Doctors come under attack in India as coronavirus stigma grows

By Ari Altstedter, Bhuma Shrivastava and Dhwani Pandya
Trupti Katdare was in a slum in the central Indian city of Indore when the mob attacked.

She and a group of other public-health workers had been tracking down a man who might have had contact with a recently confirmed case of the coronavirus. When they found him, he cursed at them, asking why they wanted his information and accusing them of trying to take him away.

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Almost immediately, at least 100 people surrounded the team, throwing stones and other objects. Luckily, they managed to escape.

“At that time, I was only thinking how we can save our lives,” Katdare said. “My husband, my kids, my family members were in front of my eyes as I wondered if I’d see them again.”

Katdare’s experience is one of the more dramatic in a phenomenon that has become common in India lately: health-care workers being subjected to violence and abuse as they try to contain the virus. Assaults have been reported across the country as people panic about catching the disease from medical workers or being stigmatized for having contracted it themselves.

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In Bengaluru, health workers were attacked as they went door to door checking people for symptoms. In Bhopal, doctors returning from an emergency shift were stopped by the police, accused of spreading the virus, and beaten with batons. And in New Delhi, one doctor was assaulted by a shopper at a local fruit market, while neighbours of one of her colleagues attempted to force the woman from her apartment building.

Particularly Bad

Medical workers have also been attacked from Australia to the Philippines, but the situation is particularly bad in India. So much so that the government released a public service announcement last week pleading for an end to the stigmatization.

“When you become a doctor, you know there’s a risk of contracting infection,” said Nirmalya Mohapatra, a senior doctor at a public hospital in New Delhi and vice president of his institution’s resident doctors’ association. “We are not scared of infections, we were mentally prepared for that as an occupational hazard. But getting beaten up, that wasn’t something we mentally prepared for. That’s not an occupational hazard we signed up for.”

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The backlash comes from people across the country’s diverse social classes, religions, language groups and geographies, making it harder to isolate one explanation for why the trend is more widespread and intense in India.

But there are some contributing factors. Trust in the health-care system was already low, while misinformation is ubiquitous on social media. And an unprecedented nationwide lockdown, given with just four hours’ notice, has intensified the hysteria.

At the same time, weeks of media coverage of how the virus spread at an Islamic religious organization in Delhi has stoked sectarian tensions that were already running high, while the virus has also played into deep fears of social ostracism in a country where for centuries some castes were classified as untouchables.

‘New Untouchables’

“The caste system is based on that idea of purity and pollution, what is pure and what is polluted, what can be touched and what can’t be touched,” said Priyasha Kaul, a sociologist at Ambedkar University Delhi. “This can almost be seen as the new untouchables: a new category of people who need to be feared, who need to be kept away.”

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As in other countries, Prime Minister Narendra Modi’s government has encouraged people to rally around the medical workers on the frontline of the virus fight. PM Modi implored citizens to come to their doors just before sunset at the end of a day-long curfew in late March to bang pots and pans together in an expression of thanks.

But tensions have risen as the government takes ever-stricter measures to contain the outbreak, which has increased to 9,240 cases and 331 deaths as of Monday. India is still under lockdown, which prohibits citizens from leaving their homes for any reason but to buy food or medicine or in an emergency.

Accelerating Outbreak

And though the country has ramped up testing in recent days, with slightly more than 179,000 samples collected so far, it’s still only performing 0.13 tests per every thousand people, compared to eight tests per thousand in the US and nearly 10 in South Korea, according to data from April 11 from the website Our World in Data. That low rate has stoked fears the outbreak could be much larger than the official statistics show.

Stringent Steps

In apartment buildings or neighbourhoods where cases have been found, the measures are getting even more severe. Residents have been prohibited from leaving their homes at all, and are subject to continuous surveillance from CCTV cameras, drones and police. Supplies are delivered right to their doors as teams come through regularly to spray disinfectant, and health workers monitor people for symptoms.

“Just as they are discriminating against doctors over fears they are bringing coronavirus into their communities and residential buildings, they start worrying if they are found to be positive they will be discriminated against by their own friends and their own societies,” said Vivekanand Jha, executive director of the George Institute for Global Health, India. “Rather than worrying about the health risks they are worrying about their own living situations.”

The physicians of Safdarjung Hospital in New Delhi, one of the public institutions designated to handle coronavirus cases, have born the brunt of the growing stigma.

Asked to Leave

One doctor endured a campaign by her neighbours to force her out of her apartment, according to Dr Manish, who goes by one name, president of the resident doctors’ association at the hospital. First, they cut off her electricity, then her water supply, then they began picking fights over trivial matters. Finally, they surrounded her one day and asked her to leave on fears she would infect the building. The police intervened and that doctor has not had any harassment since.

“We are already under so much stress and on top of that, this kind of discrimination is very disheartening,” said Sanjibani Panigrahi, a doctor at a government hospital in Surat in western India, whose video of a neighbour verbally abusing her went viral on social media. She says it was part of a campaign by her neighbours to force her from the building.

The man who harangued her spent 24 hours in jail before being released on bail, and later issued a public apology. Though Panigrahi chose not to press charges, she plans to find a new apartment when the lockdown is over.

“Not a single neighbour has come after the incident to say this was wrong and we support you,” she said. “Such a lockdown has never been done in our country. It has put people into a frenzy and panic mode. They think it’s the apocalypse.”

The Indian Medical Association, which represents doctors in the private sector, has been pushing for laws to make it easier to file charges for attacks against health-care workers, and to disallow bail for such offences.

Not Unfounded

K.K. Aggarwal, president of the Confederation of Medical Associations of Asia and Oceania, said the fears health-care workers could spread the disease are not unfounded, noting that in China, the epicentre of the global outbreak, medical workers accounted for about 3.8% of confirmed cases. He recommends governments find workers treating coronavirus cases temporary accommodation for the next few months. The local Delhi doctor’s association has arranged for some of its members forced from their homes to put up in local hotels and Sikh temples.

“Being beaten up is never a good feeling, or being chucked from your house,” said Rajan Sharma, president of the IMA. “My stand is, give the strongest punishment to such individuals.”

But Trupti Katdare, the doctor attacked by the mob in Indore, took a different approach. She and her team returned to the neighbourhood the following day.

“We counselled them we are doing this to save your life,” she said. “They realized their fault and apologized.”