The suicide of a young doctor in Mumbai has opened a debate on the entrenched problem of caste discrimination, harassment and resentment over reservations of seats in educational institutions and jobs for people from marginalised groups.

In the evening on May 22, Payal Tadvi was found hanging in her hostel room at the Topiwala National Medical College, which runs under the BYL Nair Hospital. Tadvi, 27, was a resident in the gynaecology and obstetrics department. Her family has alleged that she was being harassed by three senior doctors because of her caste identity. Bhakti Mehere, Ankita Khandelwal and Hema Ahuja – all belonging to upper-caste groups – allegedly demonstrated resentment against Tadvi for having obtained her medical seat through reservation for Scheduled Tribes.

Tadvi, from Jalgaon in Maharashtra, belonged to the Bhil Adivasi community. She had joined the Topiwala National Medical College in 2018 after finishing MBBS from Government Medical College, Miraj.

In a letter to the Topiwala National Medical College’s administration on May 10, Tadvi’s mother detailed some of the alleged harassment faced by her daughter. The three senior doctors would reportedly shout at her in front of patients, use casteist insults, tell her that she would not be allowed inside the operation theatre, perform any deliveries or be allowed to learn. Tadvi’s mother claimed to have witnessed the harassment firsthand when she went to see her daughter at work. She said Tadvi feared worse bullying if anyone complained about her harassment to college authorities.

Tadvi reportedly called her mother at around 4 pm on May 22 to say she could no longer bear the torture. Her family promised to visit her the next day, but she was dead by 7.30 pm.

The college has since formed a committee to look into Tadvi’s death and suspended the three accused doctors. The Mumbai police have booked them under the Scheduled Castes and the Scheduled Tribes Atrocities Act, anti-ragging provisions and Section 306 of the Indian Penal Code that relates to abetment of suicide.

“We asked if the college had an SC/ST cell to address complaints of caste-based harassment as mandated by the University Grants Commission, but it does not,” said Rekha Thakur, a spokesperson for the Vanchit Bahujan Aghadi, which organised a protest at the college demanding action against the accused on May 27.

Activist groups in the health sector such as the Jan Swasthya Abhiyan and Medico Friends Circle have strongly condemned what they described as the “institutional murder” of Tadvi. But the Indian Medical Association, according to The Wire, has denied that caste discrimination even exists in medical institutions.

‘Casteism is rampant’

Tadvi’s is the latest in a series of suicides by medical students from marginalised communities. In early 2010, Balmukund Bharti, a Dalit MMBS student at Delhi’s All India Institute of Medical Sciences, was found hanging in his room. While the AIIMS administration blamed depression for Bharti’s suicide, he had reportedly been abused and harassed by his professors, beaten up by his seniors under the guise of ragging and generally alienated from campus life because he was Dalit.

In March 2012, another MBBS student at AIIMS killed himself. Anil Kumar Meena was from an Adivasi community. Though he had a good academic record he found it difficult to understand English. His friends and family alleged that Meena was discriminated against because he came from a village and did not speak English fluently.

The suicides at AIIMS took place even after a government committee had reported systemic caste-based discrimination and suggested ways to address it. The Sukhdeo Thorat committee, set up in 2007 to look into caste discrimination at institutions of higher education, had found that 85% of Adivasi and Dalit students at AIIMS felt internal examiners discriminated against them in awarding grades. They also complained that upper caste students were hostile towards them.

Abhishek Royal can relate to this. A medical officer at the Antiretroviral Therapy Centre of the National Institute of Tuberculosis and Respiratory Diseases, Delhi, has faced caste-based discrimination himself.

“When I was applying for a medical seat I would hear comments like ‘You just have to get the pass percentage and you will get selected for medicine’ despite the fact that I was always good at my studies and always a topper,” said Royal, who belongs to the Valmiki Dalit community.

He did his MBBS from Aligarh Muslim University where, he said, there was not much caste discrimination. But Royal had friends in Uttar Pradesh’s medical colleges who faced a lot of harassment. Royal then joined AIIMS, Jodhpur, for a postgraduate course but quit after just 11 months because of what he described as the faculty’s preferential treatment towards upper caste students.

Roshan Radhakrishnan, consultant anaesthesiologist in Kochi, Kerala, recalled that when he was studying in Pune, one of his teachers would go around asking junior doctors about their caste. He belongs to the Thiyya community, which is counted among the Other Backward Classes. “I have worked in many institutions after that,” he said. “Casteism, bigotry and racism are rampant.”

Resentment over reservation

Caste discrimination in medical institutes largely flows from upper caste students’ resentment over reservation. Royal said aspiring medical students from Dalit and Adivasi communities are constantly told they do not have to work hard because they will get a seat through reservation. In medical school, they are taunted for getting admission through reservation and told they are not capable enough.

This is especially evident on social media groups created for those taking the National Eligibility cum Entrance Test for postgraduate medical courses. “What I have observed in NEET PG groups on social media, especially Facebook groups, is that every year when the results come out, there are a lot of caste-based hate comments floating around,” he said. “Some of them are really dirty comments.”

Upper-caste students have been claiming that reservation in medical courses goes against the idea of merit. In fact, much the discussion around reservation on social media is accompanied by the hashtag “murder of merit”.

“What is the meaning of this hashtag murder of merit?” asked Royal. “NEET PG does not assess merit but only how good you are at cramming multiple choice questions. It is superficial. There will be many students who are not good at cramming but are good in their clinics.”

R Srivatsan of the Medico Friends Circle who has written a paper about discrimination in the health sector explained that extreme caste discrimination in metropolitan India is not rooted in the religious notion of untouchability but the desire of people from upper-caste communities to retain their hold over institutions that enable them to get wealthier through better education and better jobs.

He pointed out another flaw with the merit argument, reacting to the example offered in the this placard:

“If you look at the antecedents of the person who got rank 36,000 under reservation, they are likely a first-generation or a second-generation learner and come from a regional language background,” he explained. “They will also be from castes that are completely discriminated against. If you want to talk about merit, then the sheer grit and hard work to overcome the circumstances that work against you and get to that 36,000 rank is more meritorious than somebody who has had several generations of education in the family.”

Radhakrishnan differed. “Going from high school to medical college, some people have a great disadvantage coming in and enough to say they deserve reservation,” he said. “But going from MBBS to PG, I cannot accept it.”

Radhakrishnan maintained that over five years studying for an MBBS degree offers all students access to the same teachers, patients, classrooms, books and dining halls. “You have leveled the playing field for people coming out of MBBS and so if one student has a 4,000 rank and another has 40,000 rank, then that is based on their performance,” he said.

But Royal pointed out that continued discrimination can leave Dalit and Adivasi students at a disadvantage even after completing MBBS.

“I have worked in hospitals where they have separate glasses for Scheduled Caste students or upper caste students refuse to sit with Scheduled Caste students and insult them,” he explained. “This becomes very problematic in PG, especially when you are a first-year junior resident and you have second and third years with this kind of mentality. Scheduled Caste students face a lot of mental torture.”

Also read: ‘We do not touch them’: Shocking caste discrimination in Karnataka district, finds new study

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