Dr A S Bhatia
After being selected for undergoing MBBS course at Government Medical College Jammu in 1983, the first thing I faced was the address by the then Principal Government Medical College Jammu, Dr S. L. Verma , inspite of being a short statured man but with shining brown hairs and an divine glow on his face, Dr Verma discussed the importance of Hippocratic oath. I do apology that most of the students present in the hall couldn’t understand what Dr Verma was speaking about. Now after about thirty seven years since that day of address by the most influential Principal of his times , being very close to the then Chief Minister Dr Farooq Abdullah, I tried to revisit the different aspects of Hippocratic Oath in view of the prevailing pandemic scenario. The Hippocratic Oath was written by Great Greek Physician Hippocrates in 5th BC century. It is one of the oldest documents in Human History. The original oath revolves around to treat the ill to the best of one’s abilities, to preserve a patient privacy, to teach secrets of medicine to the next generation and so on and I was much amused, What would the Great Hippocrates could have done if the medical profession in His times would also have been covered by Consumer’s Protection Act?. I am sure that the Great Hippocrates could have made drastic changes in the oath itself!
The health care workers are projected as angels in the Hippocratic oath ! Society as such was not impressed upon much by the Hippocrates to understand that the Health care providers are also human beings. They are not immortal! They are also simple human being performing their duties to the best of their abilities. The health care providers are not immortals. They are not immunized against the highly contagious diseases like corona. They are more vulnerable to fall prey to pandemic. I simply went through the different lines of the original oath, only to find out a word written in the oath to protect the dignity and self respect of persons in white coat. At the end of the oath, the great Greek Physician did not fail to write that if a health care provider fulfills this oath and don’t violate it, may it guaranteed to the health care provider to enjoy life and art, being honoured with fame among all men for all time to come.
I could find an answer where the responsibility of the society was also be fixed by Hippocrates. To the best of my understanding of the Hippocratic Oath, the society needs to be made aware of the last few lines of the most revered oath of 5th BC Century. I am surprised why the oath is being sworn to the Health care providers only. Why the relevant portion of the Hippocratic Oath, related to the role of civil society has been ignored by successive leaders, may be intentionally or unintentionally,and more important is that, this part of the oath should be sworn by the reprentatives of the society, may be a MLA, Minister, Health secretary or a Governor, They all are to be covered by the Hippocratic oath, where by the Great Greek thinker has bestowed the responsibility upon the society to take care of their health care providers.
In contrast what Hippocrates predicted and expected from the society to give gurantee for respectfull and a life of dignity and social security to doctors, I am ashamed of the acts of many of our so called leaders whereby the doctors battling the corona virus in India were trolled , evicted and humiliated. I am not able to erase the agony of painful memories of a leading neurosurgeon Dr Simon Hercules, a neurosurgeon who lost his life in the Indian state of Tamil Nadu after contracting the disease while performing his professional duties. Far from being honoured for his supreme sacrifice, his dead body was denied a proper burial and the ambulance carrying his dead body was stoned and his family and friends were beaten up. He was not allowed a respectful burial . Was this the way Hippocrates wanted the society to behave? All over the globe the health care workers are being referred to as Warriors! I too was very happy to get associated with the word, “Warriors”. My wife, Dr Harleen Kaur has also being labeled as corona warriors by media as she is on corona testing duty at IIIM Jammu, and has not come home for last four mionths! Meanwhile I tried to find the meaning of Warrior in the dictionary, Warriors are the persons well experienced in war or battles and well equipped to fight the visible enemies. I wondered , are our warriors are also well equipped throughout the globe inspite of the fact that instead of a visible enemy, they are fighting against the invisible evil, or they are being made scapegoats by successive world leaders over the years. Do our system have the courage to set the responsibility on administrators for last so many years for their failure to develop a robust health care delivery system in the country during last more than seventy years of Independence.
At Nalanda Medical College in Bihar. Doctors treated the patients while wearing only standard surgical kit- a three ply mask, gloves and plastic coated apron.After that all ate in a mess shared by more than 80 doctors, all of whom were exposed to corona virus!To the utter surprise and in open violation of the Hippocratic oath, the society and the hospital administration failed to perform their duties and forced them to work instead of being getting them quarantine. The Doctors continued to work and kept on screening the patients. Among many who lost their lives to corona, one was Dr Javed Ali, 42 years old, contractual doctor with National Health Mission in Delhi and he was continuously on front line duty for last four months since March 2020, and tested positive for corona on 24th of June and was hospitalized but ultimately succumbed to the corona virus leaving behind his wife, two children, a six year old son and a twelve year old daughter. Who will explain the deviation from standard guidelines for fixing the hours and days of duties for front line corona warriors? As a contractual doctor he could not have gathered the courage to raise a question about his continued posting in corona frontline. Why norms were not adhered to?
It is a coincidence that the year 2020 was declared as year of Nurses and Mid Wife, the WHO theme, Since the first incidence of corona was reported in India, the Indian Medical Association, IMA, has listed in its website that more than 100 doctors are feared dead on the frontlines of Covid – 19 battlefield and more than 1300 have tested positive for the virus. With this number the case fatality rate (CFR) for Doctors accounted to be 7.6%, nearly 2.5 times more than overall case fatality rate among Doctors, can be even higher as there are about eleven lakh registered doctors across the country, whereas the data accounts for only 3.25 lakh members. According to Amnesty International as of July 2020, more than 3000 health care workers from 79 countries around the world have died of corona virus, the highest number of death among HCWs reported from Russia, followed by United Kingdom, United States, Brazil, Mexico and Italy.
Amnesty International has attributed the deaths due to lack of protective gears and requirement to work in unsafe environment have been found to be the prime reason behind high number of deaths in health care providers. The Amnesty International has observed the shortage of PPE in about sixty three countries. Now the question is , As doctors are fully prepared and are honestly performing their duties, not caring for themselves, not caring for their nears and dears, these Warriors in White are relentlessly working day and night to get the country out of crunches of the corona virus and I am proud to be a part of the battalion of Warriors in White. But at the same time society needs to do an introspection to take care of all steps in safeguarding the safety of these health care providers. It is a time to do introspection for all those in power and are the policy makers in the fight against the corona pandemic. They should make it sure that the PPE , adequate infrastructure and adequate manpower be engaged in this unprecedented war. Under no circumstances the untrained final year medical students or doctors not fully trained to handle clinical emergencies be posted on frontline. Let us not exploit the helplessness of these persons in the name of war against the corona and let us refuse to make them as scapegoats, instead the government agencies should hire well qualified and well trained persons to overcome the pandemic.
After going through so many fatalities among Doctors, and after revisiting the Hippocratic oath, It can firmly be said that the society as such, has failed miserably to follow HIS part of the oath clearly mentioned in the last few lines by the Great Greek Physician way back in 5th BC, I am made to understand that there is urgent need to redefine the Hippocratic oath according to the present circumstances and get it implemented in totality in the prevailing scenario in order to protect the rights and dignity of persons in White coat!
Otherwise as Mirza Ghalib said,
Aata Hai Kaun Kaun
Tere Gham Ko Baantne
Ghalib Tu Apni Maut Ki
Afwaah Udaa Ke Dekh.
(The author is Vice President Indian Academy of Biomedical Sciences, India and Professor and Head Department of Biochemistry, Government medical College Jammu.)
(Feed back: hodbiochemgmcjammu@gmail.com)
Follow our WhatsApp channel
