Kashmir | IMA’s stand betrays the Hippocratic Oath

In one way, the ugly spat between the Indian Medical Association (IMA) and the Lancet, a globally acclaimed scientific journal, puts the spotlight on the deprivation of human rights and the plight of the Kashmiris in the wake of the undemocratic revocation of Jammu & Kashmir’s special status and the division of the state into two separate union territories — Jammu & Kashmir with a legislature and Ladakh without an assembly.

It also lays bare the IMA’s acquiescence to the government’s decision to impose a strict clampdown in the Himalayan state that has severely choked the access of people to hospitals and healthcare.

Despite a communication blackout in the Kashmir valley (the few landlines that existed are working in select pockets), a few news reports have described the suffering being borne because of curfew restrictions. Government agencies have reported that the restrictions are being lifted, in a phased manner across the state. With harsh limitations on free movement, patients and those in need of medical attention who are bearing the brunt of this three-week long lockdown.

Some reports suggest that hospital staff, such as doctors and nurses, are facing difficulties in reaching out to relatives of victims of accidents. Moreover, the first two weeks of the curfew, imposed on August 5, were the toughest for doctors and other health staff as well. Many of them who lived far couldn’t return home and those who were off-duty could not report back to work.

In at least one case that was reported, a pregnant woman whose water had broken had to walk for six kilometres to access the nearest government hospital. However, with severe contractions she had to deliver her baby in a private hospital which too couldn’t provide a hygienic wrap for the new-born as they had been unable to get new supplies because of the lockdown.

The IMA as the largest network of doctors in India should have been the first to demand the protection of people’s fundamental right to life, a critical part of which is free and easy access to quality healthcare. However, instead of lending its voice to what is a humanitarian cause, the IMA chose to question the likes of Lancet who did that.

The Lancet stands by its editorial, which had, while alluding to Kashmir’s strife-torn history, merely recommend a well-known tenet of medical profession: it said, “Prime Minister Narendra Modi vows that his decision to revoke autonomy will bring prosperity to Kashmir. But first, the people of Kashmir need healing from the deep wounds of this decades-old conflict, not subjugation to further violence and alienation.”

The IMA objects to this humane appeal on two grounds. First, the Lancet has no locus standi to comment on India’s internal affairs, and second, the Lancet’s intention to comment on Kashmir is ‘malafide’, and that it doesn’t use the same yardstick as Kashmir for Northern Ireland.

The IMA is wrong on both counts and its ‘slamming’ of the 187-year-old journal seems to be a case of ‘selective outrage’. The Lancet regularly writes about the rights of Indian doctors and people. In fact, it has been doing so before India got independence in 1947.

The Lancet wrote in the context of the great famines caused by exploitative colonial policies that killed millions of Indians. The British government, in an attempt to cover up its own role in creating famines, cunningly tried to portray these deaths due to ‘low birth rate’ and ‘plague’. In its May 1901 issue, the Lancet observed that though a factor, the influence of ‘a reduced birth rate cannot have been very great’. An enhanced mortality must be the chief factor. It is estimated that there were 20,000,000 more deaths than there should have been under ordinary circumstances, and if we put 1,000,000 deaths down to plague there remain 19,000,000 which can be attributed with some reason either to actual starvation or to the diseases arising therefrom.’

Recently, the journal has carried reports supporting the IMA’s stand on the National Medical Commission Bill as well as against attacks on doctors in India.

On ‘the troubles’ in Northern Ireland, the Lancet has a long history of taking a pro-peace and pro-dialogue stand as is reflected in their latest paper (November 2018) on the state of mental health in Ireland.

Even in India, some doctors’ associations have come forward to denounce the security clampdown in Kashmir and have demanded free and easy access to healthcare for ordinary people. It’s the most rational and humane gesture to make as doctors, health practitioners and concerned citizens.

The IMA on the other hand has been found wanting in taking timely action against doctors accused of caste-based discrimination, the latest grim instance of which in the death of Dr Payal Tadvi.

The IMA, long accused of being reduced to just a corrupt vested-interest group would do well to remember the Hippocratic Oath and its ethics that prohibit any discrimination based on creed, colour, caste, gender or any other factor. In a civilised society, a human being in need of medical attention must receive it — The Lancet was just reminding us of that.

Valay Singh is a freelance journalist. Views expressed personal.