Dr. Kafeel Khan ( Photo Twocirccles.net)

The IMA has written to the Prime Minister of India to revoke the suspension order and also to withdraw all legal cases against Dr. Kafeel Khan.

The IMA has also stated in their letter that the shortage of oxygen cylinders in the hospital were due to nonpayment of bills to the vendors. But Dr. Kafeel was accused of negligence even though he had bought cylinders from his money and saved the lives of several children.

According to RTI (Right to Information) this fact has been revealed. And the government has accepted that there was shortage of liquid oxygen for 54 hours in BRD Medical College on August 10, 11 and 12 and Dr Khan had indeed arranged jumbo oxygen cylinders to save the children.

The doctors also drew attention of the PM to the sufferings of Dr. Khan and his family ever since his suspension and subsequent slapping of criminal cases against him. They urged the PM to compensate the doctor for the period he was suspended.

The High Court of Allahabad had also in its affidavit accepted the shortage of oxygen supply in the hospital.

The Supreme Court had asked the UP Government to pay all the subsistence allowances to Dr. Kafeel Khan pending his suspension.

However the court directions were not followed and Dr. Kafeel Khan who was wrongfully jailed and his character was tinted did not get the respite due to him. His suspension was not revoked now the compensation paid to him.

During the time when the IMA strongly supported the junior doctors who had been assaulted in a hospital in West Bengal in June, Dr. Kafeel had requested the IMA to lend their support to him as well.

Two months later the IMA decided to support Dr. Kafeel and have written to the PM in which they have stated:

“IMA identifies with Dr Kafeel Khan and proclaims solidarity with him in these difficult times. We request you to kindly further Dr khan’s cause to help him get justice,” .

“Dr Kafeel Khan’s suspension may kindly be revoked at the earliest and he may be compensated. Kindly prevail on the government of Uttar Pradesh to withdraw all pending legal cases against Dr Kafeel Khan and BRD Oxygen Tragedy may be investigated by central agencies,”.

Courtesy: Two Circle

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Flashback to these series of attacks on doctors by elected representatives of the ruling regime where the association maintained a stoic silence. This Calendar os assaults tells its own story. Switch to the brute abuse of Dr Payal Tadvi in a Mumbai hospital leading to her tragically taking her own life. Again not a whimper of protest from the IMA.

The IMA, established in 1928 calls itself “the only representative voluntary organization of Doctors of Modern Scientific System of Medicine, which looks after the interest of doctors as well as the well being of the community at large.” It has branches in 23 different state and 9 union territories and has over 78,000 doctors as its members.

Health in India has remained an issue which is marred by disinterest, a lack of political will and ill-thought policies. Apart from scientific determinants, the health indicators in India are also impacted by social and political factors.

Caste bias
In the aftermath of the suicide of the 26 year old gynaecologist Dr. Payal Tadvi, who belonged to the Bhil-Adivasi community, the IMA asserted that there was no caste based discrimination in the field.

In their letter, signed by IMA President, Dr. Santanu Sen and General Secretary, Dr. R. V. Ashokan commented on the prevalance of general casteism saying, “As a fraternity the medical profession is miles ahead in overcoming the barriers of caste, religion and politics. There is no discrimination on any ground within the fraternity or with the patients. However individual bias and behaviour can be at variance to this unwritten code of conduct. IMA does not condone any discriminatory behaviour.”

IMA did not recognise the caste based discrimination that many professions in India suffer from. A profession like medicine and health, which is meant to heal, ends up ending the lives and livelihoods of many health professionals because their caste is not acceptable to the dominant castes. Infact IMA consistently termed the issue of suicide of Dr. Payal Tadvi to be arising from workload.

In their letter to doctors, the IMA repeats this multiple times. They say that doctors “especially in government hospitals”, have an “inhuman work load and suffer burn out and depression”. They also say that doctors in government hospitals particularly, have “poor working conditions” and an “abnormal overload of work” and face an “ever present ridicule for deficiency of clinical sills.”

The medical profession in general has been accused of a bias against the policy of  reservation. Doctors and medical professionals on occasions more than one, have said that if reservations are allowed in the education, it will compromise with quality.

In 2006, when the HRD Minister Arjun Singh announced a policy to introduce reservations for Other Backward Castes (OBCs) for 27% seats in central universities which included the Indian Institute of Technology (IIT), Indian Institute of Management (IIM), AIIMS, Delhi University and others, a platform called Youth for Equality with the stated objective of “determination to do something against the reservation policy” came into prominence. The IMA units in Delhi and Mumbai gave call for strikes during this time. This had exposed the inherent casteist bias of the IMA as an institution.

The Pepsi controversy
In 2015, for the first time in the history of medical associations, the IMA, a medical association agreed to endorse PepsiCos Tropicana fruit juices and its breakfast cereal Quaker Oats. It went ahead and called it a “partnership for healths. The then Secretary general SN Misra had said that although the company hadn’t paid money for the endorsement, PepsiCo may sponsor the associations conferences and meetings for three years, the agreement period. Media reports said the company paid the association Rs 50,00,000 for the deal.

The Medical Council of India suspended the licenses of the then president, Ketan Desai and secretary of the Association. The IMA took an adversarial stand here and got Delhi High court to stay the order making a mockery of code of ethics.

An editorial published in a medical journal, Indian Journal of Medical Ethics said, “it is an open secret that financial transgressions are common in medical practice. The classic case is the receipt of kickbacks for referring patients for investigations like magnetic resonance imaging scans”

Congratulating government on charging students with sedition
In February 2016, IMA wrote a letter to the then Home Minister of India congratulating him for the action they had taken against JNU students and warning medical students not to participate in such protests. The JNU students were charged with sedition then. Not only did their letter congratulate, but also they urged the government to take “strict actions against any persons or organizations or group carrying out any anti national protests, speeches, debates or writings in the country”. 

The letter was signed by then national president of the association, SS Agarwal and its honorary general secretary KK Aggarwal. Agarwal was then the co-convenor of the ruling Bharatiya Janata Party (BJP)’s training cell and till 2013 was the national convener of the party’s medical cell.

A practicing surgeon, who wrote to the IMA asking about their stand, notes, “Whilst you showed instant concern over the events in JNU, the IMA has been silent over several issues related to public health problems in the country. Whereas you include the demand for a fair conduction of the NEET exam, the association has never openly attacked the very idea of private capitation medical colleges and deemed universities controlled by powerful politicians that have played havoc with India’s medical education system. In my view, your letter to the Home Minister was nothing but an attempt to curry favour with the new power centre”

Also now, the Govt.’s attempts to replace MCI with NMC
The Medical Council of India is a representative body of the medical profession in India. Roughly 2/3rd of its members are elected through various electoral processes. Any registered medical practitioner in the country can contest the elections and every qualified doctor can vote. The government now proposes to bring another body, which will be an all nominated body.

In June 2019, the IMA filed a petition in the Supreme Court alleging that the purpose of Indian Medical Council (Amendment) Ordinance 2018 was to give permission to “incompetent” medical colleges so that that they could give financial and other support for Lok Sabha elections.
The National Medical Commission is proposed to have non-elected members nominated by the government.

While protesting the new bill the doctors had said “Anywhere in the world, medical profession is bestowed with reasonable autonomy. Patient care and safety are the main benefits of such autonomy. Regulators need to have autonomy and be independent of administrators. The proposed NMC will be a regulator appointed by administrators under their direct control.”

The members had then alleged that the constitution of NMC takes away the voting right of every doctors in India to elect their medical council.

As per the IMA National President, Santanu Sen, the proposed bill, which was passed in Lok Sabha early 2019, aimed at three different aspects. He had said, “First, by reserving 50 per cent of the seats at medical college for management, the opportunity to the poor is being denied. Second, the bill seems to increase the compensation amounts payable to the patients to impossible levels and third, the bill may lead to increased healthcare expenses incurred by common people.”

The editorial published in a medical journal, Indian Journal of Medical Ethics saidunlike “medical associations in countries such as the USA, the UK, and Canada, the IMA has not been prominent in shaping medical policy in India. It has no history of providing leadership in identifying the health problems of India and providing input into how they should be tackled. The pitiful state of health affairs in India, with some of the worst health indicators, has not prompted this large group of health professionals to introspect on the situation and come forward with constructive suggestions. Instead it has stood by as a mute spectator to the chaos in medical care in India.”
 
 
 

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Japanese encephalitis comes in the form of amassive epidemic. While Bihar and Uttar Pradesh are known for pathetic health services, India as a whole needs to ponder over the fact that, without a robust  health and education services, India can not sustain itself as a growth story. 

Both these states along with other states like West Bengal, Rajasthan, Maharashtra, Madhya Pradesh, etc have a heavy rural population but the medical fraternity does not work, or even want to work, in the villages. Over 75% of our rural population has about 32% Primary Health Centers. Of these, may be less than 20% of them have beds.

Rather than responding to this enormous rural crisis when the first aid too does not reach to the needy resulting in untimely deaths due to even very ordinary ailments, the government of India has cleverly provided a new ‘mantra’ imported from United States highly commercial health services where they are beyond the reach of the common people. This insurance culture may be good for the urban middle classes but can not replace the need for an accessible health services. The problem with the insurance culture is that your access is directly related to your premium and in the rural India if people have got health insurance, the private doctors use them heavily even for the ordinary services and if they suffer from bigger issues then it is beyond their reach.

I think that the concept of Mohalla clinic in Delhi meant a great revival of health services and Aam Admi Party need kudos for the same. State governments in India need to invest heavily in the health and education sector and make health an absolutely uncompromising issue. Every year, we see hundreds of children dying of various diseases and we have seen how in the medical college of Gorakhpur, the hospital did not have the oxygen cylinders and beds for the patients. 

Unfortunately, doctors as well as their associations have rarely spoken about this. Most of them dont even want to serve in rural areas and take it as punishment posts. After abusing all the subsidies for poor, the doctors who qualify from the subsidised medical colleges do not show any keenness to serve the poor. You cant imagine those who spend crores of rupees, paying, hefty donation fee in the private medical colleges, to serve the poor. Most of them would like to complete it at the earliest and get a visa to serve their colonial masters abroad.

The Indian Medical Association(IMA) has called for an all India strike against the ‘attack’ on doctors even when the doctors in West Bengal reached an amicable solution and called off their strike. We support the demands for the security of the doctors and the people have no right to physically assault the doctor. Even if they have complaints, it is time for IMA and medical fraternity to put their in house disciplinary mechanism stronger. There is another factor which is of a serious nature. 

The sympathy of the doctors – – politically–with the dominant right wing is a matter of serious concern. Medical ethics calls for doctors to be above partisan nature and serve the patient irrespective of their caste, gender, and religion. 

Most of the time, the IMA has behaved politically and is a group of people who are mostly against the politics and policies of social justice and inclusion. We have not forgotten when the doctors in All India institute of Medical ( Manuwadi) sciences ( AIIMS) in Delhi had launched a campaign against the government policy of reservation at the higher level initiated by late Arjun Singh, who was the HRD Minister in the first UPA. We saw the worst form of casteist slogans by these doctors who started ‘Youth For ‘Equality’ campaign which actually was Youth for casteism and caste supremacy. Ofcourse, Delhi chief minister Arvind Kejriwal and many others of kinds have been in the forefront of supporting such initiatives though they might claim that it was just a thing which had happened and now Kejriwal support reservations for SC-ST-OBCs.

If the IMA is an association which help the doctors and raise their issues then it must explain as why it failed to get Dr Kafil Khan, who was being penalised for serving the poor round the clock when children were dying because of the failure of the medical system. We have not heard a single statement even today from IMA regarding the continuous harassment of Dr Kafil Khan, by the Uttar Pradesh government even today.

Can the IMA tell us what has it done with regards to discrimination faced by tribal doctor Payal Tadvi who was killed by the continuous harassment and indignation from the savarna doctors in Mumbai last month. A few days back, a talented Doctor in Chandigarh medical college too faced caste based discrimination but the IMA remain silent on the issue. In fact, it is mostly the organisation to protect the savarna interests of the doctors. It cant speak for a doctor who faced harassment because he was a Muslim or SC-ST-OBCs.

Before I conclude, I would share my own experience at a Medical college in Delhi. The incident relates to a  six year old. One of my illustrious friend teaching in a prestigious medical college invited me to share my thoughts on Medical Ethics with his students. There was another person from abroad. I was asked to speak for 10 minutes. I had done an investigation into the case of deaths of several Safai Karmcharis in Delhi. I narrated what the family members of the deceased informed me that the doctors did not even touch the body of these people who were brought to RML. I also narrated a story from Uttar Pradesh where in a PHC in Balia, the sweepers would do the basic surgeries as doctors wont touch. Even in the medical colleges, most of the time, it is the sweeper who is asked to touch the dead bodies. I may be wrong that all doctors would not do but whereever these things happened or are happening, are wrong and must be condemned. I just said that a doctor has to rise above the caste, class, religion, nation, gender prejudices and unfortunately in India, they still suffer from them. I also spoke about Praveen Togadia’s alleged statement long back, when he called medical fraternity to not to treat the Muslims. There are many who now calls that all those ‘anti nationals’ have no right to be treated. This is purely political rhetoric and doctors would do well to rise above them. Now, as soon as I said this, a senior stood up from his seat and came to the podium, snatched my mike and said that I would not be allowed to speak. He said, ‘ we are not here to listen to these rubbish. ‘pataa nahi kaha kaha se bulaa dete hai logo ko’. I said let me finish but he did not allow. Unfortunately, our organisers too could not do anything. I did not say anything but realise how deep rooted caste and religious prejudices have entered into the medical profession.

If we celebrate the medical profession as great achievement of modern science which saved people from life threatening diseases then can we say that our doctors and scientists are humanists and rationalists whose only interest is to serve humanity and propagate the idea of rationality. That caste system is an artificial creation by human being which goes against the spirit of people being born freely and equally in rights and privileges. That some people are better than others while many others are inferior is a concept of deep rooted prejudices which existed in our society and people need to be given special treatment to bring them to the level of others. That social justice is not a dirty word and merit not the monopoly of a few twice born communities would the true spirit of humanism and must be embraced by medical as well as science fraternity.

Yes, we do agree that no doctor should be humiliated or assaulted as many treatment succeed and many fails. If the efforts are made sincerely but if not then people have a right to lodge complain and accountability need to be fixed. Indian medical science suffer a crisis because of the hegemonic caste supremacists are converting it a tool to spread their hate propaganda. If the doctors or would be doctors fall in this trap then they will lose good will of the people as well as violating the medical ethics too which ask them to rise above narrow partisan interests of people’s identity and treat them equally.

Related Articles:
Why the Silence? Death of 100 Children by Encephalitis in Bihar
Doctors Strike in Bengal: Calendar of Assaults on Docs across India

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