Jan Swasthya Abhiyan (JSA), the India chapter of global Peoples Health Movement (PHM), has accused government hospitals of serious legal and ethical violations in the aftermath of Delhi violence.
In a report released on Monday, JSA, a network of organisations, including NGOs working in the area of health, women's organisations, peoples' science organisations, service delivery networks and trade unions, asked the state government to put a series of emergency care and follow-up healthcare services to avoid such lapses in future.
The report titled "The Role of Health Systems in Responding to Communal Violence in Delhi" on March 2, highlights the challenges faced by victims in accessing and seeking healthcare during the violence and in its aftermath and the urgent steps that the Delhi government needs to take to ensure that the system plays a constructive role in helping survivors heal from trauma and get justice.
According to the report, far from providing healing from the trauma that victims have faced, the public health system itself has ended up inflicting secondary trauma through acts of commission and omission. The report documents the inability of the injured to reach healthcare facilities during the violence; in many instances mobs prevented ambulances from reaching hospitals. "This was compounded by a deep-seated sense of fear and insecurity in government-run hospital institutions that took root among the injured and their families. Eventually private and charitable health institutions became the port of first call for injured Persons," it said.
It also alleged that instead of being co-operative, hospitals have been withholding information and instead asking families to go from ward to ward, and room to room to check if their missing family members are admitted. Injured persons who did reach government hospitals such as Guru Teg Bahadur Hospital and Lok Nayak Jai Prakash Hospital reported feeling intimidated by police presence in the premises given that several reports indicate the direct role played by the police themselves in the violence.
The dismal level of care reported by some injured persons included negligent care where treatment was provided hurriedly; patients were discharged without proper treatment and sent back to areas where violence was continuing. The report noted that a common reason for denial of care was the lack of a Medico-legal Case (MLC) number and treatment record being provided to injured persons. "No record of injuries or treatment were given to families. In many cases, no details of history were recorded - such as where the violence took place, with what weapon, who the assailant was etc. Injuries were recorded in a cursory manner and some gross injuries such as fractures were not recorded at all. At the community level, the violence has led to large-scale displacement of families; access to routine treatment for chronic illnesses has been disrupted. In areas that saw the most violence Mohalla clinics do not exist and primary healthcare centres in some are lying shut since the violence started," it points out.
Terming it as an apparent abdication of the government in its responsibility in providing emergency and follow-up healthcare services, JSA called for station-hospital liaisons in all government hospitals attending to injured persons to intervene if they or their families are facing issues in accessing care or treatment records. It wanted the establishment of a toll free number for people to report instances of denial for treatment/admission for quick and appropriate action. It asked the government to issue written orders to public and private hospitals to ensure injured people are not denied care or treatment records including MLC records. Operationalisation of primary healthcare services at all affected areas through Mohalla clinics or Urban PHCs, posting of paediatricians, gynaecologists and surgeons in such centres, availability of surgical facilities, mobile vans for affected areas and a team of medics and paramedics to provide healthcare outreach and referral services to injured people were the other demands.
The documentation of the health systems response happened after the communal violence engulfed several localities of North-East Delhi since 24 February 2020. It documents the first-hand experience of JSA volunteers that have been on the ground since February 25 as well as accounts of injured persons and their families.