APPENDICES

Notes on visits to the relief camps in Amdavad

Shah-e-Alam dargah relief camp

There were 12,181 residents in the camp on the day of our visit, including 3,231 women and 5476 children. 60 women were pregnant when they came to the camp and 26 of these had delivered in the camp itself, assisted by a midwife.

22 women in the camp had been widowed in the present violence. There was one child who had lost both parents, while 25 children had lost one parent in the carnage. There were 129 deaths in the families of the inmates, including 48 women who had been raped and burnt to death.

28 toilets served the population of the camp, amounting to one toilet for more than 330 persons. There were only 22 bathrooms. UNICEF has contributed 15 of these toilets. Half of the toilets were constructed only after Prime Minister Vajpayee's visit. The Indian Red Cross provided 900 kits during Prime Minister Vajpayee's visit. Each kit contains 100 gm oil, soap, small napkin, tooth paste.

In the open quadrangle inside the Dargah, people stayed under the open sun until the PM's visit, when the administration covered it with tarpaulin.

On 5 March, a team of medical officers from the VS Hospital started attending the camp in the morning and afternoon for 3 hours each time. The residents were upset because they came without drugs, as the hospital provides drugs only on payment. So there was an altercation, after which the team stopped coming. Then another team came from the Solah Civil Hospital. Before Vajpayee's visit, the team attended the camp only in the mornings — once a day. After Vajpayee left, three more doctors — a gynaecologist, a paediatrician and a general physician — were deputed. After Vajpayee's visit (i.e. 40 days after the riots began), one mobile van was allocated for the night. Before this there was no facility for transportation at night.

Initially, no records had been maintained. A list was made later, in which only 55 cases of burns were recorded. Of these, 27 were given certificates.

Presently, there are about 700 patients per day. Out of these, 40% are from the neighbouring bastis, people who cannot go out to avail of the regular services because of the tense situation and fear of discrimination in the hospitals. Acute respiratory tract infections, malaria, tuberculosis, fevers and headaches are the main health problems in the camps. There have been no epidemics, although the Hindustan Times reported the outbreak of measles in this same camp (14 April 2002). According to Dr Anwar, almost 10 % cases are those of psychological stress and trauma, the symptoms being headache, disturbed sleep, uneasiness and breathlessness.

There is a water pipeline and 24 hours of water supply is available. This water is used both for bathing and drinking. Bathrooms are outside the camp and too few. So, men and women bathe on alternate days. Dry ration has been coming from the Collector's office since 10 days after the camp started. According to camp authorities, initially the quality of food was rather poor — the dal had worms and the grain rotten. The camp authorities left this inedible food outside the camp and managed meals on their own. The food that is coming now is of better quality.

The Red Cross Society, government hospitals and NGO's are supplying medicines. However, the medical officers stressed that there is a shortage of drugs, especially for tuberculosis.

There were only 15 toilets until Vajpayee had come. For 12,000 people these are grossly inadequate. A sanitary inspector was appointed after Vajpayee's visit, but Dr. Anwar felt that the situation still needs to be improved a lot.

Observations: The camp is crowded, cluttered and clumsy, food is littered all over, children are picking up the same food, and babies are lying on the floor. In such conditions outbreak of disease and epidemic is easy. Already cases of hepatitis and gastroenteritis have been diagnosed.

The quality of food provided as relief was of highly inferior quality. The clothes distributed to the victims were packed very well, but when opened they were mostly found to be old and torn.

When we entered the camp, the OPD was in progress. There were 40-50 people in queue, some wanting to see the pediatrician, some the gynecologist and some needed medicines. Three patients with IV drips were lying on the floor.

Patients stood in long queues awaiting attention. They stood while the doctor took the history. There was no private screening. There was no table for patients to lie down for examination. Women would find it difficult to share about reproductive tract ailments in such a situation. It is also not conducive for counselling, which was what most people needed. There were several antenatal and postnatal mothers lying in the camp.

TB is endemic in this area. There were above 50 TB patients in the camp. Even in the surrounding areas, people are suffering from TB. Follow-up for those who were on DOTS treatment is difficult because most houses are burnt and so are their DOTS registration cards. The environment is congested and sanitation is very poor. It is also known that in conditions of displacement, stress and in overcrowding camp conditions TB rates go up. Untreated, sputum positive pulmonary TB can spread in camp conditions.

There are 2-3 leprosy patients and a few cases of malaria. There are also cases of hepatitis. There were a lot of flies. There is full possibility of an outbreak of epidemic (measles, gastro-enteritis, hepatitis, etc.) by June. Provision of adequate quantity of water of potable quality and better sanitation is required.

The quantities of food provided are not adequate. Children, pregnant and lactating women need more frequent meals, more vegetable, milk, eggs and some nutrition supplements.

There is a shortage of drugs and we have received a list of medicines required.

There are complaints of insomnia, breathlessness, anxiety, headache, irritability, etc., which are being treated with diazepam, etc. Post trauma stress is evident. Many women broke down during conversation. (They all had gone through the psychological, economic and sexual violence)

Gomtipur camp in Madhav Mill Compound

There were 4943 people residing in this camp on the day of our visit, of these 437 were not registered, hence, food rations would not be allocated for them. There were 911 women and 1,561 children. 21 women were pregnant when they came to the camp, of whom 4 women delivered in the camp. 4 persons had been disabled in the violence.

There were 10 toilets, 5 each for the men and women. There were no bathrooms. There was only tank for storing water, with a capacity of 5000 litres.

A majority of the people here are from Mariam bibi ki chawl. There are 26 Hindu families among the 670 in this camp. They all belong to the Dalit community. There is another camp in Gomtipur where the majority of Dalits are taking shelter. SAHRWARU, an NGO working in the camp, has one more worker in that camp who is Dalit. Unfortunately, both the workers cannot meet as there is tension between the Dalits and the Muslims in some parts of the area. The worker from Madhav Mill compound explained her inability to meet the other worker in the Dalit camp. However, they speak to each other over phone.

The camp is organised on an open land of the Madhav Mill Compound. There has been pressure on the owner to shift the camp from there, but he has withstood it so far.

Conditions are really pathetic, much worse than the Shah-e-Alam camp, as it has no built structure, only the open sky and a mud floor of a narrow strip of land. There are only a few tents that are unable to accommodate the entire population. People are sitting in the hot sun and children are all about in the dust. Food was being cooked in the open with no proper cleaning and washing facilities. The numbers in the camps are increasing everyday. Sanitary conditions are depleting. There are no bathrooms at all and the latrines are extremely dirty and few in number. The toilets have no running water. There is one tank with a capacity of 5000 litres. Water from this tank is used for drinking, bathing, washing and cleaning. The possibility of epidemics is even more here than in Shah-e-Alam.

One medical officer visits the camp every morning from Solah Civil Hospital and an Indian Red Cross team also comes for some time. The general health problems prevalent here are headaches, stomach aches and fevers. There are not too many burn cases. Some people have wounds but they have been treated at the hospital, after which they have returned to the camp.

The camp organisers and the workers from SAHRWARU stressed that women and children are going through a lot of trauma. Nine year old A had witnessed the death of her father and brother in front of her eyes. When the mob left, she tried to reduce the flames with a blanket. However, She could not save them. Now A carries the same blanket in her hand and lives in her own world.

S, age 28, was brought to the camp. Initially she used to scream and run away from everyone. Sometimes the volunteers were forced to tie her up. Now she is quiet, but she has not spoken since.

Camp organized by Jai Ambe Yuvak Mandal, Lathi Bazar, behind Geeta Mandir

There were 264 persons in this camp, including 72 women and 42 children below 18 years. 4 women were pregnant when they arrived at the camp. All inmates in this camp are Hindus from the Jamalpur area. The camp was being run by the VHP. The facilities in the camp were as follows:

There were 4 bathrooms and 2 latrines. There was one water tank installed by the municipal corporation. This camp also receives food rations. Food is served twice a day. The women in the camp do all the cooking and cleaning. A team of 5 doctors from the Solah Hospital make a visit between 4 and 5 PM. The Red Cross has provided 47 kits which contain bathing and washing soap and oil. The camp has not received any kit from the government.

No major health problems were prevalent in the camp. According to the camp organisers, there were no patients of burns and injury.

Nobody in the area knew about this camp. It was clear that the team was not welcome. There was no inclination to offer them water to drink or chairs to sit, which was in sharp contrast to camps like Gomtipur or Shah-e-Alam.

The camp is constructed by tents put up before a house — the house owner a Hindu person who allowed the premises to be used as a camp. When the team visited, there were three officers from the Collector's office with cheques for compensation. The men were sitting on chairs and cots, while the women sat on the floor. There were 26 women when the team visited. The children were playing in the rooms inside the house. When asked about the men, they told the team that they had gone out for work. The women looked quite neat, bathed and relaxed, again in sharp contrast to the other camps that the team visited.

The camp organiser told the team that this camp was set up because their houses were burnt and they were not feeling safe to go back as the area was still under curfew. He explained how the women were living in a stressful condition and that nobody talks about the plight of the Hindu families. He explained that the area was largely populated by Muslims and that there was a need for a clear demarcation of the habitation in communal lines; and till that becomes a reality, the camp will continue to exist.

However, when the team talked to the women separately, they did not complain of their houses being burnt. They said there was a mob that indulged in large scale looting and destruction, in which their houses were also looted. Since they did not feel safe after that, they came to the camp.

The officials present at the camp insisted that all team members enter their addresses in the visitor's book. When the team members asked to be taken to the locality from where the women came from, they were not too keen and brushed it aside by saying the it was just adjacent to the camp. However, later they sent a volunteer with the team. He showed us two burnt houses from a distance and explained that because of the curfew, it was not possible to go to the exact location where the women came from.

Interviews with health professionals

Opinions of doctors about the events in Gujarat

Dr. B. neurologist, private practitioner and honorary consultant in municipal hospital.

Dr. B. is Muslim. His clinic is in a predominantly Hindu area. “Frankly I was scared and I did not venture out of my house. The janitor of my building removed all signboards referring to my clinic. That is how my clinic was not attacked. Otherwise almost all clinics on Ashram Rd belonging to minority community doctors have been ransacked, vandalized and burnt. In previous riots, Muslim doctors were never attacked. This is a first for Ahmedabad. “Personally I cannot tolerate any form of violence – I tend to get depressed.”

“I did not come out for almost 15 days. Where we were staying there was a good cooperation from majority community members. It also helped that some of my Muslim neighbours were senior officials in the Police and they saw to it some kind of police protection was available. . Although in the process they got accused of dereliction of duty and were threatened with transfers and punishments. “

“In Mansar village near Ahmedabad, two Muslim doctors' clinics were burnt on the 28^th...”

(About lapses in documentation)

“…By law postmortem reports cannot be given to anybody. To avoid hassles later in the court, postmortem conclusions and observations are as general and innocuous as possible.

When initially Muslim doctors were attacked or threatened I proposed that we condemn the act. I had no support. But when Dr. Amit Mehta was attacked there has been a chorus of protest although rightly so…”

Dr. B felt that when it came to patients, doctors generally did not discriminate. Neither did patients go by the religion as much as perceived reputation. B said that his clients included the family of some of the high profile, controversial members of the Sangh Parivar. He felt that even the doctors with known allegiance to the Sangh Parivar ideology would not and do not discriminate among patients on the basis of religion. However they have a problem when it comes to taking a secular stand.

Dr. B. is a consultant with a municipal hospital and he felt that the paramedical staff were very decent and worked very hard during the crisis period. He did not think there was any discrimination on the basis of the riot victim's religion. Although he did hear that there was intimidation of Muslim patients at the hospital by various Parivar elements.

“…I am lost today. Modi has brought us to this.”

Dr. V. surgeon and honorary consultant in a municipal hospital.

“…At the outset I should tell you that I have worked with the RSS especially in motivation camps for guidance and counselling about their future. I associated with RSS and Bajrang Dal because they helped in my practice and also they talk of good values. I came to be known. Otherwise for a non-Gujarati like me although I have been an Ahmedabadi, it is difficult to get a breakthrough. I am not a core member of the inner group of RSS, though like some friends.

I do not think there has been any discrimination in treatment because a person is a Muslim. Certainly not in hospitals like V.S. hospital Neither do I bother with the religion of the patient – for me a patient is a patient and I am a professional. I think most doctors in AMA are professional and they would not discriminate.

However recently, after the riots, the Muslim patients do not turn up at private hospitals. If they do turn up, they turn up late (when their condition has worsened) and within the hospital despite the best of treatment, I cannot assure their safety. I cannot guarantee their safety. A lady doctor who treated a Muslim lady patient, - in the OPD, mind you, was suddenly surrounded by Hindu mobs; “we will burn the hospital”, the hospital was threatened…. Even educated elite, including doctor friends of mine, objects to the Rs 1 lakh given to the patients at the taxpayer's expense.

Muslim trusts are running hospitals but Hindu doctors mostly staff them. This is because the number of minority doctors are not in proportion to the other population. Out of the 3500 registered doctors with AMA, hardly 100-150 are Muslims, less than 3 percent. Secondly, Muslim patients never trust Muslim doctors, they go to Hindu doctors. I do not know why. Also I find Muslim patients, whatever their class, are the best patients. They have the least hassles. They pay well and in time. They do not complain about fees once it is agreed. They do not go back (on their word). Most of the doctors are happy with Muslim patients. There are not enough Muslim specialists of specific specialties. Their practice is more of a general practice. No super-specialitists among Muslims. So Muslim patients do not have a choice.

Also most Muslim doctors are not practising in the centre. So Hindu patients are less likely to go to them. No Muslim patients come to them. It is a symbiotic relationship between Hindu doctors and Muslim patients. Many of the Hindu doctors are tempted to give free service to Muslim trusts. Because I want to develop relationships, good practice from Muslim community. It is a business. If there is a Muslim consultant, he will get an attachment in these Muslim trust hospitals naturally. It goes without saying.

Now with the stabbing of Dr. Amit Mehta, a lot of heat has been generated. The Hindu doctors weigh their benefits versus the risks. Because of safety reasons – not only from Muslim community but also Hindu militant organisations. Because they will be targeted…

If you ask me which is the best attachment to get in practice, I would say, a religious attachment. Rather than VS Hospital or a honoraryship. Either you are attached to a Muslim trust or Swaminarayan trust. Organisations with networks are the best attachment for one's practice and RSS is the best network going right now in Gujarat if you want to develop your business. People of all the strata are attached to the RSS. Right from rickshawwallas to industrialists. Doctors may not necessarily believe in RSS ideology. There are 4 cadres of doctors. One who opposes them (the RSS). One who are with them, right or wrong. The third category is fence sitters. And a fourth cadre who are close sympathisers. The fence sitters have become sympathisers because of a mass movement. Hard core supporters will be hardly 20-25. Sympathisers will be the majority of the doctors. Those who used to say, we have nothing to do with the RSS (“hum ko kuch lena dena nahin hain”), are saying that whatever has happened was for the right reasons – they have become sympathisers. There are others who do so purely for economic reasons also. They go to the meetings, they meet the network. RSS would not mind because they are spreading the tentacles.

Those who oppose RSS will be very few – same in number as those who support them right or wrong, the hard core. Opponents – those doctors who are at heart opponents will not come out or comment You will be surprised to know that a Congress based doctor is also not an opponent. In public even doctors of the opposite party feel they gave to say what is happening is right, because of business reasons. So it has got nothing to do with party…

…. It is a fact that Muslim patients have been by and large brought in a particular hospital (V.S. Hospital) – maybe it is the planning of the police. Security of patients within the hospital is indeed a problem. May be Civil Hospital and such hospitals are run by the Government of Gujarat whereas V.S. Hospital is under Ahmedabad Municipal Corporation which is headed by the Congress – in fact the Chairperson of the Board of V.S. Hospital is a Muslim Congressman. These could be the calculations of Muslim patients. Also behind the V.S hospital the entire settlement is Muslim, whereas, the settlement in front is all Hindu. Also in the year 1984 or 1985 there was a bad incident in the Civil Hospital - - where a Muslim was killed inside the hospital (and thrown from the 4^th floor – interviewer). You cannot find a Muslim shop for 4 kms around L.G. hospital - -therefore naturally Hindu patients prefer to go to L.G. hospital –maybe the reason.

…. But still I think there has been no discrimination by doctors of Muslims for treatment. You ask the patients, including burns patients.”

Dr. B. gastro-enterologist, Office Bearer of National Medical Organisation and Ahmedabad Doctors Forum

Dr. B is a leader of the National Medical Organisation, the medical wing of RSS. He has been active in RSS from childhood. He clarified that there was a misunderstanding about the statement regarding Dr. Amit Mehta. He said that it is no more safe for Hindu doctors to practise in Muslim areas – he never said that Hindu doctors should not treat Muslims. If Muslims need medical attention of Hindu doctors they need to attend the clinics where Hindu doctors feel safe. He feels all doctors are professional when it comes to treatment of patients – even he has a lot of Muslim patients and he financially supports the education for the past many years of a couple of poor Muslim children. He is not against Muslims, neither is the RSS. He is against unpatriotic Muslims or those members of the minority community that behaves as if India is not their motherland.

The education of Muslims is not given 'properly' in the madrassas by mullas. Therefore they are turning out Muslim children who tend to become fanatics. When asked how come Hindus are letting themselves be dictated by the Hindu equivalent of mullas in several spheres including education, he said it requires a longer discussion.

He said it is not possible for people like Dr. Maya Kodnani (named as perpetrator by several victims of the Naroda Patiya burnings) to actually participate and direct riots. He has the greatest of respect for her and her social service.

The impressions of health personnel providing services at the camps and at hospitals.

Dr. A, medical officer, Ahmedabad Municipal Corporation,

Dr. A provided voluntary services at a relief camp, now officially deputed to do so.

The team met Dr. A., a Muslim doctor who works as a medical officer from the Ahmedabad Municipal Corporation (AMC). He lives in the area and has been working since 28 March, i.e. the 'first' day of the riots in Ahmedabad. A week later, the AMC assigned him on duty in the camp. Dr. Anwar narrated the situation of the camp since the very beginning:

On the night of 28 February, the first day of the riots, many people were brought to the camp from Naroda Patiya. On the 30th, there were almost 7000-8000 inmates. There were many burns cases and bullet injuries. There was no medical help, material, dressing or first aid at the camp. For the first 5 days, only a number of local doctors worked in the camp with materials from the local chemist shops. There were no special arrangements for burns. 30 patients were shifted to the public hospital. Those with 50% and more burns were considered serious and sent to hospitals; those with 20-30% burns were treated in the camp itself.

The following day, people came in from Millatnagar and Behrampura. They mainly had firing and bullet injuries. Many were shifted to the Government hospital while minor cases were treated in the camp itself.

There were women who were brought naked (three, according to Dr. A. Some of the local women who are doing voluntary service in the camp said they had received 10-12 women without clothes and had given them their own clothes to wear). The three seen by the doctor had severe burns and reported physical molestation. Dr. A. himself had not medically dealt with any rape victims, so he referred them to the civil hospital.

Many of the people who were sent to the hospitals returned to the camp saying that the mob there did not allow them to be admitted. Shifting patients was also a problem because there were not enough ambulances. To top it all, riot victims were being charged in the hospitals where user fees are charged routinely (including V.S. Hospital). Only after the National Human Rights Commission's visit (i.e. 15 days after the riots began) was a circular sent out saying that riot victims should not be charged for treatment in the first week of April. There were also many who did not dare to visit the hospital out of fear.

S. birth attendant in a relief camp

S. spoke about how she has been taking care of the women. She narrated how on the first day 10-12 women were brought in naked, raped, partially burnt, bruised and absolutely terrorised. One woman had been gang raped and S. herself took out cricket bails from her vagina. She had to do this using paper since there were no gloves. She ran to the nearby houses for hot water and somehow cleaned the blood. She removed pieces of wood from another woman's vagina. About 12 women had been raped and further abused with cricket bails and sticks.

S. being a dai herself, expressed her concern for the pregnant and lactating women. She had assisted in many of the deliveries. In fact, people from the neighbouring areas prepared 'sira' — a healthy diet for the mother. However, they could not sustain it for long, because they too are not earning these days. She felt more nutrition and vitamins (shakti ka botal) are needed. Women also require sanitary napkins.

Mr. M. Trustee of Al Amin Hospital.

The team spoke to M. one of the trustees of the Al Amin Hospital. He said that they had information that a large mob from the majority community was preventing patients from the minority community to avail of treatment at the VS hospital. He said that even during the post mortem the mob, which belonged to the RSS, was present. He said, “even the post mortem reports mention only injury, bullet ka tho zikr hi nahin.” (there is no mention of 'bullet.')

M. himself was interrogated by the police and beaten up in his own ambulance on the 3rd of April while he was transferring patients to the government hospital. According to him, during the curfew whoever was on the road was injured — either stabbed or shot.

In Bapunagar and Sundaramnagar, the mob was in very large numbers — 2 lakhs of people attacking the minority community. He felt that this was an absolutely organised operation for which a bunch of hooligans were given prior training. He became extremely emotional and said how he had never felt that he was not an Indian.

“They call us Pakistanis. They blame us for everything. Even when a child bursts a cracker when Pakistan wins a (cricket) match, we are labelled as enemies. We are fed up of this. Take us in the Indian army. We will fight the Pakistanis and prove that we are true Indians.”

He was, however, still not bereft of hope.

“Nafrat ke is silsile ko muhabbat mein tabdeel karna hai.”

(“We will have to transform this wave of burning hatred into love”)

Dr. Sadiq (surgeon in-charge) was attacked when he went to his clinic in a predominantly Dalit residential area. The president of Al Amin Hospital was attacked and he was admitted in V.S. Hospital for eight days. His godowns were burnt. He said that there were many Hindu doctors in Al Amin. Among the 92 doctors on their list giving voluntary time, only 14 were Muslims and the rest Hindus. Only four doctors were coming for duty after the riots – two of them were Hindu and two Muslim doctors. The rest of the doctors were absent because of insecurity.

Doctors who faced direct violence

Dr. Amit Mehta. General Practitioner, practicing in Juhapura.

Dr. Amit Mehta, was stabbed on April 9, after which the Ahmedabad Doctors Forum issued a statement that no Hindu doctors should go to Muslim areas as it is dangerous: (Communal Virus Strikes Doctors in Ahmedabad; Times News Network 11 April 2002

We met Dr. Amit Mehta and his family at his residence. Dr. Mehta's clinic is in Juhapura, a Muslim dominated area. He has been practicing in Juhapura for the past 15 years.

On the first day of the riots the people of the area advised Dr. Mehta to stay away, but he went back to his clinic after two days. Once again the concerned people of Juhapura asked him not to come. He stayed away for a few days, but later resumed his visits to the clinic.

On the day of the incident he was reading the newspaper in his clinic. A man with his face half-covered tried to stab him in his stomach. He swivelled in his chair and fell down so that the impact would be less. Then the man stabbed him on his back. He could not see the assailant's face because his glasses had fallen off. Dr. Mehta was rather shocked and unable to comprehend the situation. There were no other people around as it was time for namaz. He was stabbed in the afternoon when almost all the people in the area were offering their Friday prayers. He was stabbed again twice, but managed to run out of the clinic. Then he began to scream for help. A Muslim woman, M heard him and ran out to help him. Another young person came out and tried to chase the assailant, but he fled away. M brought a towel and covered Dr. Mehta's wounds. Incidentally, the clinic is very close to the main road and the police point is situated at the entrance of the colony. The assailant crossed the police point. Obviously the police personnel around did not notice anything. Then many people came out. The police was called and Dr. Mehta was taken to the hospital in the police van. M accompanied them in the van but Dr. Mehta himself urged her to get off the vehicle at the police point at the entrance of the colony, fearing that she may get into trouble. He is now discharged and is back home.

Dr. Mehta was extremely upset with the present situation where he was not being able to return to his work, which he had been carrying on for years now. He told us how he had been brought up in a mixed locality with lots of Muslim neighbours and has worked all his life in an area where the population is predominantly Muslim. He still does not fear the local community. But he is in a dilemma. For Dr. Mehta, it is also a question of livelihood. He does not have any other clinic and does not want to start everything all over again. However, he felt he can no longer risk his life as the community cannot guarantee his safety against other elements. He said that the people from Juhapura were extremely concerned about his health. He had been receiving phone calls and visits from them. But not many were visiting him due to the prevailing tense situation. While we were speaking to him, he received a call from one of his concerned patients in Juhapura. Dr. Mehta was so touched that he could not hold back his tears. He has no bitterness about the local community, but he is afraid that those hard liners (likely to be an outsider to the locality by his reckoning) who had tried to make a point by attacking him, might target him again. We interacted with his wife and daughter as well. Even they seemed to be very unhappy at the kind of violence that had been going on, but felt helpless to do anything about it.

The team also visited Juhapura where the incident of stabbing occurred. The people of Juhapura living near Dr. Mehta's clinic were also very unhappy about the stabbing incident and had even issued a press statement the very next day condemning the attack. However, the most widely read Gujarati paper, Sandesh had not published it while the Gujarat Today in Gujarati and the Times of India in English had published it. But no one visited the area. On the contrary, all of them have only taken Dr. Mehta's interview.

When the team was leaving, they showed them Dr. Amit Mehta's clinic. Many people from the neighbourhood also came out to meet them. They said that they were very disappointed with what had happened to Dr. Mehta.

Dr. Sadiq Kazi, surgeon, in-charge, Al Amin Hospital. Also has own nursing home.

We met Dr. Sadiq Kazi at his nursing home, near Khamasa Police Chowky. The rickshaw driver who took us to Khamasa Police Chowky refused to enter the lane in which the nursing home is located, because it is a Muslim dominated area. Dr. Sadiq's nursing home is located at the junction of two streets, one Muslim dominated and the other Hindu dominated. The main entrance to his nursing home is on the Hindu street. However, he had stopped using that entrance and entered and left through the house of his landlord, which opened out onto the Muslim street. The gate to the house was barred and locked securely. The team reached the place at 4 o'clock in the afternoon, but the entire area was deserted. The team members were wandering around the place, contemplating asking for directions, when a man (Dr. Sadiq's assistant) appeared in the verandah and waved at us. He then came down opened the gate and escorted us in. The team went through the house to the nursing home.

The narration of events as received from Dr. Sadiq was as follows. Dr. Sadiq's car, which was parked outside was stoned by three young men from the nearby locality. They were well aware that this car belonged to Dr. Sadiq. In fact, the father of one of them had been Dr. Sadiq's patient. The next day, they were standing around the car, pointing out to the dents and gloating over the damage that they had caused. Dr. Sadiq decided not to take any action. A few days later, the same boys smashed all the car windows and damaged the car more seriously. At this point, Dr. Sadiq decided to file an F.I.R, in which he named the persons responsible. He did this also because he had to file an insurance claim. This incident rattled him enough to change the arrangements for entering his nursing home, as described before. No action has been taken on his complaint and those named by him are still in the area. Because of the tense situation, Dr. Sadiq is not admitting any patients to his nursing home.

Dr. Sadiq is also in charge at the Al Amin hospital in Gomtipur. He narrated that in the first five days of the violence, he was working virtually round the clock. He said that in most serious cases, they could just control the bleeding, start life support and shift the patients to a bigger hospital. Only those, who had suffered less serious injuries were treated and admitted to Al Amin hospital. He confirmed that since the riots, very few doctors were actually coming to Al Amin. He reported that both Hindu and Muslim doctors had stopped coming out of fear.

He narrated an incident where while on his way to Al Amin, he saw a mob surround a couple driving on a two-wheeler. As he was just behind them in his car, their attention got distracted and the mob started pursuing his car as well. He turned his car around and managed to reach a police picket before they could catch up with him. But by that time, the couple on the two-wheeler had been killed and burnt. Dr. Sadiq reported that his mother was terrified all the time and could not rest till he had returned home safely.

While we were there, he received a phone call from Al Amin hospital, reporting that persons with stab injuries had been brought in. He instructed the caller to suture the wounds and refer them. Dr. Sadiq blames the police squarely for the continuing violence. He feels that unless the trouble-makers are arrested, the violence will not stop. He said both Hindu and Muslim trouble makers are wandering about freely.

The safety of doctors, he said, had become a major issue. He is able to reach Al Amin hospital because he lives close by. But other doctors who live further away can not make it to the hospital at all. Hence, planned surgeries are virtually not done at all. Support staff too can not reach the hospital. He narrated the experience of one patient, which seems to exemplify the situation. An elderly man developed acute symptoms of pyo-nephritis and reported to Al Amin. Dr. Sadiq examined him and referred him to V.S. Hospital. He was admitted there. The patient needed surgery, which was been delayed, (Dr. Sadiq does not suspect any discrimination). The patient's family pressed Dr. Sadiq to conduct the surgery in Al Amin. Dr. Sadiq had to pick up the anaesthesiologist in his car, a Sikh, and personally escort him to the hospital. Finally the surgery was performed few days before our meeting.

Dr. Sadiq told us that he (a member of the IMA) had confirmed from the IMA that they had not issued any instruction to doctors not to venture out into Muslim dominated areas. He said that this was the work of a fringe group, which had formed the Ahmedabad Doctors Forum. Dr. Sadiq also reported that an acquaintance of his, a Hindu doctor, had been threatened and told to stay away from his practice in a Muslim dominated area.

Press Note (translated from Gujarati)

Medicos Welfare Society

Ahmedabad

Ref No. MVS/145/2002                                            Date: 13/04/2002

Public Appeal

All the doctors of the minority community strongly condemn all attacks by extremists on doctors, hospitals and their residences in the riots which have erupted in Gujarat. The attacks on these doctors who have been providing medical relief to all citizens of this country without any discrimination and only in keeping with the norms of humanity are inhuman and a blot on the nation's honour. We urge that such elements be contained. We appeal that such anti-social organisations and elements must be immediately dealt with.

All doctors of the minority community condemn the incidents noted below.

(1)        Lala Hospital, Modasa, which was burnt down.

(2)        Dr. Chandniwala hospital, which was ransacked and burnt.

(3)        Dr. Haradwala Pathology Laboratory, Himmatnagar, which was looted.

(4)         Dr. Rafiq Vasiwala, Himmatnagar, whose property was damaged.

(5)        Dr. Rangwala hospital, Paldi, which was damaged

(6)        Lethal attack on Dr. Sadiq Kazi and complete damage of his car

(7)        Lethal attack on Dr. Bhavnagari and damage to his residence.

(8)        Lethal attack on Dr. Amit Mehta by unknown persons.

We express regret and feel that any thinking person /intellectual would condemn such actions. We demand that anti-social organisations, elements and persons who support such actions should be meted out the severest punishment.

• Convenor
  
  

UNICEF study on mental trauma among children living in relief camps

Protocol for screening (Translated from Gujarati)

Name of Relief Camp

Child's name                                             Sex                  Age
Note: If the child's parents report any of the following symptoms, please mark '1' in the column adjoining it. These symptoms should have appeared after arriving at the relief camp.

Note: Questions 1-13 apply for children between 1 and 5 years, Questions 1-15 apply for children between 6 to 11 years

Sr.no.	Symptoms	Score
1	Insecurity
2	Fear of recurrence of violence
3	Feeling of helplessness (screaming, irritation, mood swings)
4	Over-alertness
5	Lack of concentration
6	Dismissiveness
7	Getting angry
8	Increase in physical complaints (headache, stomach-ache, cramps and pain)
9	Fear of noises (siren, aeroplane, lightning, gunshot, loud noises)
10	Changes in sleep patterns
11	Changes in thirst and hunger
12	Regressive behaviour (acting younger than their age, bedwetting, baby talk)
13	Verbal expression of anger and hatred
	Total of No. 1-13

Sr.no.	Symptoms	Score
14	Repeated discussion about the tense situation
15	Denial of being affected
	Total of No. 1-15

        

Instructions for calculation

For children between 1 to 5 years         

Total of No. 1-13	If score
	1-4	No immediate intervention required
	5-8	Counselling
	9-13	Referral
Total		(in English in the original)

For children between 6 to 11 years

Total of No. 1-15	If score
	1-5	No immediate intervention required
	6-10	Counselling
	11-15	Referral
Total		(in English in the original)

Date:    
Name of investigator and signature

Certain aspects of the survey are intriguing.

1.Although, screening was conducted from April 8 to April 24, of the 723 children screened, almost half, 367 children were screened on the first day itself. On succeeding days, less than 20 children were screened each day. The only other days on which substantial numbers were screened (i.e. April 23-24), there appears to have been a change in methodology. There is a remark 'Gr screening'. This probably refers to group screening.

2.There is no explanation about how the children were selected.

3.There is no explanation about the methodology used. (was probing done or only spontaneous responses recorded ?)

4.Some of the symptoms are not symptoms, but emotional states; there is no indication about how these were interpreted. (e.g. insecurity)

5. The protocol mentions three categories, 'no intervention, counselling and referral'. In the findings, the second category has been substituted with 'parental support required.' There is no explanation about why this substitution was done. In our normal understanding, 'counselling' refers to professional intervention whereas 'parental support' refers to only social support. They are not substitutable categories.

Sexual assaults violate the provisions of CEDAW

The findings of our investigation clearly shows how the State has retracted from it's responsibility in complying with the norms of various International instruments it is signatory to.The following are the provisions of a few of these instruments :

1.        General Recommendation No. 19 issued by the Committee on the Elimination of all Forms of Discrimination Against Women (CEDAW) states that -

“ Article 12 of the Convention requires States to take measures to ensure equal access to health care. Violence against women puts their health and lives at risk. States should establish or support services for victims of family violence, rape, sexual assault and other forms of gender - based violence, including refugees, specially trained health workers, rehabilitation and counseling”.

2.The UN Declaration on the Elimination of Violence Against Women states that States are obligated to “ Ensure that there is specialised assistance in terms of support and rehabilitation for women victims of violence” (art 4 (g) ).

3.Ms. Radhika Coomaraswamy, the Special Rapporteur on Violence Against Women in her report recommended that, ' Confidential medical assistance, legal assistance, and culturally appropriate, community – based psycho – social counselling for victims and their families should be provided to prevent rejection of an attachment of social stigma to the victims” (E/CN4/1998/54).

4.Under International human rights law, States are held legally responsible for acts or omissions of private persons when there is State complicity in the acts committed by private actors and when the State fails to exercise “due diligence” in the control of private actors. The 'due diligence' concept provides a measure for evaluating a States' responsibility for violation of human rights by private actors.

This counters the Government's statement that rape was committed by mobs

Although India is a party to various international norms and agreements, it is more than evident through our findings that the State has blatantly violated the provisions of these very instruments.

The state is in fact obligated to develop special programmes for dealing with mental and physical health consequences of violence perpetrated against women in Gujarat.

Excerpts from the MCI notification of April 6, 2002, the Indian Medical Council (professional conduct, etiquette and ethics) Regulations, 2002

(Published in Part III, Section 4 of the Gazette of India, dated 6th April, 2002)

MEDICAL COUNCIL OF INDIA NOTIFICATION

New Delhi, dated 11th March, 2002

… 1.2.1        The Principal objective of the medical profession is to render service to humanity with full respect for the dignity of profession and man.

Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion. Physicians should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments. The physician should practice methods of healing founded on scientific basis and should not associate professionally with anyone who violates this principle. The honoured ideals of the medical profession imply that the responsibilities of the physician extend not only to individuals but also to society…

...2.1.1 Though a pysician is not bound to treat each and every person asking his services, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he discharges in the course of his professional duties. In his treatment, he should never forget that the health and the lives of those entrusted to his care depend on his skill and attention. A physician should endeavour to add to the comfort of the sick by making his visits at the hour indicated to the patients. A physician advising a patient to seek service of another physician is acceptable, however, in case of emergency a physician must treat the patient. No physician shall arbitrarily refuse treatment to a patient. However for good reason, when a patient is suffering from an ailment which is not within the range of experience of the treating physician, the physician may refuse treatment and refer the patient to another physician….

…5.1 Physicians as Citizens: Physicians, as good citizens, possessed of special training should disseminate advice on public health issues. They should play their part in enforcing the laws of the community and in sustaining the institutions that advance the interests of humanity. They should particularly co-operate with the authorities in the administration of sanitary/public health laws and regulations

5.2 Public and Community Health: Physicians, especially those engaged in public health work, should enlighten the public concerning quarantine regulations and measures for the prevention of epidemic and communicable diseases. At all times the physician should notify the constituted public health authorities of every case of communicable disease under his care, in accordance with the laws, rules and regulations of the health authorities. When an epidemic occurs a physician should not abandon his duty for fear of contracting the disease himself…

…6.6 Human Rights: The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights…

APPENDIX - 1

DECLARATION

At the time of registration, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same:

I solemnly pledge myself to consecrate my life to service of humanity. Even under threat, I will not use my medical knowledge contrary to the laws of Humanity. I will maintain the utmost respect for human life from the time of conception. I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient. I will practise my profession with conscience and dignity. The health of my patient will be my first consideration. I will respect the secrets which are confined in me. I will give to my teachers the respect and gratitude which is their due. I will maintain by all means in my power, the honour and noble traditions of medical profession. I will treat my colleagues with all respect and dignity. I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002. I make these promises solemnly, freely and upon my honour.

APPENDIX - 3

Format for Medical Record

(see regulation 3.1)

Name of the patient:

Age:

Sex:

Address:

Occupation:

Date of 1st visit:

Clinical note (summary) of the case:

Prov: Diagnosis:

Investigations advised with reports:

Diagnosis after investigation:

Advice :

Follow up :

Date: Observations :

Signature in full :

Name of Treating Physician :

Excerpts from people's charter for health

War, violence, conflict and natural disasters

War, violence, conflict and natural disasters devastate communities and destroy human dignity. They have a severe impact on the physical and mental health of their members, especially women and children. Increased arms procurement and an aggressive and corrupt international arms trade undermine social, political and economic stability and the allocation of resources to the social sector.

This Charter calls on people of the world to:

Support campaigns and movements for peace and disarmament.

Support campaigns against aggression, and the research, production, testing and use of weapons of mass destruction and other arms, including all types of landmines.

Support people's initiatives to achieve a just and lasting peace, especially in countries with experiences of civil war and genocide.

Condemn the use of child soldiers, and the abuse and rape, torture and killing of women and children.

Demand the end of occupation as one of the most destructive tools to human dignity.

Oppose the militarisation of humanitarian relief interventions.

Demand the radical transformation of the UN Security Council so that it functions democratically.

Demand that the United Nations and individual states end all kinds of sanctions used as an instrument of aggression which can damage the health of civilian populations.

Encourage independent, people-based initiatives to declare neighbourhoods, communities and cities areas of peace and zones free of weapons.

Support actions and campaigns for the prevention and reduction of aggressive and violent behaviour, especially in men, and the fostering of peaceful coexistence.

Support actions and campaigns for the prevention of natural disasters and the reduction of subsequent human suffering.



Sources

National Women's Panel (Hameed Syeda, Manorama Ruth, George Sheba, Ghose Malini, Naqvi Farah, Thekekara Mari); How Has The Carnage In Gujarat Affected Muslim Women?; A National Women's Panel Investigates; Sponsored By Citizen's Initiative, Ahmedabad; 2002

Oxfam India And Bangalore Initiative For Peace And Relief; Gujarat “Genocide” - 2002 : A Humanitarian Crisis: “Waiting For Peace, Justice And Relief”; Bangalore; 2002

National Human Rights Commission (Verma J.S, Manohar S.V, Dayal Virendra); Proceedings On The Situation In Gujarat - Case No:150/6/2001-2002; New Delhi; 2002

Communalism Combat; Genocide Gujarat 2002; March-April 2002; No 77-78; Sabrang Communications; Mumbai; 2002