- Health-care professionals are under threat of violence worldwide
On 11 December, lawyers attacked the Punjab Institute of Cardiology (PIC) and four patients died on the same day due to the stampede. The second tragic incident initially happened when a lawyer took her mother to PIC, which was then followed by a below-the-belt speech by a PIC doctor. The issue was almost resolved by an apology but later on lawyers attacked PIC doctors, pharmacists and other paramedics in the form of an enraged crowd with clubs and a few firing guns, and even the police could not do anything; actually, the situation went out of control. The lawyers also blocked Jail Road and vandalised public properties. Then both the prestigious communities started abusing each other, particularly on social and other media. Lawyers, the protectors of law, and doctors, the ‘messiahs’ of humanity, started brewing up different conspiracies against each other. Both professionals basically work for the facilitations of humans and protect basic human rights. Mistakes were made by both sides. Black sheep are everywhere. But the second episode of attack was solely done by lawyers. Even the Intensive Care Unit (ICU) and medical equipment was destroyed. Incidents of ‘Wukala Gardi’ especially after Former Chief Justice Iftikhar Chaudhry-cum-Judiciary restoration movement and recent the MTI Act ‘Doctor Gardi’ both have been the parts of Pakistan’s history. Both professionals pass through rigorous hours of work but doctor’s duty hours are more hectic and long. Moreover, patience could postpone the unwanted situation. Condemnations alone will not work but a proactive approach must be adopted by giving exemplary punishments to all the culprits.
Violence in health care institutions is a common problem in the world. The common point of studies on violence against health care workers is that violence in the health field is more than at other work places and it is less taken into account. In each study it is found out that verbal violence is more than physical violence. In the researches, it is found out that the groups who are most subject to violence are emergency workers or nurses. The acts of violence are more in the emergency services during evening and in the first hour of application to the health care facilities. People who use violence are mostly patients or an unnecessary number of relatives of patients. In many countries of the world, policies have been developed to prevent violence in health care institutions and in some countries, those who use violence to health workers are sentenced to prison.
Whatever be the cause of violence, the impact is grievous. If these types of relentless attacks on the health-care profession are left unchecked by the policy-makers, political leaders, regulatory bodies and administrative authorities, then brilliant students will be scared to choose this noble profession
A policy issued by the United Kingdom government for remonstration of physical assault on doctors, concentrates on hostility against incitement and advancement of environment. Sadly, Pakistan’s government hospitals lack a system to manage such challenges seriously. Mostly violence is seen in emergency departments where patients are brought under such serious condition that saving their lives becomes unattainable. This is the main reason why young medical graduates especially girls prefer to practice abroad as they dread fights.
Currently, Pakistan’s rampant population is living in a time of turmoil due to terrible political and economic instability. Unemployment, poverty and political agitation have created anger, frustration and impatience in the common man, resulting in greater risks of crime and violence in the country. Medical employees are immensely being targeted by the violence of patients, especially in government hospitals. In Pakistan, 77 per cent of physicians have faced both verbal and physical abuse, a survey showed recently.
The Pakistan Penal Code includes a provision that the government has a political as well as legal duty to implement. Section 153-A states that: “By words, either spoken or written, or by signs, or by visible representations or otherwise, that promote or incite, or attempt to promote or incite, on grounds of religion, race, place of birth, residence, language, caste or community or any other grounds whatsoever, disharmony or feelings of enmity, hatred or ill-will between different religious, racial, language or regional groups or castes or communities: or commits, or incites any other person to commit, any act which is prejudicial to the maintenance of harmony between different religious, racial, language or regional groups or castes or communities or any groups of persons identifiable as such or on any ground whatsoever, and which disturbs or is likely to disturb public tranquillity, shall be punished with imprisonment for a term which may extend to five years and with fine”.
Violence occurs when the service cannot be steady or when access is limited to operate. Panic and stress created by such conditions can lead to violence against service providers or organisations. Violence may occur when a health care worker tries to set restraints on eating, drinking or when service is refused. District-level hospitals are needed to be provided with all medical facilities. The common problems interfering with the capabilities of basic health units are issues with the salary structure, non-serious behaviour towards posting of doctors and other staff, lack of medicines and equipment.
The American College of Emergency Room Physicians has recommended interventions such as increasing the number of security officers, closed circuit television cameras with 24-hour trained observers, panic buttons, and better control of the entry into the emergency department.
The reality is acts of violence in hospitals continue to be on the rise. Bad things can happen anywhere and administrations or policy-makers can try to get rid of this violence by;
Firstly, establishing a zero-tolerance policy against violence against staff members and visitors,
Secondly, educating and training the staff with provisions of new technologies and not just in the high-risk areas like behavioural health and security but with others too,
Thirdly, making it mandatory for employees to report acts of violence in a non-punitive environment through their internal incident reporting
Fourth, keeping abreast of new strategies and partner with local law enforcement or having a consultant review the worksite and lastly, collaborating and maintaining partnerships with law enforcement agencies.
Whatever be the cause of violence, the impact is grievous. If these types of relentless attacks on the health-care profession are left unchecked by the policy-makers, political leaders, regulatory bodies and administrative authorities, then brilliant students will be scared to choose this noble profession.