Community hospitals

Woes of the wounded

Print edition : March 27, 2020

At GTB hospital in East Delhi, which saw a steady stream of victims. Photo: divya trivedi

Paramedics attend to the wounds of Mohammad Illyas, a violence victim, at Al Hind Hospital in Mustafabad. Photo: Altaf Qadri/AP

Al Hind Hospital. Photo: Divya Trivedi

Dr Naushad of Al Hind hospital. Photo: Divya Trivedi

The body of an unidentified man retrieved from an open drain in a violence-affected area in Delhi on February 26. Photo: Adnan Abidi /REUTERS

At GTB Hospital, a camp set up by minority community members to provide monetary and material relief to families of those killed, both Hindus and Muslims. Photo: divya trivedi

When the public health services and the law and order machinery failed to rise to the occasion, community hospitals with limited resources stood as beacons of hope against the unjust system.

On the third morning after the anti-Muslim violence, the main streets of Mustafabad wore a deserted look. Debris from the previous day’s mayhem, including charred vehicles and glass shards, lay strewn across the lanes, and homes and shops stood gutted. In some areas, it appeared as if it had rained bricks. Residual fear and terror were palpable as rumours showed no signs of abating. Everybody was on tenterhooks.

But Al Hind Hospital in the locality was teeming with activity. Injured people swathed in bandages or with plaster casts sat on the steps wearing tired expressions. Inside the 15-bed community hospital, a small team of doctors hurried from patient to patient. Mats, carpets and plastic sheets had been spread on the floor to accommodate the injured.

The previous night had seen a rush of patients, with an injured person brought in every three minutes. Initially, the hospital did not keep count of the number of patients. The doctors treated the ones who arrived with minor injuries and sent them away. But soon, people with bullet injuries and acid burns began to pour in. On one night alone, 23 people with bullet injuries arrived at Al Hind. The hospital removed 13 bullets. Some of the wounded people were referred to the nearest government hospital—Guru Teg Bahadur (GTB) hospital—located about 7 km away, said Dr Naushad Ali. He was treating an injured person and instructing his assistant to obtain medical supplies as the hospital was running out of them. The neighbourhood hospital was clearly overburdened but the staff and the local people pitched in with money and resources. Many of the hospital employees, especially the doctors, had not slept since the violence started.

A man who came with multiple stab wounds and two knives jutting out of his torso could not be saved; a 32-year-old patient died owing to the lack of oxygen. The hospital also faced a crisis in medical supplies. The CATS (Centralised Ambulance Trauma Services) ambulance of the Delhi government, carrying oxygen cylinders and other crucial supplies, was stopped by the police a kilometre away from Al Hind. Since life came to a standstill in the area, the hospital could not get painkillers and life-saving medicines on time. GTB Hospital sent some supplies at midnight but they too were stopped by the Assistant Commissioner of Police from reaching Al Hind. It was only after a station house officer intervened that the ambulance was able to reach Al Hind at 3:30 a.m. People were angry at the apathy of the authorities. “Last night was terrible. No help came from any government agency. We begged the police and the politicians for help but no one came forward,” said the relative of a patient.

Dr Vikas Bajpai of the Centre for Social Medicine and Community Health, who had come to Al Hind with a team of doctors, said 160 patients had been treated at Al Hind in the days following the violence.

A 14-year-old boy from Shiv Vihar with four of his fingers crushed and a 23-year-old youth who suffered burns from a petrol bomb blast, were unable to reach a nearby hospital because of the marauding mobs. The police, instead of helping them, obstructed their way and threatened them with dire consequences if they did not return home.

Dr Bajpai said attempts were made to take a boy with a smashed skull to a hospital by two others who had suffered minor injuries. When they reached the Brijpuri barricade, the policemen refused to provide an ambulance or safe passage. When the helpless boys pleaded with them, they were beaten up.

Dr Harjeet, who helped several victims access timely medical help, related instances of police cruelty. One of the victims had a serious gunshot injury and required immediate help. But he refused to be taken to a hospital. He told the doctor: “I’d rather die here amidst my own people.” Given his vulnerable state and the risk associated with moving through the area, Dr Harjeet decided to accompany the victim to GTB Hospital. During the ride on the one kilometre stretch to exit the area, the ambulance was stopped four times by uniformed personnel. Each time, the “security men” opened the dressing on the wound.

In Khajuri Khas, Frontline found young boys lying in their homes with severe injuries and without any treatment. Every time someone from their house tried to so much as peep out, uniformed personnel would shout at them to go in. A 20-year-old student pulled up his T-shirt to show a gash on his stomach which had turned blue. When the mazaar on the main road of Chand Bagh was burnt by rampaging Hindu mobs, people living in the vicinity of Durga Fakiri Mandir, a stone’s throw from Chand Bagh, formed a human chain to guard the temple from being attacked. In the melee, the police who were charging at the Muslim residents along with the Hindu mobs fired tear gas shells at their homes. The student, who was part of the human chain, was hit by a hand grenade thrown by a policeman, he said.

“We have experienced the apathy and cruelty of the police. How can we trust them now? We are not going to get treatment. Forget getting essential food items. You are the first person to come here to inquire. As soon as night falls, the police leave their posts. We women are guarding our homes,” said a young woman.

It was only after the Delhi High Court, in an urgent midnight hearing at Justice S. Muralidhar’s residence, ordered the Delhi Police to provide safe passage to victims of violence to hospitals that the police relented in some places.

“Even in times of war, ambulances are allowed to pass. Are we at war? Who are we in a war with?” asked activist Harsh Mander, who was involved in relief operations. “It is a time of great shame for all of us. Every single institution of the state has failed the people of Delhi,” he said.

There was enormous delay for the victims in accessing trauma care. Many of the injured were reluctant to seek medical intervention for fear of being picked up by the police later. Volunteers at Lok Nayak Jayaprakash Narayan (LNJP) Hospital reported that a man attacked by the police came to the hospital with a forearm fracture but told the doctor that he had fallen down the stairs. He was afraid that filing a medico-legal case (MLC) would eventually lead to the police registering an FIR against him, which could mean a loss of job. In another case, a young man with a bullet injury on his hand declined care and almost fled from the hospital because he was told that he would have to file an MLC and speak with the police. After much persuasion by a volunteer, he agreed to take treatment.

The drawbacks in the public health system became evident during the emergency situation following the riots. MLC numbers and treatment records were not shared with the patient or their relatives, and as a result they were denied treatment at other hospitals. In some cases, the injured men were admitted to the hospital only after a lawyer or a senior doctor intervened. Delay in getting treatment resulted in the loss of many lives.

In a disturbing instance, the personal bias of doctors came to the fore. The injured persons were called “ugravadi” (aggressor) and “atankvadi” (terrorist). One doctor told a patient: “What will you do if we treat you? You will go back on the streets and be violent.” Some victims were asked mockingly if they knew the full form of NRC and CAA.

Many persons went missing during the violence, and families tried desperately to locate them in hospitals. Instead of helping the families find the missing relatives, the hospital staff made them look for them in wards and rooms.

Outside the mortuary of GTB Hospital, many people complained that the hospital was not handing over the bodies of the victims to them. One family, which had brought in a man with a bullet injury, ran from pillar to post only to find that he had died and his body had been shifted to the mortuary for post-mortem. With no doctor or person in authority willing to listen to them, family members spoke to mediapersons gathered at the hospital. The doctors defended the delay in the release of the bodies by saying that each post-mortem procedure took time. The other reason they gave was that releasing all the bodies at a time might shock or disturb the already worried families and lead to a frenzy, which the hospital was ill-equipped to handle.

The full magnitude of the displacement of Muslims from the violence-affected district of North East Delhi will take some time to unravel. But a single area, Shiv Vihar in Mustafabad, experienced the worst carnage. More than a 1,000 Muslims of this locality were displaced, according to the Jan Swasthya Abhiyan (JSA). Most of them fled with their families and with whatever was left of their belongings. Several families, who had nowhere to go, were camping at Chaman Park in Karawal Nagar, where the local people had thrown open their homes to the displaced. Churches, gurudwaras, non-governmental organisations and private sources provided temporary relief.

The AAP government in Delhi swung into action to provide relief only a week after the violence. It announced the extension of the Farishtey Dilli Ke scheme to riot victims. Under the scheme, anybody who takes accident victims to a hospital will be awarded Rs.2,000 and honoured with a Good Samaritan certificate. All the costs of the treatment of an accident victim will be borne by the government. But not all hospitals had received a formal notification in this regard, especially the ones located in the zones affected by the violence. Activists of the JSA demanded that the government “issue written orders to all private and charitable institutions informing them of the extension of the Farishtey scheme to riot victims in order to ensure access to free care”.

Private and small community hospitals stood as beacons of hope against an unjust system. Given their limited resources and capacities, Al Hind, Al Mehr and other small clinics in the area did their best. Hospitals in other Muslim-dominated areas of Delhi, such as Al Shifa and Jamia Hamdard, also pitched in. The fact that Muslims should rely on their own resources even in times such as these was shameful to the medical profession, a doctor said. “Delhi has the best medical experts in the country. If each doctor had spent a day in the service of the people affected by the violence, many lives could have been saved,” he said.

The biggest loss from the violence in Delhi was the complete breakdown of trust in public institutions, said an activist. “When we asked them to fill up forms so that it would help us reach relief materials to them, people recoiled. They openly asked how could trust us? What if this information is used for the National Register of Citizens?” she said.

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