On 28 October, over a 100 interns at the All India Institute of Medical Sciences, Bhopal went on a day and night hunger strike. They were demanding that the hospital management pay them the Rs.1000 for every 8 hours of overtime duty promised to them at the peak of the Covid pandemic earlier this year. A promise that was never kept.
“We did overtime duty during Covid, but now we are not being given our incentive money. We first tried to persuade the management by writing them a letter. We have gone on strike because there was no response” says Vedanta Tripathi*, an intern at the AIIMS, who will complete his training end of this year. According to him more than 100 intern doctors like him did overtime duty for 6 to 8 hours every day.
Prime Minister Narendra Modi had praised the doctors across India for their contributions during the Corona epidemic. Doctors, MBBS students and interns risked their lives often to save patients and also put extraordinary hours of work during the first and second wave of Covid. All this seems to have been forgotten with the first signs of the pandemic receding.
“If they can go back on promises made to doctors, can they be expected to keep their word on anything promised to common citizens?” asks Manoj Trivedi, another intern lamenting the fact that they have been forced to go on strike instead of taking care of patients. The AIIMS interns worked overtime for 44 days and at the rate of Rs.1000 for every extra 8 hours worked they are each owed Rs.44,000 by the hospital.
“AIIMS did not have enough doctors, so we interns did 6-8 hours of overtime duty. We ensured that Covid patients would get good treatment and the image of the AIIMS management would not be tarnished” says Mahendra Pratap Singh, an intern.
He contrast their plight to that of junior doctors at the Gandhi Medical College in Bhopal who also worked overtime during the Covid peak period and have already been paid by the state administration. To highlight their demands, apart from their hunger strike, the interns have also conducted cleanliness drives and donated blood to dengue patients in the city.
In talks with the AIIMS management in Bhopal the interns were told that the payment due to them was being withheld as a decision on this had to be taken by the institution’s headquarters in New Delhi. The management has asked for three week time to sort out the issue and the interns have agreed to resume work, though they will do so wearing black arm bands to continue their protest.
The AIIMS, Bhopal has been in operation since 2004 and has a capacity of 1100 beds. The interns say that several of the departments are not functioning properly and the hospital is understaffed. Patients, especially those who come from outside Bhopal, often have to wait for 8 to 10 days for get treatment.
This is not the first time doctors and other staff at AIIMS, Bhopal have gone on an agitation. In May 2018 dozens of them walked all the way to Delhi to demand the appointment of a permanent director for the institution.
In June this year, at the height of the second wave of Covid, thousands of junior doctors in Madhya Pradesh went on strike, demanding a hike in their stipends and reserved Covid-19 beds for them and their family members for a Covid-19 emergency.
On June 4 this year, nearly 3,000 doctors resigned from their respective duties after the MP High Court directed the protesters to resume their duties and called the agitation “illegal.” Following this, the state government also sent eviction notices on Saturday asking them to vacate their hostels. The protests were backed by resident doctors of AIIMS and Safdarjung hospital in Delhi too.
“We are enraged to learn about the atrocities and callousness of the government of Madhya Pradesh,” said representatives of the Federation of Resident Doctors Association (FORDA) in a statement. “The resident doctors are protesting for their rightful demands which were denied outright and the administration is spoiling the careers of thousands of trainee doctors,” they also said.
The strike ended only after the stipend of junior doctors was increased by about Rs 10,000 per month, which is close to 17% of their previous salaries.
During the second Covid wave Madhya Pradesh has seen a sharp spike in deaths, with hospitals throughout the state under great stress facing shortages of both health personnel and basic facilities such as oxygen supplies. In April and May 2021, deaths in the state were nearly three times more than normal in these months in previous years.
Officially, Madhya Pradesh reported just 4,461 Covid deaths between January 1 and May 31, 2021. Data from the Civil Registration System, maintained by the Office of the Registrar General of India, however showed excess deaths in the same period were 42 times the reported Covid death toll. While it is not possible to attribute the entire excess death toll to Covid, experts attribute this also to significant disruptions to routine health services when the second wave hit.
According to a report by the 15th Finance Commission, the per capital availability of health personnel in India is grossly inadequate. In 2018 there were 11.54 lakh registered allopathic medical doctors, 29.66 lakh nurses and 11.25 lakh pharmacists in India.
Every allopathic doctor in India caters to at least 1,511 people, much higher than the World Health Organization’s norm of one doctor for every 1,000 people. The shortage of trained nurses is even more dire, with a nurse-to-population ratio of 1:670 against the WHO norm of 1:300
Among major Indian states Madhya Pradesh along with Bihar, Chhattisgarh, Jharkhand, Maharashtra and Uttar Pradesh is way behind others in government doctors-to-population ratio.
Ashok Kapse is a journalist based in Bhopal
*For reasons of privacy all names of interns mentioned have been changed