Violence against doctors in Nepal: a growing crisis demanding urgent actions

Violence against doctors has escalated in Nepal recently, leading to nation-wide protests and strikes from doctors.1Doctors stage demonstration against attack on medical personnel.http://kathmandupost.com/visual-stories/2023/09/26/doctors-stage-demonstration-against-arrack-on-medical-personnelGoogle Scholar Within a month of the agreements with the government, we saw yet another incident of violence at a tertiary care center in the heart of the capital.2The Annapurna ExpressPatan Hospital doctors stage demonstration demanding security.https://annapurna-express.prixa.net/story/46558/Google Scholar This trend is worrying as it jeopardises the well-being of doctors and threatens the integrity of Nepal's healthcare system, which is already in shambles, with a record number of doctors leaving every year amidst an already awful doctor to patient ratio of 1:150,000 in rural Nepal.3GorakhaPatraHurdles to hospitals.https://risingnepaldaily.com/news/23880Google Scholar With violence ranging from verbal abuse to physical assaults,4Ghosh K. Violence against doctors: a wake-up call.Indian J Med Res. 2018; 148: 130-133Crossref Scopus (44) Google Scholar patients and their relatives have left no opportunity to thrash doctors and vandalise hospitals in recent times in Nepal. These assaults have not only occurred in heat of the moment situations, but have also taken place as planned crimes, months following patient's discharge or referral. Similar assaults have also led to cold-blooded murders of doctors at workplace in India.5Assam News21 arrested for mob killing of 73-year-old doctor at tea estate.https://www.ndtv.com/india-news/21-arrested-for-allegedly-killing-doctor-of-tea-estate-in-assams-jorhat-2094093Google Scholar According to a study by Bhusal and colleagues,6Bhusal A. Adhikari A. Singh Pradhan P.M. Workplace violence and its associated factors among health care workers of a tertiary hospital in Kathmandu, Nepal.PLoS One. 2023; 18e0288680Crossref Scopus (4) Google Scholar about 45.5% of the doctors had experienced some sort of workplace violence in the past. Public have become desensitised to such incidents and there is a perception that doctors deserve such treatment if patients are not satisfied with the results. The words 'medical negligence' is flung around in casual conversations; with poor media coverage adding fuel to fire. These incidents arise from widespread feelings of hopelessness and frustration with the government as well as the medical system that is understaffed and underequipped to handle the patient load in the country. One notable response from the government is the issuance of an Ordinance on Health workers and Health institutions (First amendment), under article 114 (1) of the Constitution of Nepal on June 6, 2021.7Kharel S. A historic ordinance against violence to health workers of Nepal.Lancet Reg Health Southeast Asia. 2022; 3 ([cited 2023 Nov 24]) (Available from:)https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(22)00047-6/fulltextGoogle Scholar Despite being a landmark decision, it has failed to change the situation due to poor implementation, owing to the political scenario in the country. There is a pressing need for better communication between doctors and patients, improvements in the quality of healthcare services, and health literacy. Doctors need to be better trained to deal with and avoid such situations.8Reddy I.R. Ukrani J. Indla V. Ukrani V. Violence against doctors: a viral epidemic?.Indian J Psychiatry. 2019; 61: S782-S785Google Scholar A high standard has to be set for health journalism. Prompt action from police with lawful implementation of the passed ordinance upon reporting incidents of violence is crucial. It is imperative to recognise that ending violence against doctors is a shared responsibility and it is essential to create a safe workplace environment through prompt and decisive action, for the effective functioning of our already strained healthcare system. SS conceptualised the study wrote, reviewed, and edited the original manuscript. KP and AK reviewed and edited the original manuscript. Authors have no conflict of interest to declare.