What It’s Like to Be a Frontline Doctor and Speak Up Amid Growing Censorship in India

Over the last few months, frontline doctors fighting the coronavirus across the world have taken on various roles—from that of soldiers risking their lives as they battle the deadly COVID-19 to protect their countries, to acting as whistleblowers to highlight our failing public health mechanisms. But if recent events have shown us anything, it’s that despite the great emphasis placed on protecting our healthcare professionals from being exposed to coronavirus, it’s the people and the system who are really failing them.

In India, one such failure has emerged in the form of censorship and intimidation meted out to doctors who complained about either the extremely poor quality of personal protective equipment (PPE) provided to them, or the utter lack of it. Several reports have emerged of doctors speaking up and then facing backlash—from either the public that has even abused and assaulted some doctors over the stigma their job carries, or the authorities who’ve even threatened to have them suspended or revoke their registration. In fact, over the last one week, the nightmare of Indian doctors succumbing to the coronavirus infection while treating patients has come true.

VICE reached out to one such frontline doctor, geriatrician Harjit Singh Bhatti, who is based out of Delhi and is the national president of Progressive Medicos and Scientists Forum. Over the last few weeks, Bhatti has not only been attending to coronavirus patients at a Delhi-based private hospital, but has also been speaking up voraciously about many issues that ail public health workers. Recently, Bhatti started a social media campaign called #DocsNeedGear to highlight the crisis of PPEs in hospitals—which went massively viral as celebrities and other political leaders used the hashtag to demand PPE for healthcare folks. In this interview, he spoke about the growing censorship, threats and ground realities faced by healthcare professions in India.

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There are way too many reports of doctors being gagged by authorities or criticised and attacked by people because they voiced their opinions or dissatisfaction, like not getting enough PPEs. What’s happening exactly?

HARJIT SINGH BHATTI:

When you’re in a pandemic, doctors have hopes from two forces—your government and the country’s people— for not only supporting you but also helping you use your skills at a time like this. Instead, we’re facing threats and dangers from them. You can see our struggle when some of the best and established hospitals and medical institutes are asking for donations because they face a lack of PPEs. Imagine how hospitals and clinics in smaller cities, or even villages, must be faring at this time. Doctors aside, healthcare workers also include ward boys or sanitation workers who require equal protection. Unfortunately, doctors like me speaking up about these issues are being seen as opposition. That’s wrong because we’re not anti-government. We’re just requesting them to listen to us only because we have faith in them.

Why do you think your criticism is not being received well?
Over the last many years, the Indian public healthcare system has deliberately been overlooked and hence, has deteriorated, which is the fault of several governments and not just the present one. Niti Aayog (the policy top think tank by the Government of India) called our public healthcare a ‘sinking ship’, and this ship, now, has to take to the other end of the pandemic. While we’re dealing with limitations of budgets, PPEs manufacturing, infrastructure, and so on, the authorities understand that these can’t be fixed overnight. So the first thing they do is silence the frontline workers, so that none of these shortcomings are exposed. This is why doctors and healthcare workers are being targeted, or being accused of spreading fake news.

How did you personally face discrimination or threats for speaking up?
First of all, my alma mater, the All India Institute of Medical Science (AIIMS), came out with a statement very recently stating that I’m not associated with them at all. This is all because of me speaking up so much in public. Secondly, I’ve also been a victim of a lot of slanderous articles online by certain propaganda news outlets.

I’m sure all of this must be very scary or demotivating for you, especially at this time.
Doctors being seen as opposition is disheartening for me. Many doctors who want to speak up are scared. They spent years to get where they are, and today, they don’t want to have a case against them, or get terminated or suspended, or get their registration cancelled. Their career will be over. There is a massive fear among medical professionals because of this. Then the attitude of the public towards the doctors has made things worse—wherein landlords are throwing healthcare workers out of homes, or people are attacking them when they see them in public. So you see, coronavirus is actually the third invisible enemy for us. The first two are the authorities and the people who try to silence us.

How scared are you, as a doctor and as someone who’s speaking up about all of this?
I’m personally not scared because if I don't speak up, all these shortcomings in our fight against coronavirus may not come out. And it’s not like I’m attacking the government. I’m, in fact, giving them feedback and inputs. I do have hopes that our government is responsible and responsive, and they will take it positively. In fact, ever since doctors started to raise this issue, there actually has been a push in PPE manufacturing. Even the Indian Railways has started manufacturing them. So you see some response to the criticism. This keeps me positive and makes me want to speak up.

But there are still others who are scared, who’re being directly attacked or arrested or suspended. They’re going through a lot of mental trauma, and the only result of this would be that the next time onwards, they will be scared of giving their genuine inputs. The government should use its resources to figure out genuine complaints on social media too, instead of pressurising those who speak up to delete their social media tweets or posts. If it happens to one doctor, it affects all of us.

What is the difference between what’s being shown in the news, and what’s happening on the ground?
When you hear the health ministry, they say there is no shortage. But when you see notices at hospitals, there are instructions like you have to use one mask four times. And this is happening in big institutes with big funding and get direct media attention. The others are in much worse situations. In Aurangabad, doctors are on strike because of this. In Andhra Pradesh, a doctor was suspended for saying his hospital doesn’t have PPEs. Punjab has strikes. In Haryana, Uttar Pradesh and Bihar too, they’re talking about shortages. Doctors in Delhi, too, said they have a limited stock. It’s across the country. I’ve come out with a video asking the government and corporate machinery to make PPEs. This is a country where we have only manpower, and even that is restricted. For every 11,000 patients, we have one government doctor. So if one doctor is quarantined, infected or dies, the whole healthcare system collapses. You can’t replace a skilled worker overnight. This is not volunteer work; it takes years to build this skill.

What is the discrimination and attacks on the doctors indicative of, according to you?
There has always been a dissatisfaction towards medical professionals among the public. The public healthcare system is in a deplorable state, while the private healthcare is unregulated. So generally, people think doctors are just trying to earn money. These attacks are indicative of their frustration and dissatisfaction. Now, of course, they feel we’re coming to them with infection. What they don’t understand is that if you attack doctors, people will also suffer the consequences. However, the authorities are cracking down on such people and supporting the doctors.

Do you think it’s ironic that people come out to exhibit token gestures like clapping or lighting diyas for the healthcare workers, but are also attacking or discriminating against them?
Unfortunately, the Indian public has become very politicised. They look at things in a “for” and “against” way, and not “right” and “wrong”. If the government asks you to light a diya, people think it’s something to do with supporting the government and not the message. That’s why you saw this grand form of celebration, with people breaking social distancing and lighting fireworks. This environment is very dangerous. If you can’t follow the message, then there’s no point. Tokenism has no benefits. Tokenism is good for politics, not reality.

There have also been some concerns from healthcare professionals when details of coronavirus patients have been made public. What do you think of this surveillance and invasion of privacy at this point?

Labelling people’s homes with quarantine messages is fine. But putting their private details out on social media or propagating it for the whole public to see is problematic and putting them at risk. That’s what happened with how the authorities dealt with members of

the Tablighi Jamaat

. Now, Muslims are being attacked. People know that coronavirus is highly contagious, and revealing identities and personal information will just instill fear. Generally, in medical practice, patients’ privacy should not be disclosed, even if they give consent. We cannot anticipate public reactions. Yes, success stories should be talked about, but disclosing identities, especially when you’re under quarantine, is wrong. Medically, and ethically, that is not right.

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