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Sunday, Dec 15, 2019

A doctor’s death in Mumbai exposes social fault lines

Tadvi kept her parents and husband abreast of the harassment, and would often break down over phone. Transcripts of conversations on WhatsApp revealed that Tadvi was often allegedly relegated to an assistant in important procedures, depriving her of crucial experience.

india Updated: Jun 06, 2019 09:53 IST
Sadaguru Pandit, Faisal Tandel and Dhrubo Jyoti
Sadaguru Pandit, Faisal Tandel and Dhrubo Jyoti
Hindustan Times, Mumbai/New Delhi
People protest outside BYL Nair Hospital in Mumbai on May 27. Payal was studying at TN Topiwala National Medical College, attached to the hospital.
People protest outside BYL Nair Hospital in Mumbai on May 27. Payal was studying at TN Topiwala National Medical College, attached to the hospital.(Pratik Chorge/HT Photo)
         

Sanjay Dabhade moved to Pune from the hinterlands of northern Maharashtra in 1988 with a head full of dreams.

The young man from a marginal farming family had struggled through school and college battling a fog of slurs and stigma because of his tribal roots, and standing in front of the 141-year-old Byramjee Jeejeebhoy Government Medical College, he felt his hope of becoming a doctor was within touching distance.

But a month in the hostel, the dream turned into a nightmare. Dabhade, and other students who had entered the prestigious college by affirmative action, were singled out for insults, their roll numbers segregated and report cards marked by caste. In class, teachers often made fun of their accent, tone and uneven pronunciation of the English language, and in the hostel, students would taunt them for “stealing” seats.

Special scorn was reserved for Dabhade, who hailed from the Pardhi tribe that had been tagged as criminal by law for 80-odd years under the British-era Criminal Tribes Act. “I had never seen such a big city, and never such discrimination. We felt deep isolation as usurpers who didn’t belong to these top institutes. We would even hide our scholarships for fear of our roots being found out. Many were depressed and would be fearful of upper-caste students. They were never our friends,” said Dabhade, now a lecturer at Pune’s DY Patil Medical College. “It was a miracle we survived.”

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He didn’t intend to become an activist but has spend the past two weeks on the streets protesting against the death of Payal Tadvi, a 26-year-old medical student who killed herself after months of alleged sustained caste-based harassment at the hands of three seniors.

Just like Dabhade, Tadvi belonged to a scheduled tribe (ST), hailed from an economically marginal background and the same district of Jalgaon. The killing has made Dabhade question if any progress has been made in three decades since he was in medical college. “The mentality of upper-castes has not changed at all. When it comes to reservation, there is no understanding; they cannot accept constitutional values, our progress,” he rued.

Dabhade is one of thousands of young people, students, activists and political workers who have swamped the streets – from small villages in Maharashtra and Chhattisgarh to arterial roads in Delhi and Mumbai – against what they term as the institutional murder of Tadvi.

BRAVING THE ODDS

Tadvi was the second child of Abeda and Salman Tadvi and grew up in north-western Maharashtra’s Jalgaon district with her brother, Ritesh. According to accounts by her childhood friends, parents and relatives, Tadvi was a bright girl who loved sports, singing and dancing – and would often lighten the mood in class or at home by cracking jokes. A trained dancer, Tadvi is remembered as a studious, disciplined girl determined to pull her parents – her father is a wage labourer and her mother a government clerk – out of poverty.

Her husband Salman Tadvi, also a doctor, remembers that it was in 2014 that his parents approached Tadvi’s parents for marriage after they learnt that she was pursuing her MBBS. She finished her degree in 2016 and they married the same year.

“Payal was the first doctor from her village. And our main aim was to work for our community at our native place. We had decided that in future we will help our villagers and local community in healthcare,” he said.

At the time, Salman was finishing his postgraduate degree in Mumbai and Tadvi her internship in Aurangabad. In 2017, as she prepared for NEET, she took up a job as a medical officer in a primary health centre in Dhanora, near her ancestral village in Chopda, and quickly became popular because of her special attention to local women. “She saw the poor condition of tribal women in the area, who couldn’t access healthcare. Being from the community and a woman, she became more determined to finish her degree and help them,” said Manjur Tadvi, a Research Officer at the Pune-based Maharashtra Tribal Research and Training Institute who also hails from Jalgaon.

Payal’s mother outside Nair Hospital in Mumbai on May 28.
Payal’s mother outside Nair Hospital in Mumbai on May 28. ( Bhushan Koyande/HT Photo )

In 2018, both Tadvi and Salman came to Mumbai. She joined the Topiwala National Medical College, attached to the BYL Nair Hospital, as a MD student and he got a job with Cooper Hospital. “The busy schedule saw that we did not meet each other sometimes for eight days at a stretch. So I rented a flat in Byculla, and would go to meet Payal every second day…it was her dream to come to Mumbai,” he added.

But unknown to the family, Tadvi’s dream was slowly crumbling – according to the FIR filed by her family after her death, their statements, complaints to the police, lawyers’ affidavits, testimonies of friends and colleagues and an internal inquiry by the college, all reviewed by Hindustan Times.

NIGHTMARE BEGINS

In the hostel, she had been paired with Bhakti Mehar and Hema Ahuja, two senior students who allegedly verbally abused her, made her clean their clothes and wiped their feet on her bed. In class and outside, the two women, along with a third, Ankita Khandelwal, allegedly picked on her in person and over common WhatsApp groups, describing her as incompetent, screaming at her in front of others and abusing her over small infractions. Ahuja, in particular, repeatedly said that while she was the topper of her batch, Tadvi didn’t deserve to be there because of her low rank, said an official of the Mumbai crime branch investigating the case.

Tadvi kept her parents and husband abreast of the harassment, and would often break down over phone. Transcripts of conversations on WhatsApp revealed that Tadvi was often allegedly relegated to an assistant in important procedures, depriving her of crucial experience. Being a cancer patient, Abeda visited the BYL Nair Hospital for treatment between October and December 2018 and told police she witnessed how her daughter had to face taunts and insults over petty issues at the work place and also for going out of the hospital for lunch or posting selfies.

The aforementioned crime branch official said that roughly two weeks before Tadvi’s death, Abeda tried to approach the dean of the hospital with the grievance, but she was directed to submit the complaint through proper channels. She, accordingly, submitted the complaint and also got an acknowledgement, but Salman withdrew the complaint apprehending that Tadvi might have to face more harassment.

Things came to a head on May 21, when Tadvi and a few friends went out for dinner. The three women doctors spotted photographs of the dinner posted on social media and started abusing Tadvi, saying she was incompetent and undeserving because of quota. When Abeda spoke to her daughter on the afternoon of May 22, Tadvi was inconsolable. Around 7.30pm that evening, her friends found her body hanging from the ceiling fan in her room.

When news broke of her death on May 25, protests swept Maharashtra. Though the police initially denied any caste-based harassment, they later registered a case against Ahuja, Mehar and Khandelwal under Section 306 (abetment of suicide) of the Indian Penal Code (IPC), sections of the SC/ST Atrocities Act, Anti-Ragging Act and Information Technology Act, 2000. A 21-member anti-ragging committee of the BYL Nair Hospital recorded statements of over 50 people on May 24. The report was submitted to the Maharashtra University of Health Sciences on May 28.

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Girish Mahajan, state medical education minister who visited the hospital the same day, said prima facie evidence proved Tadvi faced harassment and caste-based remarks at the hands of the three resident doctors. Tadvi’s family met chief minister Devendra Fadnavis last Thursday and was assured a speedy investigation.

Little is in the public domain about the three accused women, who are in custody till June 10, except that they all hail from middle-class families. Their parents have repeatedly denied the charges to media, and pointed out that the girls had “friends from all categories”.

In their bail plea, the three have claimed that Tadvi ‘shirked’ her responsibilities for about a month in November and December 2018 and she suddenly stopped coming to the hospital. They contend that the atmosphere in the hospital is very stressful and that their interaction with Tadvi was only work related.

“Situation may arise where things are stressful and people may decide to conduct themselves with high efficiency and pull up others who don’t. If the deceased was acting in a manner, which was not proper as a student and as a trainee, she was expected to be pulled up. (If) she found same to be too stressful, she could have left the job,” reads the bail plea.

In Tadvi’s autopsy report, doctors reserved the final opinion about the cause of death, although they have noticed ligature mark over the neck of the deceased. Final opinion will be given after chemical analysis of various samples. Her lawyer, Nitin Satpute, who has since been removed, argued in court last week that Tadvi could have been murdered.

Defence lawyers Abad Ponda and Sandeep Bali denied this charge strongly, and point out that there was no suicide note. “There were so many people present when the door of Tadvi’s room was broken and people entered. Nobody has said that there was a suicide note and for that thing prosecution cannot ask for custody of the doctors,” Ponda stated. In court, they have also suggested that marital discord might have driven Tadvi to take the extreme step.

The case is expected to wind its way through the Mumbai sessions court over the next few months; but outside the courtroom, it has had a far-reaching impact in the medical community and among India’s marginalised sections.

A PROFESSION DIVIDED

Activists have long complained that medical colleges, with their highly competitive and deeply insular systems, are dens of caste-based discrimination that expressed itself through anti-reservation sentiments. Delhi’s All India Institute of Medical Sciences, for example, was the epicenter of the 2006 anti-quota protests even as multiple Dalit and Adivasi students claimed overt and covert discrimination in hostels, viva marks and classrooms.

These complaints, expressed through affidavits and testimony, forced the government to set up a committee headed by former University Grants Commission chairperson Sukhadeo Thorat in 2007. But the panel’s recommendations on setting up an elaborate anti-discriminatory structure in educational institutions was largely ignored – even after the medical profession was shaken by the suicide of Dalit student Bal Mukund Bharti in 2010 in AIIMS.

Such discrimination is rampant at other medical institutions as well. At Aligarh Muslim University (AMU), Abhishek Royal narrated that it was common for SC/ST students to be referred to by caste slurs in hostels. During his postgraduate course at AIIMS Jodhpur, he said he faced caste-based bullying. “Some of my seniors used to utter words like ‘neech to neech hi hote hain’ (those of low-birth will always remain so) behind my back…If I told my caste in clinical practice, I was considered a non-credible clinician.”

These are not isolated incidents. Neetisha Xalxo, an assistant professor at Delhi University, said when she moved to the Capital from Ranchi in 2006, she noticed Adivasi students faced hostility and stereotyping from fellow students for everything ranging from clothing and food patterns to language. “They would tell us that we don’t look adivasi,” she said.According to her, little has changed since then, but that the forms of discrimination have become subtler.

“There is exclusion, discrimination and humiliation at different levels. In engineering and medical colleges, students are at a tender age and there is no mechanism to tackle this bias. The SC/ST Act deals with criminal offence, but here discrimination is sophisticated and deals with language and attitude. Moreover, evaluation is often in-house, making vulnerable students more dependent on teachers,” explained Vivek Kumar, a professor of political science at Delhi’s Jawaharlal Nehru University.

In Tadvi’s case, for example, her colleagues, the college dean and members of the Maharashtra Association of Resident Doctors (MARD) quickly rallied to her support. “She was a bright student and it’s a great loss for the society since we have lost an efficient lifesaver,” said Ramesh Bharmal, dean, BYL Nair hospital.

But MARD is mum on the allegation of caste-based harassment. In Nair hospital, many feel that excessive workload and mental health is the main issue, not anti-quota sentiment and harassment. “Ragging and workplace harassment undeniably exists in medical education but caste isn’t a cause for it. During our tenure as MARD office bearers, we received complaints of ragging but none was caste based,” said Sagar Mundada, former MARD president and MD psychiatry.

A junior resident doctor said on condition of anonymity that they had brought up the issue of harassment with the head of the unit a few times but they weren’t taken seriously. “It is a common culture across our hospital for head of units to not listen to junior residents. The senior residents are often given the final word,” the resident added.

But some changes are afoot. The country’s largest body of doctors, the Indian Medical Association (IMA), has constituted the first-ever committee to evaluate suicide cases among doctors. “It is a well-known fact that resident doctors in government hospitals carry an inhuman workload and suffer burnout and depression, often a reason for suicide among residents,” said Dr Jayesh Lele of IMA, Maharashtra. He said Tadvi’s case stood out because of the allegations of caste-based discrimination. “This is a big issue,” he added.

HOPE OF A COMMUNITY

Tadvi was born in the Tadvi-Bhil community spread across northern Maharashtra, southern Rajasthan and Madhya Pradesh in a region colloquially known as Khandesh. The community traces its roots to the larger Bhil tribespeople, the largest of STs in India. Tadvi-Bhil is classified as ST in Maharashtra but Other Backward Class (OBC) in Madhya Pradesh.

Tadvi refers to the name of the tribe chieftain who led his community into Islam in the 17th century near modern-day Burhanpur in Madhya Pradesh. Legend has it that the conversion was done in honour of a visit by Mughal emperor Aurangzeb.

Many of the 85 clans that make up the tribe (there are roughly 300,000 members of the tribe in Maharashtra) continue to refer to themselves as adivasi and the villages they inhabit are covered by the fifth schedule of the Constitution that provides for special protection and grants for ST-dominated areas.

“We are followers of Islam but it is not our identity. We marry within ourselves. We worship the river and nature (naisargadev). Our identity is Bhil,” explained Manjoor.

Most Tadvi-Bhils are marginal farmers, wage labourers and government jobs are the only way out of poverty. The community also has little political heft, and counts no strong leader, MP or MLA from its ranks.

“Only two percent people have permanent jobs. Upper-class Muslims with businesses don’t accept us. We face discrimination even in mosques. Whatever progress we have made, it is because of reservation,” added Manjoor.

In this bleak background, Tadvi was a bright streak of hope – the community’s first postgraduate doctor – and Tadvi-Bhils are seething at seeing this dream snuffed out. Over the past week, old women, infirm men, young children have joined hands in protest across Raver, Amalner, Chopda, Yawal and other small hamlets of north Maharashtra. Their only demand: justice for their hero.

Even in her death, Tadvi is effecting change. The quick investigation and arrest of the accused in this case is being described by activists as a near miracle given that cases of caste-based atrocity often hang fire for decades without resolution, and conviction rate for crime against SCs and STs in Maharashtra stands at 10% and 8.1%, respectively (data from the 2016 report of the National Crime Record Bureau).

“This case could be a turning point in dealing with caste-based harassment. The protests have put pressure. This is probably the first case where the victim has been able to convince the state to take action,” said Ashok Bharti, president of the All India Ambedkar Mahasabha.

(With additional reporting by Aayushi Pratap)