The healthcare profession, especially in countries with fragile healthcare systems, is fraught with risks, as was tragically underscored in August 2024, when a young female doctor was raped and murdered at RG Kar Medical College in Kolkata. This horrifying incident ignited nationwide protests, highlighting the multisystemic failures in protecting doctors and other healthcare workers. The Physicians of Indian Origin United for Wellbeing and Safety of Healthcare Workers (PIUWSH), an advocacy group of Indian-origin doctors, which started as a WhatsApp group of extraordinarily motivated doctors sharing the outrage of their community in India, soon emerged as a global voice to push for systemic reforms and advocate for the safety of all healthcare workers, particularly in India.

On August 09, 2024, the resident doctor who is referred to as “Abhaya” to protect her privacy, was working late into the night when she was brutally raped and murdered. This attack, which occurred within the supposedly secure confines of RG Kar Medical College, was a devastating reminder of the vulnerabilities faced by healthcare workers, particularly women, in India. The medical community erupted in anger and frustration; a raw nerve had been hit. The doctors and healthcare workers across West Bengal and India mobilized to demand justice and improved safety measures calling for an overhaul of safety measures in hospitals.

Peaceful protests began in Kolkata, with junior doctors leading strikes and public demonstrations as the senior doctors worked extra to allow their juniors to continue their movement. However, these peaceful protests suffered violence as local mobs, likely hired to sabotage the movement, attacked the demonstrators, vandalized hospital property and destroyed valuable evidence. Despite the overwhelming police presence, law enforcement did little to stop the violence, further angering the medical community and amplifying their calls for action.

The movement quickly became not only about Abhaya but about the broader societal issues. Many from the non-medical community identified the late doctor as a daughter, a sister and came out on the streets in support of the doctors, lending momentum to the movement.

The doctors around the world felt the anguish and were driven to make their support known. A global group of alumni from various medical colleges in India and organizations of physicians of Indian origin united to send correspondences to eleven elected representatives’ offices through official channels as well as in person. Over the next two months, such waves of letters were sent at least two more times. This group later formally organized into PIUWSH.

The horror of the crime and the resilient, unified call for action from the medical community moved the Supreme Court of India to intervene. In addition to firmly doubling down on the need for Abhaya, the Court, acknowledging the widespread national outcry and the growing demand for systemic changes, ordered the formation of a National Task Force (NTF) to investigate the incident and assess the safety measures in Indian hospitals. This task force was responsible for proposing guidelines to improve working conditions and security for healthcare workers.

PIUWSH, while still in its infancy, took the initiative to connect with the leadership of the Indian Medical Association (IMA) and a leading member of the NTF to discuss the most effective way they could aid the national effort. Based on this conversation, the group contributed a comprehensive set of evidence-based recommendations to the NTF​. These recommendations, rooted in a thorough root cause analysis of the RG Kar incident, focused on practical solutions like regulating duty hours to prevent exhaustion and alertness, improving hospital security measures through personnel and infrastructure, and introducing stronger legal protections for healthcare workers including process, outcome and balancing measures.

PIUWSH took it’s the movement beyond the streets of India, hand in hand with the global Indian diaspora. In September 2024, one of PIUWSH’s members met with the Prime Minister of India during his visit to the United States to discuss the concerns of healthcare workers and shared with him a copy of the recommendations composed for the NTF. Other members have met with the Consular Generals in various cities to convey the sentiment of the physicians’ community in the U.S.

Through these diplomatic channels, PIUWSH was able to communicate the demands of the medical community to the highest levels of government. The group’s role as a bridge between healthcare workers in India and the global medical community proved instrumental in pushing for continued focus on the safety and well-being of healthcare professionals.

Media coverage played a crucial role in sustaining public attention on the RG Kar tragedy. PIUWSH, in collaboration with national and international media outlets, helped maintain the spotlight on the incident. Major Indian press and TV news outlets like the Tribune, the Indian express, Times of India, TV9 and international news channels such as BBC worked with members of the group that would later form PIUWSH to draw attention globally towards the developing crisis. Newspapers with international readership, including The New York Times, the Telegraph, the Asian American news and the Indian eye also brought to light the plight of the Indian doctors, the reasons for their fight and why the global community cares deeply about the issue.

PIUWSH utilized platforms like X and Instagram to disseminate information, share updates from the protests in India, and engage with global supporters through hashtags such as #JusticeForDoctors and #Workplacesafety.

PIUWSH and their allies also helped organize and participated in several solidarity events, candlelight vigils and demonstrations in the United States and other countries. In some of the largest demonstrations, PIUWSH members joined the New York City India Day Parade, the Global Citizens’ festival and coordinated gatherings in hundreds of cities with posters  calling for justice for Abhaya and advocating for safety in Indian hospitals. These protests brought global attention to the plight of healthcare workers in India and reinforced the importance of safety reforms.

As PIUWSH continues to advocate for healthcare worker safety in India, the group remains committed to its broader mission of ensuring the safety and well-being of healthcare workers everywhere. The tragic events at RG Kar Medical College exposed the deep vulnerabilities within India’s healthcare system due to socio-cultural, administrative, health communication related, infrastructural and various other causes, but they also highlighted a universal problem faced by healthcare workers to varying degrees, which is hostility within the system and from the community they care for.

The goals of the Indian doctors’ protests will only be met when satisfactory measures for justice for Abhaya are undertaken and commitment towards significant changes in the healthcare system to prevent another such occurrence are not only verbally promised but also credibly executed on the ground. As this article is being written, the doctors in India have already entered the second week of their hunger strike, four already in the ICU. The protests continued for more than two months with periods where the doctors returned to their usual roles, having placed their trust in the justice and governance, but have had to return to the strike as they witnessed very little of what was on paper translated into action. PIUWSH’s immediate goal is to continue to make their peers in India feel supported and heard, and to continue to keep the international spotlight on the atrocity that one of their own suffered.

In the long run, through collaboration with international medical organizations, and advocacy groups, and through continued positive contributions to the members’ alma maters as well as the community of undergraduate and postgraduate medical trainees at large, PIUWSH hopes to gain the trust of their most important stakeholders. This way, hopefully, they can foster a safer, more supportive environment for healthcare workers in India, and in time, beyond India.

(Dr. Avinash Gupta is a New Jersey based Cardiologist, and President of Federation of Indian Associations NY NJ CT NE)