Rape is a trauma like none other.
The prevalence of rape in India and the failure of the Indian establishment to contain it, are testimony to what Indian women are forced to endure in an aspirational and tech-savvy country that seeks to hold a respectable seat at the international table.
Recent reports in the national Indian press about a paramedic being accused of rape will surprise very few people. The emergency services including the police are often considered part of the problem, either as active perpetrators or ineffective spectators. The issue of sexual violence against women in India gained unprecedented public awareness during the ‘Nirbhaya’ episode, when people held mass vigils to demand ‘justice’, not the least because the rapists had been identified by the police. The victim ultimately died from her wounds and the murder trial took an extraordinary and unacceptable amount of time, despite being ‘fast-tracked’. Elections were fought and potentially won on the slogans of safety and protection of women. However, since then, incidents of rape in India have not shown a substantial decline. The responsibility for this is predictably tossed around on the political stage. The reported rape by a paramedic in India brings the matter close to home for the international family of acute care providers in all domains.
In most countries, there is a societal acknowledgement that the victims should not and cannot be blamed for these heinous crimes. By contrast, in India, there is a complex cultural perspective that arises from the traditional importance of women in the mythology of the majority religion: Hinduism. Despite its uniquely high prevalence, rape is often incorrectly considered to be a self-limiting exception because women are considered worthy of worship in this god-fearing country. Just because many men are righteous, this does not mean that some are not criminal. To punish and control them is a responsibility and a failure to do so is a matter of shame. There is also a systems issue: as in several other countries, there are people in India who opine that the woman invites her rape by going out late at night.
Importantly, healthcare workers are trusted by people and often work late at night under the cover of darkness. These are only two reasons why they have the opportunity both to commit this crime—but also to stop it, as a true medic would.
The legal, statutory and licensing basis of paramedic practice is in its early evolution in India, where a regulatory framework is not fully defined. Training has yet to mature beyond basic life support, where it exists. This provides an opportunity for Indian colleagues and those who support them internationally. The work of safeguarding vulnerable groups can be built into the training of the Indian paramedic rather than added as an afterthought as has perhaps been the case in several countries.
The international community of paramedics can demand that paramedics be trained with a special focus on the safeguarding of women. Indian medics in international meets should be pressed formally and informally to adopt codes of practice such as in the USA to identify any predatory behaviour of colleagues, and there should be a campaign for more severe penalty of people in professions of trust who betray this code. Friends and family members of rapists should be rewarded for reporting them to the police and giving evidence. Finally, the language around rape should change—why not change the description of this crime from the usual phrase, ‘a woman was raped’ to ‘a man committed a rape’, appropriately reassigining responsiblity?