GLOBAL HEALTH EMERGENCY : NEED TO REVIEW LAWS AND POLICIES (SDG 16)
TITLE: VIOLENCE AGAINST HEALTH CARE PROFESSIONALS: A WAKE UP CALL
The global community, in these times of dismay caused by the sudden outbreak of global pandemic COVID-19 has not only realized but recognized the importance of role that emergency care providers especially the doctors and healthcare providers play in delivering of health care services. It is estimated that the emergency care addresses over 54% to 90% of the deaths and over 900 million to 2.5 billion disability adjusted life years in not only low but also in middle income countries.1
In simple terms, emergency care is a part of healthcare services which cross cuts traditional methods, and disease-focused disciplines and focuses to dispense prompt interventions for disease specific emergencies as can be seen in the case of COVID-19 outbreak.
At this point it becomes pertinent to mention that indeed the emergency care services address atleast 12 of the Sustainable Development Goals target (SDGs; targets 3.1–3.9, 3d, 11.5 and 16.1), if not more and are particularly consistent with the Universal Health Coverage.2
It seems that the incidences of violence against doctors has not been an uncommon phenomenon in India. We have often come across news headlines speaking about the plight of doctors, where they had been victims of violent attacks, though not directly by the patient himself but often by his relatives (Type II) and sometimes even by unknown but apparently sympathetic individuals and political leaders (Type I and Type IV).3
However it is very heart wrenching when instances of violence against medical community surface up, that too in times like these when they have been the frontline soldiers in the battle
1 Chang CY, Abujaber S, Reynolds TA, Camargo CA Jr, Obermeyer Z. Burden of emergency conditions and emergency care usage: new estimates from 40 countries. Emerg Med J. 2016 Nov;33(11):794–800. Available at http://dx.doi.org/10.1136/emermed-2016-205709 [Last Accessed April 26, 2020].
2 Reynolds TA, Sawe HR, Rubiano AM, Shin S, Wallis LA, Mock CN. Strengthening health systems to provide emergency care. In: Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, et al., editors. Disease control priorities: improving health and reducing poverty. Volume 9. 3rd ed. Washington, DC: World Bank; 2018. http://dx.doi.org/10.1596/978-1-4648-0527-1/pt4.ch13. [Last Accessed April 26, 2020].
3 Violence against doctors: Why China? Why now? What next? Lancet. 2014; 383:1013. Available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206759/ [Last Accessed April 26, 2020].
against global outbreak of a deadly pandemic and have been working tirelessly so as to ensure immediate, proper health care services to entire mankind irrespective of other worldly considerations such as race, caste, sex or ethnicity.
The recent past has witnessed several instances where the health care service providers especially the doctors had targeted and attacked by the miscreants, they have been lynched, mobbed and brutally beaten. The unfortunate events of Stone pelting on doctors in Indore on 2nd April, 20204, vandalization of ambulance and brutality against doctors in Moradabad on 15th of April, 20205 can be quoted as a few major incidences. Another incident as recent as that of 28th April, 20206 where locals pelted stones on police and doctors against cremation of COVID-19 suspect show the extremely saddening conditions of doctors in this emerging superpower.
Such acts of violence are a matter of grave concern and needs to be immediately addressed to ensure not only safety and security but also humane treatment to doctors. Doctors who are making their best efforts to prevent spreading of the virus and even more efforts to cure those who are suffering from it, those doctors who selflessly and tirelessly are working round the clock to do justice to the Hippocratic oath which they swear to while joining this noble profession. But despite this members of medical community have emerged out to be most vulnerable victims as they have been perceived by some as carriers of the virus.
These events undeniably point out towards the fact that our doctors are facing gross violation of Human Rights. Human Rights which are universally accepted moral principles that set out the treatment regarded to human beings irrespective of their sex, ethnicity, religion, culture or profession. The Universal Declaration of Human Rights, 1948 (UDHR) being the bulwark instrument on the matter, sets out international standards for human rights so as to ensure freedom peace and justice on this planet.
In this context it is pertinent to mention about the 17 Sustainable Development Goals (SDGs) which form the heart of the 2030 Agenda for Sustainable development, adopted by all the United nations member states in 2015. These SDGs are the principles which provides for the
4 Two doctors hurt in stone pelting during coronavirus tracking in Indore, PTI, Deccan Herald Available at: https://www.deccanherald.com/national/north-and-central/two-doctors-hurt-in-stone-pelting- during-coronavirus-tracking-in-indore-820413.html [Last Accessed April 26, 2020].
5 Doctors, cops injured after stone pelting on ambulance in Moradabad, PTI, India Today Available at https://www.indiatoday.in/india/story/doctors-attacked-in-moradabad-up-cm-orders-to-book-10-accused-under- nsa-1667251-2020-04-15 [Last Accessed April 26, 2020].
6 Haryana residents throw stones at police and doctors, protest against cremation of COVID-19 suspect, PTI, Indian Herald Available at https://www.nationalheraldindia.com/india/haryana-residents-throw-stones-at- police-and-doctors-protest-against-cremation-of-covid-19-suspect[Last Accessed April 29, 2020].
essential blueprint to ensure peace and prosperity for people and the planet, for now and into the future. Special importance must be accorded to Goal 167 of the SDGs in light of the present context as it assumes great importance and seeks to prevent violence, promote peace and rule of law, strengthening institutions and increasing access to justice.
In light of the recent violent attacks on healthcare workers, and keeping in mind the global concerted effort to end violence, attain worldwide peace and security as highlighted in the Sustainable development Goals set out by United Nations, especially giving due and much needed importance to Goal 16 of the SDGs which seeks to ensure peace, justice and strong institutions, the Indian Government has set out its legislative machinery in motion.
The Union Cabinet, finally in its meeting held on 22nd April 2020 has approved promulgation of an Ordinance to amend the Epidemic Diseases Act, 1897 so as to protect healthcare service personnel as well as their property including their living/working premises against violence during epidemics. The President has also given his assent for promulgation of the said Ordinance.8
The Ordinance provides for making such acts of violence cognizable and non-bailable offences and provides that commission or abetment of such acts of violence shall be punished with imprisonment for a term of three months to five years, and with fine of Rs.50,000/- to Rs.2,00,000/-. In case of causing grievous hurt, imprisonment shall be for a term six months to seven years and with fine of Rs.1,00,000/- to Rs.5,00,000/-. In addition, the offender shall also be liable to pay compensation to the victim and twice the fair market value for damage of property.9
Offences shall be investigated by an officer of the rank of Inspector within a period of 30 days, and trial has to be completed in one year, unless extended by the court for reasons to be recorded in writing.10
This amendment is a welcome step and It is hoped that this Ordinance will have the impact of infusing confidence in the community of healthcare service personnel so that they can continue to contribute to serving mankind through their noble professions in the extremely difficult circumstances.
7 Sustainable Development Goal 16 – Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all level
8 PIB, Ministry of Health and Family Affairs Promulgation of an Ordinance to amend the Epidemic Diseases Act, 1897 in the light of the pandemic situation of COVID-19 available at https://pib.gov.in/newsite/PrintRelease.aspx?relid=202493. [Last Accessed April 26, 2020].
9 Epidemic Diseases (Amendment) Ordinance, 2020.