| Indian Journal of Medical Ethics | ||||||
![]() Home Current Issue Past Issues Support About IJME Jul-Sep2002-10(3) |
DISCUSSION A hospital's politics affect its secular
image Rupa Chinai Vadilal Sarabhai (VS) Hospital is the largest Corporation-run hospital in
Ahmedabad but also caters to poor patients from all over Gujarat. Set up some 70
years ago by Sardar Vallabhbhai Patel, the hospital's constitution originally
provided for an independent, eight-member board, balanced between ruling
corporation politicians (currently the Congress), four permanent seats for
members of two families representing the original donors, and a member of the
opposition party in the corporation (currently the BJP). Subsequently, the
balance was tilted with the inclusion of a ninth member (representing the ruling
party) with voting rights. Today the VS hospital draws its funds from the Ahmedabad Municipal
Corporation but continues to be independently managed by this board of
trustees. The other day, as Ahmedabad burned, frenzied mobs stationed at the gate of
the VS hospital attacked ambulances bringing injured patients to the hospital,
and stabbed a patient's relative. Later that day, a mob rampaged through the
hospital threatening patients from the minority community. That same day, a meeting had been organised to understand community
perceptions on how the hospital's services could better serve patients during
the ongoing crisis. It was attended by leading citizens of both communities.
This included Gandhian Chunibhai Vaidya; M H Jowher, computer consultant and
social worker; and public health specialist Dileep Mavalankar. Also present were
heads of departments dealing with the bulk of riot victims, staff, board
members, and the Ahmedabad Mayor, Mr Himmat Singh, who heads the Board. One critical issue was the total absence of emergency and vital drugs in
the hospital store. Despite a directive from the Corporation and State
government to provide free drugs and treatment to all riot victims, neither
money nor drugs had reached this cash-starved and over-burdened institution
during this crisis. Superintendent Dr Makwana had made a public appeal for emergency drugs,
surgical and orthopaedic items, and sent a requisition to the state government a
month earlier, but this had evidently not been pursued. The hospital's drug
constraints had not been communicated to the public, and volunteers and
family ran between pillar and post hoping to get free drugs. The delays and the
communication gaps left over-worked hospital staff dealing with ugly tempers in
the city's already surcharged atmosphere. There were other problems, as perceived by the members of the Muslim
community. Patients with bullet injuries received a certificate mentioning
'injury' without specifying how it was caused. This had grave implications for
compensation or insurance claims. Patients complained that they were discharged
before it was warranted. People complained that their relatives died unattended.
Patients and their relatives had also complained that some staff members had
demonstrated prejudicial behaviour. This had created the perception that the
hospital no longer offered a safe haven to members of the minority community,
they said. During my visit to the hospital on this occasion I met a patient who had
been treated for a bullet injury and had been lying in the terrace, for over 12
hours, in 45 degree heat. The patient said he had been denied treatment despite
instructions from the hospital superintendent. The doctors said the patient had
resisted admission and insisted on going home. At the meeting, Mr M H Jowher expressed appreciation of the yeoman service
provided by the hospital and all its staff. He also pointed to the various
perceptions of the Muslim community, and urged the Board to improve its public
relations. Allegations of communal attitudes or behaviour warranted prompt and
impartial enquiry by the administration. Unfortunately, Mr Jowher's comments were twisted to imply that he was
accusing all the hospital doctors of communal bias. A partial walk-out was
followed led by a corporation civil servant, BJP corporators and some doctors.
Within a few minutes the hospital union gate-crashed and disrupted the meeting.
In the power play for vote banks between the BJP and the Congress, the
hospital's secular identity is taking a severe beating. Issues of financial
viability, accountability and responsibility are taking a back seat. Consequently, there is a widespread perception among hospital staff, and
the community living near the hospital, that the current Congress-led
Corporation is "pandering" to one community. It is also unfortunate that the medical profession seems unwilling to take
a stand against colleagues who discriminate in their treatment of patients. In
response to the suggestion that doctors were under oath to save lives, and
punishment lay in the hands of the law enforcement machinery, one senior doctor
said, "If a patient comes with hand injuries, clearly caused by untimely
explosion of country-made bombs, why should we treat them?" Despite the subversion of its meeting to build community relations, the
board's effort to confront prejudicial tendencies in the hospital appears to
have been yielded some results. Muslim social workers reported that the
hostility they earlier encountered is not so visible. The message appears to
have gone through that any person displaying bias will be held accountable. It's
a small sign of hope, and an eye-opener to the task that lies ahead. Rupa Chinaiis a board member of the VS hospital representing one of the donor families. She is also health correspondent at The Times of India, Mumbai.Times of India building, Mumbai 400 001. E-mail:rupachinai68@yahoo.com |
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