The continuing communal frenzy in India's western Gujarat state has not spared doctors, patients, or for that matter, good Samaritans who rush the injured to hospitals.

A report published in several newspapers about a man who was stabbed by a mob of Hindu fanatics inside a hospital, earlier this month, because he had brought in a stab victim is typical of the situation in the state, say health volunteers.

Such is the prevailing atmosphere of mutual hatred between Hindus and Muslims in Ahmedabad, Gujarat's economic hub, that doctors now need to check the religion of their patients before daring to treat them — for fear of being attacked by fanatics.

For the 100,000 Muslims forced to live in makeshift camps in Ahmedabad following a pogrom unleashed on the community after Feb 27, finding medical care and, for that matter, adequate shelter from the searing 45 degrees Celsius Indian summer and even food has become a daily problem.

According to Dr Abhay Shukla of the Medico Friends Circle (MFC), a voluntary organisation, this is the first time in India's history that doctors are being attacked just attending to patients belonging to another faith.

When MFC released a documentary on the public health situation in Gujarat following the pogrom at a press conference in Mumbai, the nearest metropolis, earlier this month, its team was heckled by hacks with pro-Hindu leanings.

The team was asked why it did not care to visit Kashmir (where 'jihadist' militants are active) or for that matter Godhra in Gujarat, where a train carrying Hindu supporters of a campaign to build a temple on the site of a mosque was firebombed on Feb 27. That incident triggered the anti-Muslim pogrom.

Major public health crisis

Nevertheless, the team warned of a major public health crisis in the makeshift camps that have sprung up without help from the government.

Already, inmates are suffering from ailments such as gastroenteritis on top of the trauma of having been chased out of their burning homes and beaten and raped by the mobs.

The team found many cases of unhealed burn injuries and victims who were prematurely discharged from hospitals, and got poor follow-up thanks to the continuing violence. Cases of chicken-pox, measles, typhoid, jaundice and respiratory diseases and diarrhoea, especially among children are common.

Over two months after violence began in Gujarat, the camps remain overcrowded and lack proper facilities. There is a 48 percent prevalence of malnutrition among children, according to a study carried out by Gujarat's department of health in one camp.

People cannot return home due to insecurity and continuing violence. Most have nothing to return to because their homes have been burned down by supporters of the Vishwa Hindu Parishad (VHP) or World Hindu Council, an affiliate of the ruling Bharatiya Janata Party (BJP).

Jaya Velankar from the Forum for Women's Health based in Mumbai, a and member of the MFC team, said that police have so far registered only three cases of rape, although witnesses are ready to testify to many more that occurred especially in the worst-hit district of Panchmahals.

Gang-raped and abused

Typically, the rampaging mobs took care to leave no proof and burnt to death many of the rape victims. She said many women were gang-raped, assaulted and abused in a heinous fashion and it was clear they were systematically targeted as a community.

Not even a fraction of the aid that poured in for the earthquake in Kutch last year has been available to the victims of what some have described as genocide, she said, adding that any help for the inmates of the camps has come from members of the Muslim community or from religious organisations.

Dr Ritu Priya from the Centre for Social Medicine, Jawaharlal Nehru University in New Delhi, said there are reports of mobs roaming through the wards of hospitals, wearing saffron headbands and threatening patients and staff. The sanctity of the hospital and the medical profession must be protected, she added.

In a situation where there is no respect for hospitals and their humanitarian work or security against continuing violence, it is difficultto talk of rehabilitation measures, said Dr Neha Madiwalla, another team member.

The team came across several women suffering from post-traumatic stress disorder as a result of sexual assault and among children who had witnessed the brutality.

Though the United Nations' Children's Fund (Unicef) is carrying out a mental health programme, it is nowhere near the scale required. Unicef screened 723 children for signs of mental trauma and found 239 children in need of counselling while another 12 needed psychiatric care.

Food shortage

Many women are pregnant or had delivered in the camps, and volunteers said it was difficult for them to be cared for. There is a shortage of nutritional food for mothers or newborn babies.

Women also suffered from several hygiene-related infections and also the mental trauma that follows sexual assault or the witnessing such assaults. Several of the women living in the camps arrived there naked and with burn injuries.

Doctors have generally disregarded obvious and hidden signs of sexual assault and it is doubtful if any medical evidence is available for rape cases, the team felt. In fact, there is no woman doctor attending to them.

A team of 88 doctors has to cope with the 70-odd camps in Ahmedabad alone and visits are done on a weekly basis, which is inadequate.

Though officials deny any outbreak of diseases within the camps, the MFC team found six people to have died of typhoid. Heat, poor sanitation, inadequate provision of drinking water and bathing facilities are adding to the misery of the victims.

Polarisation

Meantime, there has been a complete polarisation of the medical community in Gujarat. Warnings have been issued to Hindu doctors to avoid Muslims areas and eight doctors have been attacked so far for attending to members of the minority community.

While a few doctors remain undaunted and are carrying on with their tasks despite the risk, there are almost none who dare take a publicposition on these issues. Medical professional organisations have stopped inviting Muslim doctors for their meetings in places like Godhra, for instance.

This systematic pressure in segregating treatment of victims can eventually lead to the setting up of separate hospitals for members of different communities, team members warned.

There have been calls by the MFC and other organisations for the cancellation of the registration of doctors who are members of the groups like the Vishwa Hindu Parishad (VHP), and especially those who had actually participated in the pogrom and even led them.

Even on the medico-legal front there were several lapses. About 70 people had died in Ahmedabad civil hospital alone, but no dying declarations were taken from any of them. Also bodies were not kept for the mandatory 72 hours, but were disposed of in a few hours.

Thus, the government's intention of disbanding the camps must be resisted simply because the inmates are still safer in them than anywhere else, the team members said.