Does the murder of more than 700 people in Gujarat (as we go to
press, the killings have entered their fourth week, with every sign
of continuing) merit an editorial comment in a journal on medical
ethics?

It could be argued that the communal killings are a crime against
humanity and not specifically within the purview of medical ethics.
However, doctors have special responsibilities – both as educated
professionals, and because of the services they provide. And it is
here that they appear to have failed.

The medical profession has an important role to play in providing
treatment and emotional support to victims of communal violence.

Some reports in the media, on the medical profession's response, have
been encouraging: some have worked round the clock to provide
life-saving treatment to victims of the violence. They provided
treatment irrespective of religious affiliations, and despite the
very real threat of violence if they treated minority patients.
Indeed, our friends in Gujarat report that doctors in Ahmedabad "who
have tried to do some relief work have been thwarted by the majority
community goons."

The government has not provided essential health services to the
thousands of displaced men, women and children living in camps, in
crowded, unsanitary conditions which can trigger off epidemics.
There are many burns victims who urgently need medical supplies and
treatment. Survivors of this carnage have lost everything they own,
have experienced the most horrendous physical and psychological
traumas, and are afraid to approach public health services for fear
of further persecution.

The fact that the medical associations did not galvanise themselves
for relief work indicates how deeply the medical profession has been
affected by the sharp communal divides being promoted by political
interests.

A generalised phenomenon

Indeed, the medical community is becoming polarised, both in Gujarat
and elsewhere in the country. We hear doctors confide that the
minorities "needed to be taught a lesson". Some boast of how their
friends participated in the violence.

We also hear that VHP secretary Praveen Togadia was once a 'renowned'
cancer surgeon. "It is his legacy that is bearing fruit in the state
today," according to an analysis in the press.

Both types of reports echo earlier reports of the profession's
behaviour in the communal violence which has become all too common
in recent years. In 1993, public hospital staff in Mumbai worked day
and night despite the threat of violence, as the frenzy of killing
lay just outside the campus gates, sometimes entering them. Some
remember that the "hospital staff stayed scrupulously impartial in
treating those sent to them, irrespective of creed." However, there
were also reports of doctors denying medical care to minority
patients, and of hospital staff harassing minorities and preventing
them from getting treatment.

A growing threat

It has also been noted that the class, caste (and religious)
backgrounds of the vast majority of health professionals "provide a
fertile ground for social forces using castism and communalism" for
political purposes. Indeed, some health researchers have had
personal experience of the castist and communal views of some people
in the profession. There is a feeling that health professionals are
increasingly supporting communal views. This may not have been
translated to obvious discrimination in medical practice. However, as
political parties promote communal divisions, and the threads
holding our society together are torn apart, doctors will soon
actively participate in communal violence. And there have been
reports that the rioters and looters in Gujarat included doctors and
'educated professionals'.

Doctors and social responsibility

The role of health professionals in caste and communal violence has
not been studied extensively. This itself is a subject for concern.
The medical profession's response – or lack of it – to communal
violence needs to be documented and analysed.

The medical profession should be concerned when one of its fraternity
is involved in the carnage in Gujarat. Shouldn't medical
associations withdraw the license of Dr Togadia — and all others in
the medical profession who have spoken and acted as he has?

Finally, as a result of their work, doctors have access to important
findings on the results of communal violence. However, there has
been a reluctance to publish such findings in the belief that it
would incite more violence. So, though communal violence is a
tragically regular feature of our society, there is little
documentation on its physical and psychological consequences. It is
absolutely imperative that health professionals record their
eye-witness accounts of communal violence and the health
profession's response, towards preventing further violence.

Editorial Board

Dr Arun Bal, Dr Amar Jesani, Dr S P Kalantri, Dr Santosh Karmarkar,
Ms Neha Madhiwalla, Dr Ratna Magotra, Dr Bashir Mamdani, Dr Sanjay
Nagral, Dr Samiran Nundy, Dr Sanjay A Pai, Dr Sunil K Pandya, Dr
Anil Pilgaokar, Dr Suhas Pingle, Dr Nobhojit Roy, Dr PK Sarkar, Ms
Sandhya Srinivasan, Dr George Thomas.

References

1.Nautiyal Shefali. This doctor refused to desert his post when hell
broke loose. Indian Express, March 15, 2002.
2.PTI: Gujarat doctors: breaking communal barriers March 9 2002.
3. Murlidhar V. Two major riots in Bombay. Issues in Medical Ethics
1993 1; 2: 7.
4. Srinivasan S, Varodara. personal communication.
5. Kaushal P. Band of brothers. Indian Express, March 17, 2002.
6. Davie Pamela. Red Cross assists divided communities in Gujarat Red
Cross website. March 6, 2002.
7. Jesani A. Violence and the health care profession in India.
Radical Journal of Health October 1998.