Poor logistics, lack of protocol during VIP convoy duties leave T.N. government doctors in the lurch

Tasked with ensuring medical readiness during VIP and VVIP convoy movements and camp duties at mega events or mass gatherings, government doctors in Tamil Nadu often find themselves struggling with logistical shortcomings. Inadequate arrangements, especially the lack of suitable vehicle facilities, proper accommodation for night stays, and poor coordination have made these mandated duties arduous.

Convoy duty for doctors involves providing emergency medical support for VIP movements, including for Presidents, Prime Ministers, Governors and Chief Ministers. Doctors, often specialists, are assigned to follow the motorcade in ambulances or official vehicles, to render assistance if a medical emergency were to arise. Teams from government medical college hospitals in Tamil Nadu are deployed on convoy duty, and their tasks involve, among other things, providing resuscitation and airway, breathing and circulation (ABC) management. Two doctors (with one preferably an anaesthetist), a staff nurse and nursing assistant are part of the team.

No accommodation for the night

In one recent instance of being assigned to convoy duty, the medical team, including specialists, had to sleep on the floor after scrambling for sheets, as no proper arrangements were made for their night stay, said A. Ramalingam, secretary of Service Doctors and Post Graduates Association.

“Doctors are assigned to VIP/VVIP/political leaders’ convoy duties on a rotational basis. Usually, the medical team includes an anaesthetist, a physician/surgeon, and when required, specialists such as cardiologists, are deployed. We have no issues being deployed on convoy duty but basic facilities are often lacking. We can order food online if it is not provided, but essential amenities, particularly proper accommodation for night stays, are indispensable. The last time I was assigned to convoy duty, it turned out to be one of the worst experiences as basic facilities were not in place,” a doctor said on condition of anonymity.

Lack of proper vehicles

A major concern is the type of vehicles provided. “The medical team has to travel with the VIP convoy in 108 ambulances, which goes against a 2018 order mandating at least a multi-utility vehicle for convoy duties. This directive is simply not being implemented,” Dr. Ramalingam said. The 2018 order issued by the Directorate of Medical Education noted repeated representations about the use of very old vehicles for doctors assigned on VIP convoy duty, and the fact that they were unable to keep pace with VIP convoys. As it relates to the safety of doctors, the directorate instructed deans of medical college hospitals to arrange multi-utility vehicles, even on a rental basis, without fail.

Another doctor, who has experience with convoy duty, said it was often impossible to keep up with the convoy. “Ambulances can travel only at a certain speed, so we usually reach destinations five to 10 minutes after the convoy,” he said. He also pointed out that when VIPs from the Centre are accompanied by their own medical teams, there is little to no coordination.

No coordination, no protocol

Camp duty at mass gatherings such as government functions and festivals is no better, doctors claim. “Often, duty timings are unclear and it takes long hours. There is no coordination among the police, revenue and health departments, nor is there a standard protocol. Recently, on duty, our team spent over 12 hours at a particular venue from 8 a.m. due to the lack of communication about revised VIP arrival timings. Women staff, in particular, face hardships. These duties also affect routine patient care,” another doctor said.

Dr. Ramalingam suggested that instead of deploying medical college hospital staff, the Health Department should consider forming dedicated mobile medical teams for convoy and camp duties.