Everyone should have access to medical care

Does it matter if an injured person is a protester or a policeman or a bystander? Do the wounded deserve medical treatment regardless of their words, actions, job profile or political beliefs? In normal times, most people do not ask such questions because the answer is clearly “yes”, and that “everybody deserves access to medical care”.

But these are abnormal times in India, when the most basic humanitarian principles need to be reiterated and reaffirmed. The ongoing protests against the Citizenship Amendment Act (CAA) and the proposed countrywide National Register of Citizens (NRC) have led to deaths, detentions, darkness and despair among millions of people. It has also released police brutality and citizen energy on a scale not seen in recent times.

Last week, in a strongly-worded public statement, the Indian Medical Association (IMA), which has over three lakh members, said: “No violence is acceptable in a hospital. Hospitals are sacrosanct. Everyone has the right of access to medical care… The government and the establishment have no right to deny anyone their right of access” to medical care.

The immediate trigger for that statement were ground reports and video footage from areas that have seen protests against the CAA-NRC. A particularly disturbing example was from Mangaluru in Karnataka. CCTV footage shows policemen barging into a private hospital, chasing people inside, trying to forcibly open a room by kicking it repeatedly and by using lathis. A demonstrator with gunshot wounds was undergoing surgery, two more had been brought dead to the hospital, its management told the media. Relatives of the injured person have told television journalists that he was being treated when policemen in riot gear stormed in and used teargas about 30 metres from the intensive care unit. There were severely sick people in the ICU.

The visuals of policemen storming into a hospital and banging on doors are hard to forget. It brings to the fore what is acceptable and what is not in times of protests.

Can the police storm a hospital or any medical facility in hot pursuit of someone engaged in an anti-government protest? When India’s home minister Amit Shah was asked about it, he said: “It may have happened once or twice while chasing rioters” (during protests against CAA) and “such incidents should be avoided”.

But can an injured protestor, a police person or bystander be denied access to medical care no matter what his words or actions may have been? What are the short-term and long-term consequences of the targeting of hospitals and medical workers if we accept such acts as the new normal?

It’s not just the IMA which felt it necessary to speak out publicly. Several public health advocates, medical professionals and healthcare workers who are part of the Peoples’ Health Movement and other networks have noted in a signed statement that they have “serious concerns regarding the use of excessive force by the police and their attempts to interfere with the provision of immediate medical assistance to those who have been injured”.

The health advocates have appealed to the police to actively support the medical community and allow unhindered access to medical treatment for all injured, and urged the government and courts to independently and impartially investigate allegations against the police for hindering medical assistance to the injured protesters and hold accountable those responsible.

The statement points out: “According to testimonies of injured protesters, the police interfered with their right to medical assistance, including taking injured students from the hospital to the police station before their medical care needs were addressed.” It flags critical issues that rise out of situations where forced entry into hospitals and denial of immediate medical attention to wounded protesters is justified in the name of law enforcement.

“When the police enter hospitals and emergency departments it can have a detrimental effect on patient care. It is unfortunate to see that the law enforcement agencies are not only stopping people from accessing medical care, but they are also forcefully entering hospitals where the injured have been taken. That raises concerns that in future, protesters requiring medical care might avoid the hospital system for fear of arrest,” the statement notes.

Health advocates point out that the United Nations Basic Principles on the Use of Force and Firearms by Law Enforcement Officials require law enforcement officials to ensure assistance and medical aid are rendered to any injured or affected persons at the earliest possible moment, whenever the lawful use of force and firearms is unavoidable.

They also note that injured people are rarely in a position to advocate for their own medical and legal needs during emergency care and traumatic injuries can limit the ability to fully consent to legal interrogation.

Doctors and health advocates are not only releasing statements; many have banded together and are reaching out to protesters who are injured and need medical attention. In Delhi alone, 30-odd doctors and nurses are now part of a group which calls itself Progressive Medicos Scientists Forum (PMSF) and are holding mobile medical camps close to protest sites. A nurse who was part of a medical volunteer team and was seated inside an ambulance parked close to a protest site told this columnist that the police asked him and his team members to leave though they said there were there only to provide emergency medical aid.  A woman from the Democratic Youth Federation of India, stationed as a medical volunteer near Assam Bhavan, where protests were expected, was temporarily detained by the police.

Another group which calls itself Medical Aid Support is putting together a list of medical volunteers and psychotherapists who can provide medical aid. Both have a presence on Twitter and regularly share important information.

What is happening in India is not entirely novel. In Hong Kong, where anti-government protests have been going on for months, the crackdown on medical volunteers has elicited a sharp rebuke from local doctors and health professionals providing frontline care through the protests.

If war has rules, so should protests, including the ongoing ones in India. Disproportionate use of force to deal with protesters leading to deaths and severe injuries are unacceptable. In a clash between protesters and the police, there is high potential that people on both sides will be injured. Denying any of them access to immediate healthcare or storming hospitals where the injured are being treated is totally unacceptable.