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Indian Journal of Medical Sciences, Vol. 63, No. 6, June, 2009, pp. 263-271 Practitioners section Ragging: A public health problem in India Garg Rajesh Surveillance Medical Officer, W.H.O- National Polio Surveillance Project (NPSP), Badaun (U.P) Code Number: ms09049 PMID: 19602763 Abstract Ragging is any disorderly conduct that has the effect of teasing or handling with rudeness any student, which causes or is likely to cause annoyance, harm or to raise fear in a junior so as to adversely affect the psyche of the junior. Ragging is practiced all over the world, with different nomenclature like hazing, fagging; bapteme in French; doop in Dutch; and Mopokaste in Finnish. The first recorded cases of ragging were in the 8 th century BC during the Olympics in Greece. Ragging has been frequently associated with a broad spectrum of physical, behavioral, emotional and social problems among the victims. It independently increases suicide risks. Some of the reasons given by students for ragging are they were also ragged by their seniors; sense of superiority; and introduction. Other factors perpetuating ragging are use of alcohol in hostels and lack of implementation of serious anti-ragging measures by college authorities. Various practical steps to control ragging must include strict role of authorities, ban on alcohol within college and hostels, surprise raids in hostels at night, postings (with accommodation) of wardens in hostels, separate hostels for juniors, presence of college "disciplinary committee" and "cultural committee," strict punishments for those involved in ragging, actions by Medical Council of India (MCI) and University Grants Commission (UGC) against the erring colleges and universities and formulation of anti-ragging laws. Ragging should be declared a public health problem because it involves the physical, mental and social exploitation of not only an individual but also of his/her family and the society as a whole.Keywords: Bullying, cultural committee, disciplinary committee, ragging, reasons, steps Introduction Ragging is a form of abuse of newcomers to educational institutions, wherein some senior students force the unorganized newcomers to undergo several forms of mental, physical and sexual torture. The juniors are usually too frightened to resist this organized group of tormentors. The torture of innocent students often runs for months and involves the same batch of students being physically and mentally abused by the same and/or different group of seniors (including those from the opposite sex) over and over again. Ragging can be thought of in terms of verbal, physical and sexual aggression. A single act may be a combination of more than one of these. [1] Bullying is not only restricted to academic institutions. Workplace bullying is also gaining attention. [2] Ragging is practiced all over the world, with different nomenclature like hazing, fagging, bullying; bapteme in French; doop in Dutch; and Mopokaste in Finnish . [3] The term hazing has apparently been taken from the old American West practice of controlling stock animals. The word hazing was later appropriated in the West for the ridicule and rough jokes forced on newcomers, who were called "greenhorns." [4] As far as the history of ragging is concerned, the first cases of ragging were recorded in the 8 th century BC during the Olympics in Greece. The practice spread fast and menacingly - first to the armed forces and then to the educational institutions. Even though it claimed its first victim, the son of a former civil war general, at Cornell University in US in 1873, it was World War I that injected cruelty into ragging. Students that had gone to war returned to college, grimly determined to use on the campus newly learnt methods of torture . [3] Ragging, An International Phenomenon Ragging or bullying is not limited to a particular country or continent; rather it has been an international phenomenon. Ragging has been highlighted in western literature also (e.g., in Britain, Tom Brown′s Schooldays and Boy by Roald Dahl; and C. S. Lewis′s The Silver Chair). [1] In a comparative, cross-sectional, multilevel study in 35 countries in Europe and North America for the period 2001-2002, it was observed that adolescents from families of low affluence reported higher prevalence of being victims of bullying. Adolescents that attend schools and live in countries where socioeconomic differences are larger are at higher risk of being bullied. [5] Bullying is a substantial problem affecting Canadian children also. [6] In a survey on final year medical students in 6 medical colleges of Pakistan, 52% of respondents reported that they had faced bullying or harassment during their medical education. The overwhelming form of bullying had been verbal abuse (57%), while consultants were the most frequent (46%) perpetrators. [7] A report in 2007 by the Indian anti-ragging group Coalition to Uproot Ragging from Education (CURE) analyzed 64 ragging complaints and found that over 60% of these were related to physical ragging, and 20% were sexual in nature. [1] These facts and figures are nothing but the reflection of a large picture wherein the downtrodden people are always oppressed by the mighty ones, and academic institutions are not an exception to this rule.Ragging in the Indian Context Although so many definitions are given by different authorities regarding ragging, the Hon′ble Supreme Court of India has given a comprehensive definition of ragging: "Ragging is any disorderly conduct, whether by words spoken or written, or by an act which has the effect of teasing, treating or handling with rudeness any student, indulging in rowdy or undisciplined activities which cause or are likely to cause annoyance, hardship or psychological harm or to raise fear or apprehension thereof in a fresher or a junior student and which has the effect of causing or generating a sense of shame or embarrassment so as to adversely affect the psyche of a fresher or a junior student." [8] It is an act of aggression committed by an individual or a group of individuals over another individual or a group of individuals wherein the individual/ individuals of the group first mentioned, by virtue of him/her/their being senior to the individual/ individuals of the group mentioned second, somehow get the authority and audacity to commit the act of aggression; and the latter, by virtue of their being new to the institution, spontaneously become victims. Any interaction which is aggressive and asymmetric (not on equal footing) is ragging . [9] The scum of ragging has not left our literature untouched too. Who can forget the initial description of ragging - a bottle of cold drink and three nude freshers - in the book Five Point Someone by Chetan Bhagat. [10] A search on the internet or in any encyclopedia will reveal limitless other ways that the "raggers" use to satisfy their hungry ego. But if this aggression has become so big that we have started getting the shocking news that a precious human life has been lost due to the menace of ragging, it means that the things are crossing the limits, the water has risen above the nose and we have to act now and control the situation at this moment. The death of a medical student, Aman Kachroo, at medical college, Kangra, Himachal Pradesh, stirred the conscience of the entire nation. It still sends chills in one′s spine whenever the topic of ragging comes up. Now, at present, as a person from the field of public health, I think of ragging not only as a personal issue, an issue related to a particular person, but as a social problem with the questions and answers both lying with the society. Ill Effects of Ragging The ill effects of ragging include all the dimensions - right from the physical injury through beating, hitting by objects or by forcing to perform dangerous tasks to sexual abuse by forced stripping, forced masturbation, forced unnatural sex, etc. The psychological effects include constant fear, loss of concentration, inferiority complex and guilt because of decline in academic performance and feeling of insecurity arising out of financial exploitation. [11] Being a victim or perpetrator of school bullying, the most common type of school violence, has been frequently associated with a broad spectrum of behavioral, emotional and social problems. [12] Results of a prospective study of Korean adolescents showed that bullying independently increased suicide risks. [13] Based on an analysis of a national representative sample comprising of middle school and highschool students in United States (US), it was found that 39% of the students were involved in bullying others and/or were victims of bullies at least three times in the preceding 12 months. Bullies, victims and those who are both are at a significantly higher risk of suffering from self-inflicted, accidental and perpetrated injuries; abusing over-the-counter medications; indulging in hurting animals and people on purpose, using a weapon that could seriously hurt someone; and of being frequently absent from school, as compared with their peers that are not involved in bullying or have rarely participated in it. [14] The ill effects of bullying are not only restricted to the victim alone. The catastrophe of a victim of ragging seems to be limited to that individual and his family; but if we look deep into the skin, then we come across the vast ill effects on the conscience of masses. What about other students that were the batch mates of Aman Kachroo? [15] After the Aman Kachroo episode, the parents who had sent their wards to a professional college for achieving their desired goals are breathing under constant threat regarding the safety of their kids. And this fear is certainly going to hamper the future prospects of the coming generation, the future of our country. There must be some corrective steps to eradicate this evil. But before that, we have to understand the basics associated with ragging, the reasons and the psycho-social factors behind ragging. Reasons Behind Ragging The reasons behind ragging are listed in [Table - 1]. One of the reasons given by students is on the following lines; As they were ragged by their seniors, so it′s their right to rag their juniors. [11] It′s similar to the Indian saas (mother-in-law) who misbehaves with, and insults and tortures, her bahu (daughter-in-law) only because she too was humiliated when she was a bahu of that particular family (Kyunki Saas bhi Kabhi Bahu Thi !!). Another reason is the sense of superiority. The crueler a senior is, more terrified are the juniors. This is just like the typical Bollywood movies where everybody is afraid of "Don" or "Bhai." Introduction is another important reason given by students that favor the practice of ragging. [11] Ragging is justified by these students on the ground that ragging is the only way by which the new students can be taught about the traditions of the institution. Another factor perpetuating ragging is the use of alcohol in hostels. The prevalence of unhindered, nonprohibited flow of liquor (literally !!) in the hostels may be denied by the authorities but it is a naked fact of most of the professional colleges. [16] Under the influence of alcohol, the students in their early ages are swayed away by emotions, and their so-called hidden machismo comes out and they set on their mission to "improve and guide" the juniors and put them on "right paths," as according to them the junior students know nothing about this cruel world. There is a lack of supervision and of implementation of serious anti-ragging measures by many college authorities. Whenever a case of ragging is reported, the first reaction of authorities is to wrap up the things as early as possible as it will hamper the prestige and reputation of the institute. [16] The vacant post of wardens in the hostels is also a major issue. Many a times, the warden is not actually staying in the hostel, particularly during the night, when the ugly demon of ragging raises its head. As far as the outside world is concerned, ragging is not considered a social evil. People consider ragging as simple teasing; dancing, etc., and they don′t know the real extent of ragging in the hostels. Many a times when a ragging incident is reported, as it involves a severe punishment, it generates sympathy towards the senior and leads to compromise and suppression of the case.[11] Steps to Stop the Menace of Ragging So what can we do to solve the problem? Enact a new law? Put the guilty behind bars and suspend them from the college? Yes, this is one of the solutions but not the only solution. One has to think of this in the context of a psycho-social problem. The solution, apart from punishment as deterrence to ragging, must also suggest ways to build up confidence in the relationships of juniors, seniors and the authority. The efforts to fight against ragging must include ongoing programs with elements of primary, secondary and tertiary prevention. These programs should be supported and monitored by a public health policy with a strategy aimed at creating awareness among the entire community about bullying, prohibiting bullying and the importance of developing emotionally and physically safe environments in institutes and workplace settings. Public health policy should mandate the monitoring, detection and reporting of bullying incidents; provide guidance for school intervention; and offer guidelines for medical consultation . [17] Teachers, including administrators, and students can promote or ameliorate bullying and other forms of violence when in the social role of a bystander, i.e. being an active and involved participant rather than a passive witness. [18] An urgent global public health need exists to ascertain the regional prevalence of mortality related to bullying and hazing. [19] [Table - 2] shows various practical steps which can be taken to improve the situation. The first and foremost is the role of authorities. At the start of the session, the students must be addressed personally by the head of the institution about the harms of ragging, ban on ragging, anti-ragging laws and finally in a stern voice that ragging in any form will not be tolerated. [20] The "dress code" and "hair style code" imposed on the juniors by senior students must be curtailed. Alcohol and smoking should be strictly banned within college and hostel premises. Surprise raids by the college authorities in hostels at night will be a strong deterrence in this regard. [11] There should be compulsory postings of wardens in the hostels, with accommodation, so that the warden can stay at the hostels in the night. To ensure this, single and unmarried resident doctors/ lecturers should be encouraged to opt for the post of wardens by giving them special incentives and free accommodation in hostels. Provision of separate hostels for the juniors and newcomers would be a positive step towards prevention of ragging. [21] Entry of senior students should be banned in these hostels. Recording daily evening attendance of the newcomers should be made compulsory. If any newcomer is found in the room of any senior student, particularly in the evening/ night, it should be taken very seriously. A college "disciplinary committee" should be formed of active faculty members. Every year, annual functions, competitions, personality contests, quizzes, plays, etc., should be held regularly to provide the youths a channel to divert their energy and mind on a creative and positive path. As far as the aspect of ′introduction′ and ′tradition′ is concerned, light moments can be shared with juniors at a common place like college cafι, auditorium, mess, etc., in the presence of a junior teacher, like residents/ lecturers. There should be strict punishments for those who are involved in ragging, which may include expulsion or suspension from the university or classes, fine, public apology, withholding scholarships or other benefits, suspension from hostel or mess, etc. If the individuals committing or abetting ragging are not identified or cannot be identified, collective punishment can be awarded to act as deterrent. [22] The Medical Council of India (MCI) and University Grants Commission (UGC) must also act against the colleges and universities, with action against the erring dean/ principal along with de-recognition of that college or university and suspension of grants if college authorities were found unable to curb ragging in campus. In the wake of the recent Aman Kachroo ragging case in Himachal Pradesh, the University Grants Commission (UGC) said that universities and colleges under it will have to implement a strict anti-ragging regulation from the next academic session. [23] This is indeed a step in the right direction. There is an immediate need of an anti-ragging law. Some states have already promulgated anti-ragging law, for example, Kerala, [8] but what we need now is a comprehensive law having applicability across the whole nation enacted by the Parliament of India. The Supreme Court of Sri Lanka decided in April 1998 on the constitutionality of a law that aimed to outlaw and suppress, inter alia, verbal abuse (recognized as ragging, bullying or harassment) within educational institutions. [1] The role of media in the formation of a public opinion on this issue cannot be denied. In the last 57 years, at least 250 cases of deaths have been linked to bullying, as reported in English language newspapers from around the world. The majority (62.3%) of the reports of bullying-related deaths originated in Europe, with most (93%) of them occurring in the United Kingdom. [19] As far as the problem of ragging in India is concerned, it is widespread but under-reported. India′s only registered anti-ragging NGO, Society Against Violence in Education (SAVE), has noted 7 reported ragging deaths in the year 2007 alone; and 31, in the period 2000-2007. [1] Although it seems that the number of ragging cases is very low, yet what we see in media is nothing but an "iceberg phenomenon." Health professionals have the unique responsibility of promoting the development of community initiatives for the prevention of bullying and related health problems. Physicians need to be aware of the physical and psycho-social symptoms associated with ragging so that they can screen the children involved and provide the support needed to develop healthy relationships. [6] Also, ragging, although widely believed to be a major factor for campus violence and suicides in educational institutions in India, it is yet to be recognized as traditional and systematic human rights violation in the field of education; and such human right violations in education have not been given the proper attention they deserve. However, within the United Nations, ragging has been considered an issue of human rights in education, and a 4-A scheme has been advocated whereby governmental human rights obligations to make education available, accessible, acceptable and adaptable have been recognized. [1] These measures may not be able to completely abolish the heinous practice of ragging, but certainly these will act as the harbinger of change in the society. We can′t allow anyone to destroy the dreams and life of the students, who are the future of this country. The definition of health as given by World Health Organization (1948) in the preamble to its constitution is "Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity." [24] In the light of this definition, ragging is a health hazard as it disturbs all the parameters of health of the newcomers. In the present times, the topic of ragging needs more attention from our leaders and intellectuals than in the past as it is disturbing the harmony in the educational institutions and society. Isn′t it the right time to declare ragging as a public health problem because it involves the physical, mental and social exploitation of not only an individual but his/her family and society as a whole? So international health agencies like WHO should consider ragging as a public health hazard and frame guidelines for its prevention and control in collaboration with the governments of the respective countries. Remedial measures as enumerated above and some more novel ideas invited and received from different quarters must be implemented without any delay. The society must come forward to condemn ragging in any form, and the media must spread awareness about the perils of ragging and bring people on a common platform with regard to this issue. [21] Let′s hope that no other Aman Kachroo hits the headlines in future.[26] References
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