Five years ago, the government of West Bengal state in India pledged to clamp down on violence against doctors. It promised public hospitals better security equipment, female guards to support female physicians and controlled entry points, according to an internal government memo seen by Reuters. None of these measures had been implemented at the public hospital where a young female doctor was sexually assaulted and killed on Aug. 9, allegedly by a police volunteer, four trainee doctors there told Reuters. Instead, in the days leading up to the homicide-assault, which prompted nationwide outrage and a doctors strike, only two male guards manned R.G. Kar Medical College and Hospital, they said. They were supplemented by a few closed circuit cameras that did not comprehensively cover the sprawling premises, according to the trainees.

One of the doors of the lecture hall where the doctor had been resting during a 36-hour shift when she was attacked had no lock, said two other trainee doctors who had also slept there. The air conditioning in the designated break room had malfunctioned, they said.

After two doctors at a different hospital were assaulted by a patient's relatives in 2019, West Bengal had promised to install "effective security equipment and systems," regulate entry and exit to hospital premises and create a compensation policy for assaulted staff, according to the state health department memo dated June 17, 2019.

The two-page document, which is reported by Reuters for the first time, was prepared after chief minister Mamata Banerjee met that day with trainee doctors protesting the attack on their colleagues as a "record note" of the interaction. The memo did not state to whom it was addressed.

Banerjee had directed officials to take "effective and prompt" action "within a specified timeframe," according to the document. It did not detail the preparation period.

"If those measures had been taken, this incident may never have happened," said Dr Riya Bera, a postgraduate trainee at R.G. Kar, of her colleague's death.

Asked by Reuters about the 2019 assurances, West Bengal Health Secretary N S Nigam said the COVID-19 pandemic had disrupted improvements for two years but "a lot" had been done since 2021, including strengthening CCTV coverage and engaging private security in hospitals.

"We are committed to do the remaining work and fill the gaps that emerged after the R.G. Kar incident," he said.

Banerjee on Aug. 28 also announced that $12 million would be spent to begin work on improvements such as better lighting in health facilities, resting spaces and female security staff.

The chief minister's office, as well as R.G. Kar hospital, did not respond to calls seeking comment.

Authorities continue to investigate the Aug. 9 incident, for which no charges have yet been filed.

'Patriarchal attitudes and biases'

The assault on the doctor in Calcutta, who cannot be named under local laws, recalled memories of the 2012 gang rape of a physiotherapist in a Delhi bus, which convulsed India in anger and triggered protests.

Reuters interviewed 14 female doctors at government hospitals in West Bengal and elsewhere in India about their challenges in a country where women's safety is a long-standing concern.

They described poor working conditions, including aggressive treatment from the families of patients and having to sleep on benches in dimly-lit corridors due to a lack of rest facilities.

Some doctors spoke of napping in break rooms with no locks during lengthy shifts, only to have people barging in. Others described confronting male patients who photographed them without permission, claiming that they were documenting evidence of their treatment.

Indian Medical Association (IMA) President RV Asokan told Reuters that while the Aug. 9 homicide-assault appeared to be unique in its brutality, "the fact that anybody can walk in shows the vulnerability of the place, and this when more and more women are joining the profession."

Some doctors have taken self-defense measures: One doctor at a hospital in Odisha state, which neighbours West Bengal, said her father gave her a knife to ward off potential attackers.

And Dr Gauri Seth, a post graduate trainee at Medical College, Calcutta, told Reuters that after the Aug 9. incident, she would not go on duty again without carrying a pepper spray or scalpel to defend herself.

About 60% of India's doctors are female, and three-quarters of them have described being victims of verbal abuse, physical attacks and other harassment while on duty, according to the IMA, the nation's largest group of physicians.

"Due to ingrained patriarchal attitudes and biases, relatives of patients are more likely to challenge women medical professionals...(they) also face different forms of sexual violence at the workplace," India's Supreme Court wrote in a Aug. 20 ruling ordering the creation of a taskforce on medical workers' safety.

India introduced tough laws governing crimes against women following the 2012 Delhi gang rape, including expanding the definition of rape to include all penetration without consent, as well as criminalizing voyeurism and stalking.

But the situation remains bleak, according to activists and government data.

Almost 450,000 crimes against women were reported in 2022 - the most recent year for which data is available - up 4% on 2021, government data show. More than 7% of the alleged crimes were rape-related.

Lawyer and rights activist Vrinda Grover blamed inadequate training for police investigators and broader cultural issues.

"What is very disturbing in this case is the ordinariness of what the victim was doing: she was in her workplace," she said. "There is something wrong with a society where such conduct is so commonplace."

Living her dream

The 31-year Calcutta physician, whose battered, half-naked body was found by colleagues, had always wanted to be a doctor, family members and friends told Reuters.

"When I bumped into her last year, she told me she was very happy and was living her dream," said Somojit Moulik, who had studied with the victim in medical school.

When Reuters visited the victim's family home, the nameplate bore only her name with the prefix Dr, in an indication of how highly her relatives valued her achievements.

Her aunt said in an interview that her niece had been set to marry a physician she had studied with later this year, and that she had not complained about safety issues at work. But in the wake of her death, colleagues are speaking out. Dr Shreya Shaw, a postgraduate trainee at R.G. Kar hospital, said she found two strangers shaking her awake at around 3 a.m. when she was sleeping in a designated rest room, which did not have locks.

"It was initially quite scary to wake up to unknown men in the dark," she said, adding that she was shocked the patients could enter the floor where she was resting without being stopped.