People's Democracy

Doctor, AIIMS Needs You!

R Arun Kumar

ALL India Institute of Medical Sciences (AIIMS), the premier medical institute in our country is again in the news for all the wrong reasons. A fine of Rs 2500 was slapped on it by the Delhi High Court for non-compliance of its directives. The amount might not be significant but the reasons behind being fined merit our attention. The fine was imposed for the failure of the institute in the timely submission of the action taken report on the discrimination meted out to the SC and ST students in the institute.

Many instances of caste discrimination being practiced in the institute came out in the open during the anti-reservation stir. Though these incidents did not get the same coverage as the anti-reservation agitation in the media, whatever little coverage they have received were sufficient to shake the conscience of all the democratic and progressive loving people of the country. Unfortunately, the administration of the institution refused to accept the reports that were coming regularly in the media about the prevalence of caste discrimination. Moreover instead of cleaning the stables, attempts were made to identify the people who were raising their voices against discrimination and scuttle their voice. But the sustained campaign against the attitude of the administration on this question and the refusal of the people to bow down to the pressure, forced the government to appoint a committee to go through this entire question and submit its report.

The committee headed by the chairman of the UGC had subsequently gone through the entire issue, conducted a thorough enquiry and submitted its report to the government. What is highly condemnable is the attitude the administration adopted towards the committee. Instead of cooperating with the committee and helping it in its enquiry, the administration that was always denying the existence of caste discrimination acted in such a way that raised many question about its sincerity. Even after the report was submitted the administration of the institute refused to accept the findings of the report. So it is natural for the administration to go slow even when the court asks for the action taken on the basis of the report. The entire episode on this issue makes us feel that the administration is uneasy and trying to hide something.

INSTANCES OF CASTE DISCRIMINATION

Many instances of caste discrimination are reported in the AIIMS. Absence of special programmes for the SC and ST students, discrimination by the faculty, discrimination by the students belonging to the upper castes-in classroom activities, hostels, cultural events and sports are some of the broad areas of discrimination prevalent in the institute. Let us look into some of the instances in each of the above mentioned categories to understand the seriousness of the problem that was to be eliminated in independent India, but has not been even after sixty years of independence.

It is really astonishing to note that a premier institute like the AIIMS does not have any special programmes for the SC, ST and other backward sections of the students. This is all the more startling when such programmes are present even in IITs and other reputed institutions. It is highly condemnable that a premier government institute is so lax in carrying out remedial programmes for the weaker sections of the society. It is an accepted fact that along with reservations, remedial courses have to be taken for the students who are coming from the weaker sections in developing their language skills in English and other basic courses to help them handle the pressure and manage the advanced courses taught in premier institutions. We should note here that the students from SC and ST communities who take admission in this institute are also the brightest, but because of their socio-economic conditions and the rural background they need this special care from the society. A society’s democratic spirit can be understood only through its treatment of the weaker sections of the society and not through its treatment of the privileged. The AIIMS desperately fails on this count.

There is a strong element of subjectivity that is prevalent in the nature of the examinations and evaluation that is conducted in AIIMS. This makes the students fear the faculty and many times the faculty uses this position of advantage to force the students into submission. In AIIMS this is also used as a tool to punish the students on the basis of their caste. Majority of the students report that the examiners ask them of their caste background either directly or indirectly and this influences their evaluation and the marks secured by the students. Many instances have come out where meritorious students from the SC, ST communities are discriminated by a section of the faculty on the basis of their caste. This had reached dangerous levels during the anti-reservation stir. Members of faculty, who were against reservations, noted the names of the students who were for reservations and ensured that they did not fare well in their examinations in spite of their better performance. A student who had secured high marks in the entrance examination and was eligible enough to be in the open category was admitted in the reserved list in open violation of the norms. He consistently performed well in the examinations and passed in all the subjects in all the semesters. But after his open stand for reservations he was failed in the examinations as he had complained against the students who have behaved violently with the SC and ST students. The administration acted in a dubious manner on his complaint and conducted a re-examination with the same set of examiners and thus ensured that he got the same result. Even the decision of the governing body which decided that the examination will be conducted by other professors was not adhered to.

Even during teaching classes there is discrimination practiced on the basis of caste of the student. The students from the SC, ST communities are not allowed to perform dissections properly, especially during the cadaver dissections, they are not given enough opportunity to perform the clinical examinations and most importantly students who are weak in certain subjects are never given the support that they need for overcoming the weakness. Coupled with this, the attitude of the upper caste students acting on the strength of the upper caste faculty had driven many students from the weaker sections to undertake psychiatric treatment for depression and other ailments.

The discriminatory attitude of the upper caste students towards the SC and ST students is even more glaringly visible in the hostels. This had reached alarmingly high proportions during and after the anti-reservation stir. All the SC, ST students staying in various hostels are forced to vacate their rooms through a sustained application of pressure through humiliation, abuse and even violence. Abusive statements are written on the doors of their rooms, doors were locked from outside when the students were in the rooms and they were even threatened with physical violence if they did not vacate the room. Through these methods the fanatic section among the upper caste students were successful in pushing these students into ‘ghettos’, in the top two floors of only two hostels. The SC/ST students are restricted entry to join the private mess and the trend of forming a private mess is now more and more on the lines of caste and one’s position on the question of reservation.

Caste discrimination in AIIMS has assumed such proportions that it pervades all fields of activity in that institute. Even sports are ‘reserved’ according to caste lines. ‘Elite’ sports like basketball and cricket are a strict no to the SC and ST students. They can only play volleyball and football. They are also marginalised in the organisation and participation in the cultural activities that are organised in the campus. Even the prestigious cultural event of the AIIMS, PULSE, stinks with the caste stigma. Thus a premier institute that is looked upon as an example in medical education, research and providing health facilities to the poor is increasingly becoming a haven for all sorts of reactionary ideas. It is no wonder that because of this very reason, AIIMS led the movement against reservations. The prevalence of these kinds of ideas predates the anti-reservation stir but saw the light of the day because of the proportions they had assumed during and after that period.

RAMPANT ELITISM

Because of this reactionary mindset the premier medical institute of our country is failing to discharge its social responsibility. Elitism has reached such an extent that some of the doctors and students feel that AIIMS is a world in itself and they need not think anything about the society or the people at large. They conveniently forget that it is these poor people who are funding the institute through the taxes that they pay to the government. According to a report it takes at least Rs 19,00,000 to make a doctor in our country. The student pays only a part of the entire amount and the larger part is borne by the society and quite necessarily too. When the society is spending such a large amount on making doctors it should be thus natural for the doctors too to reciprocate and cater to the needs of the society. It is increasingly becoming difficult to find doctors belonging to this breed.

Another instance of this elitism is the refusal of some doctors to serve in the rural areas. Of course, nobody agrees to the government’s proposal to increase the academic year for the medical students by one year. The government must fill all the posts on a permanent basis and increasing the length of the academic year and appointing the students for one year is not a solution to the problem of lack of staff in rural hospitals and PHCs. Unfortunately, there is again an attempt to make AIIMS the base for the students agitating against the rural service. Reports indicate that 51 percent of the posts of surgeons, obstetricians, gynaecologists, paediatricians and physicians were lying vacant in our country and only one out of every ten registered allopathic doctors are serving in the rural areas. These statistics point to the fact that majority of the people living in our rural areas are deprived of even basic health services, though it is they who contribute substantially to the education of the doctors. No wonder India ranks 128 in the human development index in the latest report and tops the list in countries having a high infant mortality rate, malnutrition and deaths due to diseases like Cholera etc., that can be easily cured. The absence of a public health policy, requisite number of qualified doctors and the failure of those present to serve the most deprived sections in the society is the reason for this sorry state of affairs.

It is the duty of the educational institute to train the students not just as specialists in their own fields, but also as good human beings. Good human being implies first and foremost showing concern to fellow human beings. AIIMS, the premier medical institute in our country that caters to 1.5 million patients in its outpatient department and another 80,000 as patients and performs over 10,000 surgeries a year unfortunately is failing on the second count. That is the reason why we have some of the finest specialists in the medical field in our country in the AIIMS together with people who are unconcerned to the social realities of our country. They oppose reservations and also rural service by the doctors showing their unashamed elitist bias. A doctor trained in practicing discrimination cannot forget it and practice without any such prejudices and live true to the Hippocratic oath.

There is an urgent need to correct this dichotomy. If the doctors and specialists in the AIIMS and institutes of that nature refuse to correct this anomaly, people who generally look up to them will lose their faith and interest in such institutes. This will only help the reactionary forces who are waiting to pounce upon such opportunities and demand the handing over of such institutes to the private players. To counter these forces, it is necessary for the AIIMS community to be sensitive to the concerns of the society, shed itself of all the reactionary elements and inhuman practices like caste discrimination. It is time for such doctors to cleanse themselves of the social ills.