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Journal Article

Citation

Martins RS, Bhatti OA, Mian AI. JAMA Health Forum 2020; 1(10): e201263.

Copyright

(Copyright © 2020, American Medical Association)

DOI

10.1001/jamahealthforum.2020.1263

PMID

36218555

Abstract

On April 6, 2020, health care workers protesting the lack of personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic in Pakistan were thrashed, dragged through the streets, and detained by police in a shocking display of police violence. As increased violence against health care workers erupts across the world amid the pandemic, with more than 265 COVID-19-linked attacks or threats across 61 countries as of June 2020,1 lower middle-income countries, such as Pakistan, face tremendous challenges in addressing this issue. This article highlights violence against health care workers during the COVID-19 pandemic in Pakistan and discusses measures to ensure the safety of health care workers in Pakistan and globally.

In Pakistan and many other countries, the absence of formal reporting systems for incidents of violence against health care workers severely hinders effective intervention.2 Only incidents stark enough to receive media publicity surface into mainstream attention. Peaceful protests by health care workers in Pakistan expressing concerns regarding the lack of PPE and other equipment, inadequate compensation, and limited internet access during the COVID-19 pandemic have been met with force by law enforcement personnel, including baton charges, physical assaults, and arrests. These incidents are similar to those reported in other countries, including Malaysia, Egypt, India, and Brazil, where responses to protests by health care workers have ranged from threats of firing to harassment and arrests.2 To worsen matters in Pakistan, rather than prioritizing health care workers' requests, the federal and provincial governments have actively downplayed or even exacerbated concerns. For instance, a high court ruled against a petition from health care workers requesting government provision of additional PPE,2 while a provincial government reduced health care workers' wages to channel funds to a government COVID-19 fund.

Other incidents in Pakistan have occurred at hospitals, mostly government-owned facilities, where patients' relatives have verbally or physically abused and even shot at physicians and hospital staff, in addition to vandalizing hospital property. Perpetrators are often angered by the lack of sufficient resources to admit or treat patients with COVID-19 or are upset by the death of a family member caused by inadequate care. Patients' relatives have also instigated violence out of anger at hospitals' refusals to hand over the dead bodies of patients before obtaining the results of a COVID-19 diagnostic test, as required by hospital policy based on government directive. These factors instigating violence are comparable to patterns reported in other countries, including Yemen, Afghanistan, and India.

In some cases, violence has arisen from a deep-seated mistrust in health care workers, with some believing COVID-19 to be a hoax. Illiteracy, religious conservatism, and superstition render the general public in Pakistan particularly susceptible to conspiracy theories. One such theory, propagated by a religious leader, claims that physicians were intentionally killing patients for money and blaming COVID-19, while another preacher claimed that COVID-19 was a manifestation of divine wrath over sinful living. Other theories, spread by a renowned political commentator, include COVID-19 being a strategy to target Islamic countries and allow Jews to rule the world, or to inject nanochips into the bodies of Muslims in the guise of a COVID-19 vaccine. A similar incident of violence against health care workers due to belief in conspiracy theories was reported in Afghanistan, where physicians were mobbed by a deceased patient's family who believed that physicians had intentionally killed the patient.

In Pakistan and other countries worldwide, COVID-19-related violence targeted at health care workers has underscored the need for widespread institutional reform to protect the rights and safety of health care workers. Because most reported incidents have arisen from the use of force by law enforcement against protesting health care workers or from mob attacks at hospitals, these areas require special intervention.


Language: en

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