I have just read a BMJ news story about doctors being beaten up in Nepal for the death of a patient. While this may seem to be quite shocking for the western society, it is an everyday reality for us, medicos, living and practising in Nepal.
Over the past five years such incidents have been occurring at regular intervals. As rightly mentioned in the article, high expectation from a doctor is one of the prime reasons for violent behaviour on the part of relatives of a patient. Doctors are seen as god in the Nepalese society. The popular belief is that they can treat and cure any condition. Hence, nothing can and should go wrong after a patient is brought to a hospital. And if it does, it is because the doctor did not try hard enough. And with this thought comes anger which leads to violence.
But this is not the only reason. If it was, such incidents should have been more common a decade ago when the “god-doctor” interplay was more readily believed and relied upon. The overall administrative and political scenario- the sense of lawlessness- deserves blame. I am not a political analyst but ask a common Nepali and he or she will tell you that with the recent political change in the country, people like to assert themselves through physical force rather than go through the legal method. It is not just the medical sector but such acts of violence are prevalent in every field. Entrepreneurs get beaten up by workers; roads get blocked for days for a small accident; issues that could be solved by legal methods amicably turn violent more often. Nobody has the patience to wait for legal methods anymore. Everybody wants on the spot decisions. And through force and violence you get noticed in Nepal.
What has added to this is that, in the past, many private medical care facilities handed over huge amounts of compensation readily whenever relatives got violent over the death of their patient in the facility. Perhaps they did it out of fear to protect their infrastructure, or to hide their own incompetence. Whatever may be their reasons, it has led to a common notion that if the relatives respond violently to the death of their loved ones, they might receive financial compensation. And believe me, money can be a strong motivating factor in a poor country like Nepal.
The problems as it seems from the above discussions are many but the proposed outlet solution is simple: the legal way; and this is what the Nepal Medical Association is demanding. If a patient or his/her relative feels that negligence has occurred, they should complain about it to appropriate authorities, even sue the doctor and hospital and not resort to violence. If the doctor is found guilty, he or she should provide appropriate compensation and undergo legal action. With the consumer protection act already in place, this is not a big deal at all. But if a patient, relative of a patient or anybody for that matter resorts to beating up doctors, then such a person too should take legal action. So far neither of this has happened. Doctors get away with negligence and patients and relatives with violence against doctors. The legal way is the road less walked upon.
Finally, it is a pity that doctors have to resort to protests, go on strikes, even shutdown hospitals to do what the government should be doing: to remind everyone of their duty to follow the law. And it is a bit funny too that they are going through all of this to say, ‘sue me, please’. A mockery of our government and system, indeed.
Siddhartha Yadav is a medical student in Nepal and former BMJ Clegg Scholar.