On Monday, the Indian Medical Association held nationwide protests to signal their support for their colleagues in West Bengal who had gone on strike after two interns were allegedly attacked by a mob following a patient’s death in Neel Ratan Sarkar Hospital in Kolkata on June 11.

In Delhi, outpatient clinic services were suspended at government hospitals such as All India Institute of Medical Sciences and Safdarjung Hospital. Only emergency wards, intensive care units and labour wards functioned.

In an attempt to understand the issues at stake, Scroll.in spoke to a doctor and a patient at the All India Institute of Medical Sciences. The conversations threw up concerns about India’s healthcare facilities and the lack of infrastructure and staff, which doctors identified as the source of conflict between patients and them.

The doctor

“The problem is that patients think we are god,” said Dr Aswini Kumar Behera, a junior doctor in the ophthalmology department at All India Institute of Medical Sciences in New Delhi. Along with several other junior and resident doctors, Behera, 30, sported a bandage wrapped around his forehead, a sign of protest against the alleged attacks on doctors in Kolkata.

“I cannot give my best if I treat patients out of fear of getting beaten up by their family members,” he said.

Dr Aswini Kumar Behera experienced an instance of violence as an intern in 2012.

Behera studied at Calcutta National Medical College between 2008 and 2013. He said that such instances of violence against doctors had become increasingly common. During an internship in 2012, he faced a similar situation. “I had just finished a 24-hour long duty in the gynaecology ward,” he said.

A patient came at 10 am and she was undergoing labour pains. Behera examined her and told the family members to wait for the concerned doctor to arrive. “They started to verbally abuse me but I counselled them and called the doctor responsible,” he said. “When I turned to leave, someone grabbed my collar and I shouted. I became numb and did not know what to do at that point.”

He said that the lack of infrastructure at government hospitals and staff shortages were among the sources of conflict between doctors and patients. “We can only admit as many patients as per the number of beds,” he said. “The population has doubled but the facilities have remained the same.”

Doctors in these hospitals are also made to do other tasks such as blood sampling, digitally logging medical records and handling medical equipment, he said. “This adds to a lot of time wastage because these are tasks that nurses can help us perform,” Behera said. “It just adds to our inefficiency.”

To add to this, Behera said that doctors treated at least 150 to 200 patients a day. “All government hospitals are overburdened,” he said. “The doctor to patient ratio is just shooting up. We all are regularly skipping meals so that we can attend to more patients.”

The World Health Organisation prescribes one doctor for 1,000 patients. But according to the National Health Profile in 2015, there is one doctor for 11,528 patients in government hospitals across the country.

Along with a Central law to protect doctors, Behera added that emergency departments needed more counsellors to directly speak to family members of patients.

He dismissed the politics around the strike as Chief Minister Mamata Banerjee in West Bengal accused the Bharatiya Janata Party of giving it a communal tone. “Shame on these politicians for using us,” he said. “We have to operate on everyone equally. We have even treated convicts who sit with their handcuffs attached to the bed.”

In AIIMS, emergency and trauma centres functioned but several patients did not receive treatment from outpatient clinics because of the protest. “We will carry forward the backlog of patients to the next day,” Behera said.

While several patients waited on pavements, the doctor said that protest was important for their safety. “No one will know the feeling we get when we see a patient improve and live,” Behera said. “This is what drives us. I have watched people die and remember it very clearly.”

The patient

Rina Devi, 35, looked unperturbed when the doctors turned her and her ailing 17-year-old son away from the paediatric outpatient clinic because of the protest at AIIMS. “They told us to wait for four more days,” she said. “They were supposed to prepare a report today but they did not do it. We are used to waiting. But we need the doctors.”

Devi had come Delhi by train from Gaya city in Bihar on May 16 to follow up with doctors after her son had been diagnosed with renal artery stenosis in 2014. This condition obstructs the flow of blood to the kidneys. Since the diagnosis, Devi and her son have made frequent trips to Delhi because they could not afford the medical expenses at private hospitals in Patna, the capital of Bihar.

Rina Devi's son could not be treated as outpatient services were suspended because of the protest.

Devi added that she had been warned by a relative about the protest on Monday. “My relative said that I should not go to the hospital because he read about it in the papers,” she said. “But I didn’t think much of it so I came here with my son anyway.”

Her son was not able to walk, she said. “He had high blood pressure and he temporarily lost his vision,” Devi said. “When we came here in 2014, the doctors admitted him and he got better.”

After their arrival in May, Devi has accompanied her son to conduct around five blood tests and an ultrasound test. From her temporary home in North West Delhi’s Sultanpuri, she commutes for at least an hour and a half daily to get to AIIMS with her son. “Sometimes I spend the night in the clinic with my son,” said Devi, a homemaker whose husband runs a barber shop in Dhanbad district, Jharkhand.

“We have already spent around Rs 5,000 on the medicines, tests and our travel. My husband earns around Rs 6,000 per month and has to borrow money for our son’s treatment.”

As she waited outside the clinic while her son napped, Devi wondered how doctors faced such attacks. “We cannot even think of hitting a doctor,” she said. “We will be kicked out if we start fighting doctors. I am not stupid to come here all the way from Bihar. It is for my son. If doctors stop working then it will affect us.”

Despite the protests, Devi is adamant on staying and is yet to book her ticket to return to Bihar. “We were supposed to leave today [June 17]. But I will only leave once the doctors have treated my son.”