COVID-19 has overwhelmed the health system across the globe. Sixty-five Nepali resident doctors in Delhi have been tirelessly treating COVID patients for over a year. The All India Institute of Medical Sciences (AIIMS), the premier medical institute of India, has been reluctant to recognize even our basic human rights. We have dependent families back home in Nepal but are sharing the workload of patient care amidst the raging COVID-19 crisis in India without an honorarium. We are among the frontline warriors in the fight against COVID, whether at the AIIMS COVID Emergency Area, COVID screening area or at the Intensive Care Unit. The immense delay and apathy toward providing financial security to those of us who are working away from our home country, has increased psychological stress over and above the financial crisis. Nearly all of us have been infected with the deadly disease, with a few needing oxygen support, and have had a hard time to recover. We are in India during a crisis, helping India recover, but are not being taken care of, neither by the Indian Health Ministry nor our own institute.
We have come to India for a post-graduate or doctoral level three-year residency training in MD/MCH/MDS/DM in many different specialities and super-specialities at AIIMS. But, because of the raging pandemic, we are bound to care for COVID patients only. This has significantly cut down our training duration. If we were to do the same training in the US or UK or any other premier institute anywhere in the globe, we would have been paid a basic living expense. There are three Institutes of National Importance (INIs) in India where foreign nationals come to complete residency after clearing the INI CET exam (Institute of National Importance Combined Entrance Test). Other two institutes--the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh and the Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER) in Puducherry--pay foreign nationals for the work they do but AIIMS does not.
We are not sponsored by the Government of Nepal which has only issued a no objection certificate to be admitted for training as foreign nationals in India. We write the same entrance exams, pass a common national test same as our Indian counterparts to get enrolled in the same course, purely and entirely based on merit, among hugely competitive seats dedicated to any foreign national across the world. We perform the same type of duty for the same duration as our Indian counterparts. Amid the raging second wave of COVID-19 pandemic, we are in extreme financial and psychological crisis with decreasing physical health but are still tirelessly treating COVID-19 patients round the clock, but are unfortunately being ignored for more than a year.
The Delhi High Court in 2013, had directed AIIMS to start paying its foreign doctors on par with Indian doctors. The court had pointed that when it came to a fundamental right available to even non-citizens, to be paid for the work they do, the terms of the prospectus of AIIMS on non-payment to foreign nationals could not be binding. That judgement was later stayed till an appeal filed by AIIMS is adjudicated. The prime minister's office and the Ministry of External Affairs in 2018 then directed the institute to make necessary amendments and release the due salary of the foreign doctors. However, the AIIMS administration is adamant that they will not pay the foreign nationals working as resident doctors. It is noteworthy that even undergraduate and interns are allowed honorarium for COVID duties whereas AIIMS administration is surprisingly unable to draw a distinction between the duties and responsibilities of a professionally trained doctor undergoing post-graduate training from that of interns. The Health Ministry also asked for the financial implications to which AIIMS administration had responded that it would hardly be IRs 60-70 million per annum (a small fraction of AIIMS annual operating budget). We desire for nothing extravagant but are merely asking that we be paid at least daily living expenses for the work we do, which is a basic human right.
The situation has worsened with the pandemic, and we have been reduced to a point of borrowing money in India during a raging crisis when banks are not operating at full capacity due to prohibitory orders in Nepal. Even Indian PM Narendra Modi’s announcement of insurance policy worth IRs 5 million for the frontline health workers who are treating coronavirus patients does not cover us, as we are foreigners.
COVID-19 has led to unprecedented challenges including difficult duty rosters, travel restrictions, quarantine requirements, isolation stressors and concerns about the spread of the deadly virus back home in Nepal. We have been denied even basic payment against the instructions of Indian PM Modi and the Indian Health Ministry. We, therefore, urge the Nepal government and the Nepali Embassy in India to coordinate with the Indian government to help us get paid.
(Collective plea of Nepali Residents at AIIMS in India)