Why attack hospitals?

During the manifestations against a new ‘loi du travail’ that the government was seeking to introduce in France, some ‘casseurs’ present among the crowd on June 14 attacked the Hôpital Necker in Paris.

They directed their fury on 14 bay windows that open on the Rue de Montparnasse which were situated next to operation theatres where operations were going on. The damage done is estimated at 200,000 euros, according to the article in the French magazine Le Point of June 16.

Attacks on hospitals and hospital staff, especially doctors, are nothing new. They ought to be absolutely condemned in the most vehement terms possible, and particularly so by the political establishment at the helm. This is not always the case, but for a change both sides of the political divide in France have done so following the attack on Necker. If only this example could be followed each time a health care facility is the target of fury by anyone, and exemplary punishment meted out by the justice system of the country concerned, it would no doubt dissuade any future attempts by miscreants, and provide reassurance to patients that their safety will be protected, and to the attending staff that disturbance in the vital work they are carrying out will not be tolerated.

Some time back there was an aerial attack by terrorists on a hospital in Afghanistan run by the NGO ‘Médecins Sans Frontières’. Extensive damage was caused to the infrastructure, and the death of several patients was reported. Reports that have come out about the state of health and medical conditions in Afghanistan make for heart-rending reading, especially to medical/health professionals, and the worsening of the situation by such unwarranted assaults is indeed a matter of even great concern.

In Syria too there was an attack on a hospital, this time causing the death of the single paediatrician – besides other damage — who was giving dedicated care there under already difficult circumstances. The incident was ascribed to American forces, a ‘collateral damage’ and unintended according to official sources, but who knows. Either way, wherever such dastardly attacks take place, causing physical destruction and interrupting the work of those who are already desperately trying to save lives under severe resource constraints, it is the duty of leaders and of civil society to come forward and send the necessary strong signals so as to prevent further attacks.

In Mauritius too our hospitals and health centres are not immune to violence, directed against doctors and nurses, of which several examples will come to the mind of the public. The most notorious one involved, many years ago, the champion weight-lifter Sabapathy, who physically assaulted the doctor on duty at the Casualty in Candos.

In fact the Casualty in hospitals is more often the site of violence, despite the presence of policemen posted there since many years now. Doctors and nursing staff have complained any number of times about the inadequacy of this arrangement, citing cases when the police officer posted there was either unavailable or came by after the incident would be over. The question we have to ask ourselves as a people is: are we such savages that we cannot behave ourselves when we come to seek help for our lives, and we dare attack the very people from whom we are expecting to get that help? We do not have any shame, not even a little amour-propre.

There are several reasons for the unruly behaviour of some têtes brûlées, and those of them who are politically connected feel that they can act with impunity. There was the case of a drug addict who happened also to be a political agent, and he would come in the middle of the night to the Casualty and demand his dose of pethidine, armed with a cutter. This happened several times, and the matter was reported to the authorities, but no action was ever taken against him. But the doctor was transferred!

There are also patients who want to jump the queue, and will make a hullaballoo about it when they are reminded that others have been waiting before them. This happens both in the Casualty and OPDs (outpatient clinics for cases to be seen on appointment). In the Casualty the major issue is that a sizeable percentage of patients could have been seen in their local health centres, but prefer to come to hospital. There are reasons too for this preference. I will cite only one here, namely that patients believe that they get better treatment in hospitals, which is not quite true.

Nevertheless, the result is that the Casualty is, therefore, overcrowded with many non-emergency cases. Besides the overcrowding, this also reduces the time the doctor could more usefully give to a more deserving patient. And it is the experience of many doctors that the most undeserving ones are often those that make the most noise. On the other hand, talk to doctors at the health centers, and they will tell you that there also they are overwhelmed by the sheer numbers of attendees.

We are a very sick nation.

There are ways to prevent physical violence taking place in hospitals under normal civilian conditions, that is when a country is at peace and is functioning under the rule of law, ‘normally’. Many years ago, around the time of the Sabapathy incident if my memory serves me right, there was an article in a British medical journal, The Practitioner, on this very topic, and contained some practical suggestions. A doctor’s association made a copy of the article and sent it to the Ministry of Health, offering to discuss the issue and find a solution. There was not so much as an acknowledgement from the ministry, which just goes to show…

Nonetheless, despite and under the most trying of circumstances, including the constant threats present in conflict or war zones, doctors continue to perform their bounden duty to save lives and relieve suffering. Medicine and its allied professions are still noble occupations, and those who attack its practitioners are most vile and ignominious. It is a reflection of their insensitivity and inhumanity to their fellow human beings, de surcroît those who are in distress, and the least that can be said is that they are beasts in human garb. Shame on them.

* Published in print edition on 24 June 2016