The day junior doctors took to the streets in demand for public health

November 18, 2012

by Dr. Punyabrata Gun (Translated by Dhiman Chatterjee)

[This is another contribution on People's Health Movement from Dr. Punyabrata Gun. We have published two previous articles of the author titled “Peoples’ Health Movement in India: Looking Back at Dalli Rajahara - Achievements and Problems” and “The Journey of Shramajibi Swasthya Udyog (Working Class Health Project)”. These articles have been translated from Hindi or Bengali. - Editors]

In the second half of 1979, Medical College Students’ Union under the leadership of Medical College Democratic Students’ Association, carried out an enquiry in the hospital. ["Medical College" refers to the Calcutta Medical College- Ed]

It was seen:

• Of the seven posts of Emergency Senior Officer-on-Duty, three positions were vacant. Despite the fact that house-staffs had heavy work pressure, they were made to work as Junior Officers on duty.

• For the last one month E.C.G. machine was not working. So the cardiac patients were sent to other hospitals and few of them had died on the way.

• Blood was not available in case of emergency but was available in black market (we are talking about the time when Central Blood Bank was located in Calcutta Medical College).

• There was a dearth of oxygen cylinders.

• Many important and life-saving drugs were not available in the hospital. As a result, patients died miserably without proper medication.

• In the outdoor and indoor departments of the hospital, excluding penicillin or sulfa drugs, no other antibiotic was available. In the Dermatology department, even penicillin was not available.

• There was no Burn Unit in the hospital. Burnt patients were kept in the verandah. As a result even a patient with 20% burn case died because of infection when modern medicine can cure even 80% burn cases.

• In the outdoor, patients had to wait for 3 hours to get a chance to talk to the doctors for 1 minute on an average (those who were fortunate, got at the most 3-4 minutes). Then after waiting behind a long queue in front of medicine counter, people got on an average daily medicine worth 5 paisa. Many patients had to return empty handed because of non-availability of medicines.

• Patients needing surgical procedures had to wait for admission for one to one-and-half years after showing the doctor in the outdoor.

• Patients need at least 3000 calories daily but were given 1500-1700 calories, while admitted in the hospital.

• In the gynaecology and obstetrics department, in the Eden Hospital building, three patients were accommodated in each bed.

• In the emergency department, tuberculosis patients were kept in the most dark and damp room.

• Whereas it is mandated that there should be one nurse for each 5 patients, in reality there were one nurse per 15-20 patients.

• Medical College had a total loan of about 55 lakhs of rupees to different drug companies causing irregular supply of medicines.

With the aspiration of making changes of this terrible situation, in 1979 the students and junior doctors of Calcutta Medical College, under the leadership of students’ union, launched a movement which became famous as “Hospital Movement”. The students and
junior doctors of R.G. Kar Hospital also launched a similar movement. The movement of 1979 was a preparation for a bigger movement in the next decade. House-staff Intern Association (HIA) or Junior Doctors Association (JDA) were formed in different medical colleges. These individual HIAs or JDAs came together to form All Bengal Junior Doctors’ Federation (ABJDF). The charter of demands was prepared through discussion. Some of these demands were of immediate nature while others were long-term demands with far-reaching consequences.

Nobody Comes Home from the Hospital

By Birendra Chattopadhyay (Tr: Kuver Sinha)

Voice of Poets in support of the Junior Doctors, 1983

Nobody comes home from the hospital, they told me
My elders, when I was a child.
It was the land of the British. Older myself,
The country free, I understood why it had been so.
A hospital is not for everybody. The honorable who rule this country
Come back home fattened, fat as they are
The country is for them, the hospital is theirs.
Others come back, or don’t, as luck would have it.
And others still who have nothing
Don’t even enter.
A hospital is never theirs. Its ugliness, within and without
Does not touch them.
The game of medicine and food,
That game of hide and seek
Is unknown to the brothers of Kanu and Sidhu
Even though streets are named after them.
Nobody comes home from the hospital, they told me
Only a half-truth, I realize now. Some come back, lucky as they are
To have entered, to have come back.
So it has been since the time of the British.
It hasn’t changed one bit. A little perhaps, on second thought
The black market of medicine and food
Was a little smaller
When it was the land of the British.
And it wasn’t as dirty and putrid
Within and without
A hospital, as it is now.
A garden of hell, as it is now.


Immediate demands:
1. Supply of essential and life-saving drugs should be regularized and be made available.
2. X-ray, E.C.G., blood and other essential laboratory tests should be made possible 24 hours a day.
3. All the willing licensed, Junior Doctors should be offered Government jobs. The canard that Junior Doctors are unwilling to go to the villages should be stopped.
4. The stipend for Junior Doctors should be increased and all post-graduate students should be given stipend.
5. Maximum working of 48 hours a week should be ensured.
6. The draconian Hospital Bill should be withdrawn.
7. In the hospital management committee, representatives from all levels of health workers should be inducted.
8. Irrational DCMS course which produces quacks should be scraped.
9. Real security for health workers of all levels should be ensured.


Main demands:
1. People-centric, scientific health policy should be introduced; right to health should be considered as a fundamental right and to realize it in practice (in the central and state levels), essential medicines should be prepared.
2. Scientific drug policy should be introduced and in order to ensure availability and distribution of the essentials drugs, low-cost medicine under state control should be prepared.
3. Coherent medical education should be formulated; medical education should be controlled


First convention of ABJDF was held in January 1982. The charter of demands was placed before the Government. However, the Government refused to even recognize ABJDF.

After few days, with the regret letters (inability to offer jobs) from Public Service Commission in hand, junior doctors staged a protest march and a memorandum was given. But the Government refused to accept the memorandum.

Junior doctor, Paresh Chowdhury, died in office due to continuous 24 hours work without any break. Government refused to take any responsibility and failed to offer any compensation.

On 23rd March 1983, ABJDF convention took place amidst campaign and leafleting in the Outdoor facilities of the hospitals supporting the demands of ABJDF. Another charter of demands was placed but the Government remained indifferent. In the hospitals and medical colleges, memorandum was given to the Superintendents and Principals who also chose to remain indifferent.

A deputation was given to the Health Minister on 23rd April. He assured the delegates that the Chief Minister would meet and discuss with the Junior Doctors within 7 days. Based on this assurance, proposed outdoor strike was called off but the Government was silent even after 7 days.

On 3rd May more than 1000 junior doctors went in a procession to give deputation to the Health Minister but the Health Minister was so busy with the panchayet elections that he could not spare any time for them.

Between 9th and 14th May, outdoor boycott programme was launched in different hospitals. Badges were worn to mark protest.

On 6th June, Burdwan Medical College authority illegally dismissed two house-staff members on false charges. From 13th June both outdoor and indoor boycotts took place along with two days of hunger strike. But the government remained silent. Mass organizations of CPIM were asked to campaign in front of the hospital gates against the protesting junior doctors.

On 15th June, functioning of the hospitals was paralyzed as junior doctors boycotted outdoor, indoor and emergency departments. For the sake of the patients, emergency squads were started in the hospitals. At the time of treating the patients in P.G. Hospital, visiting faculty of Orthopaedics department and State secretary of government doctors’ organization (Health Services Association), Dr. Arun Banerjee, was attacked by the opponents of the protests. His only fault was that he had supported junior doctors’ movements. Junior doctors were attacked by DYFI and Co-ordination Committee members in front of police. On 17th June, a meeting took place with the Chief Minister on demands placed by the junior doctors.

On 7th July, government announced increase in salary of junior doctors but remained silent regarding the demands concerning public health. On 8th July, terming the attitude of the government as bribe, protest march was organized where effigies of the Chief Minister and the Health Minister were burnt. Between 9th and 13th July, boycotting outdoor departments, junior doctors ran parallel outdoor facilities. It was proposed that the increase in salary could be used for the benefit of the patients. Land and Revenue Minister, Mr. Benoy Choudhury, told in a press conference that conducting parallel outdoor clinics in hospitals tantamount to outright revolt.

On 4th August, another meeting took place with the Health Minister but the government remained adamant and refused to accept the demands. From 5th till 12th August, junior doctors again went for strike.

On 27th August, Health Service Association (HSA), Indian Medical Association (IMA) and ABJDF jointly organized a meeting of all doctors supporting the demands. Government was still silent. From 15th to 17th September, Outdoor boycott was carried out in rotation in support of the demands concerning public health policies.

From 21st to 27th September, after giving an ultimatum, junior doctors went in for complete strike.

On 1st October, government announced that junior doctors who were participating in strike would not be given course completion certificate and their stipend would be stopped. This declaration of the government was protested by HSA and IMA.

“Chief Minister told that they are demanding jobs for everyone. We have already expressed that arranging jobs for all is not possible for us”. Ganashakti, 20/09/1983.Socialism is needed to provide medicines to patients.For job is required communism.This is not an improper statement. Logic is clear ⎯ as clear as clear sky of autumn.I shall also tell on your behalfThe workers of jute mills which are under lockouts
“Babua, unless socialism comes the wheels of the machines should not move”Shall inform the peasants of Bankura
“Socialism has not come. So deep wells will not be dug on soil”I shall whisper to the river (she is shrewish)
“Socialism has not come. So do not rush towards the sea”Samir Roy
Voice of Poets in support of the Junior Doctors
1983

On 4th October in SSKM Hospital and Nil Ratan Sircar Medical College, police ruthlessly lathicharged the junior doctors who had stationed themselves in the offices of the Superintendents. In National Medical College attack was carried out by the Co-ordination Committee members. In protest even at midnight, junior doctors launched a spirited protest march. On 5th October, ministers justified the lathicharge. Benoy Choudhury said that the police had lathicharged in their self-defense! In National Medical College police had injured 28 doctors and had arrested 14. More than 1000 junior doctors-students-nurse-staff had burst in protest. At night, overcoming all adversities, a sit-in was staged in front of the Raj Bhavan.

On 6th October, HAS and IMA organized a strike that resulted in the complete stoppage of activities in outdoor departments of 18 hospitals.

On 8th October government started slanderous campaign that children in B.C. Roy Children’s Hospital were dying because of strikes carried out by the junior doctors. But hospital superintendent clarified that no child had died due to this strike. In Bangur Hospital CPIM-led Nagarik Committee attacked the doctors.Responding to the call of IMA, thousands of people, including several eminent personalities, carried out a protest march and submitted a memorandum.

On 9th October CPIM cadres carried out parallel attacks in B. C. Roy and Bangur Hospitals.

10th October, CPIM had gheraoed ABJDF president’s house.

11th October, Chief Minister ill-behaved with the delegates invited for a discussion. In protest two junior doctors left the room while the Chief Minister was adamant in his discussion with the remaining delegates.

On 13th October, Government backtracked and withdrew punitive measures. Accepting some more demands, government urged the junior doctors to withdraw the strike.

On 14th October evening, IMA and HAS decided to withdraw movement and at night ABJDF decided to rejoin work and at the same time took vows to carry out struggle to realize other demands.

I graduated from Calcutta Medical College in August 1983 and thus became a junior doctor while the movement was on-going. I could see the effects of this movement while working. At that time most of the beds available in the hospitals were free beds. I cannot recollect that patients of free bed had to buy any medicine from outside, however expensive those might be including costly antibiotic and cancer drugs. Laboratory tests could be done inside the hospitals. But this good condition did not prevail for long. Within three years in 1986, junior doctors had to resort to another protest movement.

Government had also taken lessons from the movement. Since government doctors’ organization (HSA) had supported the movement of ABJDF, so government doctors aligned with the ruling party formed their own organization (Association of Health Service Doctors). Using carrot and stick principle of transfer and promotion, majority of the government doctors were compelled to join this organization.

During the course of the movement, when the government doctors refused to act as “strike-breakers”, then denying jobs to many highly qualified and experienced jobseekers and sidestepping the convention of first posting in rural areas, as many as 87 doctors were appointed in hospitals and medical colleges of Calcutta. These doctors had only qualification that they were SFI cadres. Later on, they were made permanent and some of them had stayed in the government hospitals without any higher educational qualifications, just because they served as “ears and eyes” of the government. As a obedient subservient of the government, a new association of junior doctors, Junior Doctors’ Council (JDC), was formed.

About 30 years have passed since the movement of ABJDF. Public health condition is deteriorating over every passing day. With the introduction of new economic policy, liberalistion and structural adjustment programmes in 1991, government is gradually withdrawing itself from health,education and related welfare activities and in its place private capital is spreading its tentacles in the field of health service. After 34 years of left front rule, one more year has passed with the new government in power. Though this government is named as government for change, but no change is observed. But one leader of ABJDF is a parliamentarian now and another member an MLA.

Still it is hoped that again the junior doctors will rise, again they will take to the streets with the slogan that “health is not a matter of charity, right to health is my fundamental right”. Again that movement will receive huge public support; again it will take the shape of a mass protest.

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