Will the protests against the Delhi gang rape reach rural India?

In the backwaters of India, in rural areas still governed by feudal mindsets, rapes and gang rapes continue with impunity. The candle flame wave being carried through Delhi’s foggy, winter nights is not reaching this India.


On 29 December, I woke up to the news that the ‘survivor’ of a brutal gangrape on a moving bus in Delhi 13 days earlier died. As a woman of Indian origin, who has been in Delhi throughout this period, I felt saddened and ashamed. During the day, as I travelled through the city, I was moved by much of the public response. However, the politicisation of this entire event has been appalling.

On Saturday as India too awoke to the news that the ‘survivor’ had succumbed to the unspeakably macabre injuries inflicted on her by her six rapists, the government promptly began fortifying itself against a backlash. The centre of Delhi became a ghost town. The iconic areas of India Gate, which had seen much of the public protests since the gang rape, and the entire area surrounding India’s Parliament and Rashtrapati Bhavan (the Presidential palace), where the week’s protests had spilled into, were all cordoned off. Officers from Delhi’s police force, on their festive breaks, were recalled to duty. All to contain the public outcry.

The Indian government had previously responded to the public outrage by way of a two minute and 13 second speech by the Prime Minister, Manmohan Singh, eight days after the gruesome incident.  It was too little, too late.

But following the demise of the unnamed victim, the government - in an attempt to correct their tardy and high-handed approach, sprang into damage limitation mode. Sonia Gandhi, India’s most powerful politician, made a televised address to the nation referring to the victim as India’s “own beloved daughter, their cherished sister, a young woman of 23 whose life full of hope, dream and promise was ahead of her”.

Other politicians followed suit in their messages of condolence and condemnation. But in a country where 31% of the polity - 1148 politicians, including Members of Parliament and State Legislative Assemblies - have criminal cases pending against them, their calls to action are nothing short of hypocrisy. Worse, some 641 lawmakers face serious charges like rape, and in the last five years, more than 30 men charged with rape have stood in Indian elections. For the politicians’ promises to have any teeth they must swiftly begin to cleanse their own fraternity. Otherwise, their promises of action are nothing but hollow.

Western media reports have claimed that this incident has "shaken India" and "left a country in a crisis". But which India are they talking about? It is the urban, educated, mostly middle class India that is revealing a visibly scarred conscience. Away from there, in the backwaters of the country, in rural areas still governed by feudal mindsets, off the nation’s radar, rapes and gang rapes continue with impunity. The candle flame wave being carried through Delhi’s foggy, winter nights is not reaching this India. 

Long unaddressed social, cultural and economic issues are the cause of this disconnect. The alleged perpetrators of the Delhi gang rape come from the underbelly of Indian society; from India’s slums - notorious for their poverty and squalor. Their questioning by police has revealed dysfunctional and apathetic childhoods.

Despite the ‘India rising’ story of the last few years, the country retains an entrenched patriarchal mindset, which extends from the home to institutional settings. From the very outset, the socialisation of women in the domestic space is redolent of unabashedly misogynistic practices. Akin to the submissive role Indian Goddesses play to their husbands in popular Hindu mythology, Indian women remain subaltern to their husbands. A city domestic worker’s comments, justifying her husband’s violence towards her, are telling: ‘My husband is good. But if I don’t obey, ofcourse he’ll beat me up. That is nothing unusual."

According to the National Crime Records Bureau’s data for 2011, in 94.2% cases the perpetrator of a rape is known to the victim. This abhorrent statistic evidences reprehensible, familial patriarchal attitudes. Disconcertingly, women themselves sometimes encourage the notion of the inherent superiority of men. This plays out in the importance they ascribe to the raising of their sons as compared to that of their daughters. Mothers giving their sons preferential treatment is common practice.

Sons are viewed as a blessing, daughters a scourge. So the birth of a son is celebrated. He is viewed as an asset: on marriage, he will add to the family’s finances by way of his bride’s dowry. (Dowry, the material wealth gifted to the bride, groom and the groom’s family by the bride’s family– a social practice unarguably demeaning to women, is still widely practiced. This abhorrent practice reduces a woman to a liability to be transferred from father to husband.) Dowry related deaths and female foeticides remain rampant in India.

There is also institutional collusion in the abasement of women. India’s unequivocally sexist rape laws are a case in point. When a rape happens the victim is viewed as a repository of shame, when really the moniker ought to be accorded to the perpetrators. When rape cases come to the fore, the laws are framed so that it is routinely the behaviour of the woman which is scrutinised and pilloried not that of the assailant. Consequently, rather than the laws being a deterrent for the perpetrators, they become a deterrent for the victim to report the case. Unsurprisingly, an FIR (a first hand report made to the police) is filed in only 12% of the cases.

To tackle India’s disgraceful record of crimes against women, we must address these systemic issues. The recent events have provided a rallying call to those who want the country's malfunctioning and indolent judicial system reformed. The public are demanding fast track courts to try those accused of rape. But in a country where there are 12 judges for a million people, any gains in speed of rape cases would come at the cost of other trials. What is needed is a comprehensive reform of the judicial system that sees it being better financed. Currently, a very miniscule percentage of the GDP is spent on the judiciary.

Better and fairer legislation, judicial reform, more female police officers (a dismal 7% of India’s police officers are women) are more immediate measures to tackle the rise in crimes against women. But simultaneously and most crucially, the prevailing medieval attitudes towards women have to be challenged, contested and transformed.

It will be a protracted battle - but it must begin now. A placard at a candlelight vigil in memory of the departed rape victim read: ‘She is not dead, just taken to a place where rapes don’t happen’. But she leaves behind many women in a place where they can, and do, all too often.

A candlelight vigil in Kolkata. Photo: Getty
Christopher Furlong/Getty Images
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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide