Monday, March 20, 2023
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India’s healthcare workers are the most vulnerable, but there is no framework for their health

The Modi government and several states put in place laws against harming healthcare professionals during the Covid crisis. But violence is just the tip of the iceberg.

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In the battle against the coronavirus pandemic, healthcare workers are at the frontline risking their lives. As per the latest data released by the Indian Medical Association, 106 doctors have lost their lives to Covid-19 all over India. While there is no centralised data on positive cases among healthcare workers, as many as 2,000 of them have been found positive in Delhi alone.

Under the current circumstances, many concerns have been raised by healthcare workers about their safety, including the lack of Personal Protective Equipment (PPE), safe and hygienic quarantine facilities, mental support during these stressing times and several incidents of violence as well as long working hours due to staff shortage. While the shortage of PPE has been highlighted and addressed to some extent, it is the incidents of violence against healthcare workers that have received the most attention, both from the public and central and state governments.

As a result, the Narendra Modi government only focused on addressing the issue of violence by passing the Epidemic Diseases (Amendment) Ordinance 2020, amending the Epidemic Diseases Act, 1897 to make violence against healthcare workers during an epidemic a cognizable and non-bailable offence with enhanced punishment. While this is a fair response, it does not address the issue of occupational safety of healthcare workers in an overarching manner.

Also read: India kept improvising during coronavirus. Age of Pandemics needs a new public health law

Not nearly enough

The ordinance is not only inadequate in protecting healthcare workers from the range of occupational hazards they face, but also does not address the issue of violence structurally. The ordinance protects healthcare workers from incidents of violence only during an epidemic, although these incidents are a systemic problem that exist outside of the current situation. It also fails to recognise that deterrence is not the solution to violence against healthcare workers, and that more structural reforms are needed.

Additionally, other critical facets of occupational health and safety remain unaddressed. In a recent instance in Delhi, nurses went on strike due to unsafe working conditions, while five nurses and one doctor committed suicide due to stress and the stigma of contracting Covid-19. In Manipur, doctors exposed to Covid-19 have been asked to pay to avail quarantine facilities.

While some community health experts have suggested measures like infection control audits across hospitals, they are only short-term measures. These instances in the current public health crisis point towards a larger gap — the lack of a legal framework to guarantee occupational health and safety of healthcare workers.

Also read: Coronavirus crisis is India’s chance to bring health reforms stalled by British colonial rule

Frameworks in place

The International Labour Organization mandates that all member nations shall establish a national system for occupational safety and health, which shall include laws and regulations as well as an authority responsible for occupational health and safety. In the United States, the Occupational Safety and Health Authority (OSHA), established under the Occupational Safety and Health Act of 1970, “sets and enforces standards to ensure safe and healthful working conditions for working men and women”. So far, OSHA has only issued non-binding guidelines for healthcare workers, and a Bill is pending in the Senate to mandate OSHA to issue enforceable standards guaranteeing occupational health and safety for healthcare workers specifically.

The government of India has also taken steps in the direction of occupational health and safety. In order to bring together 13 different laws regulating occupational health and safety in different sectors, the Occupational Safety, Health and Working Conditions Code, 2019 was introduced in Parliament last year.

The Code lays down a broad legislative framework for the occupational health and safety of persons working in an establishment with 10 or more employed workers where any industry, trade, business, manufacture or occupation is carried on. Under the Code, occupational safety standards need to be framed for different sectors by the central government on the advice of the National Occupational Safety and Health Advisory Board. However, it is unclear if the Code extends to healthcare establishments.

Also read: I am a public health adviser who got Covid. This is my advice to Delhi and Modi govts

Devising a dedicated framework

Given the extreme working conditions of healthcare workers, particularly, under the current circumstances, the least India can do is provide them with safe working conditions by means of a dedicated occupational health and safety framework. The Code should be extended to healthcare establishments to have enforceable standards ensuring protection of healthcare workers from any form of occupational hazards likely to cause death or serious physical or mental harm.

For the meaningful implementation of these standards, other laws and schemes, which lay down the requirements for healthcare establishments like the Indian Public Health Standards and the Clinical Establishments (Registration and Regulation) Act, 2010, should also be updated to reflect these standards.

The current crisis should not only be used as a wake-up call to ensure occupational safety of healthcare workers but also as a preparedness measure towards a more resilient post-Covid India for future public health crises.

Shreya Shrivastava is Research Fellow, Vidhi Centre for Legal Policy. Views are personal. 

Towards a Post-Covid India is a briefing book with 25 legal reforms recommended by the Vidhi Centre for Legal Policy. Join a series of conversations — ‘Law with a Difference’ — on the book. ThePrint is the digital partner.

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