doctor in Odisha was arrested for raping two patients and a nurse in Uttarakhand was raped and murdered. There was no public outrage for these women… The anger we all are experiencing since the last week should be channelled to push for reform and not retribution or revenge. Our hospitals are the first places to start cleaning up the mess.
Finally, I would like to urge healthcare workers and decent people all over, to heed to what global health researcher Sonali Vaid wrote, “[We must] Build alliances. Doctors can’t be safe in a society where [sexual violence] is an hourly affair. It is also traumatic for doctors who have to examine & write reports of rape victims. Medical community & inclusive feminist movements must ensure a joint rallying cry for a safer society for all.”
A fundamental problem with the Indian medical profession is doctors generally deeming themselves as a class apart from everyone else (here’s something I wrote on this topic some years back, though the article title is not that descriptive). One really hopes that this debilitating elitism will be dealt with head-on in the coming weeks and months.
Ending the essay with condolences to the departed doctor’s family, about whom one can read more in this Guardian report.