Covid-19 : Healthcare crisis & workers safety

(Dr. Sada Hussain Channa, )

'First do no harm' (Primum non nocere) is a fundamental principle of bioethics that all medical students and trainees are taught throughout the world. But what they learn proves insufficient to protect them on the contrary circumstances, When harm is inflicted upon them.

Amid pandemic, Doctors, Nurses and paramedics battling COVID-19 have tested positive while treating patients due to unacceptable shortages in critical protective equipment that can stop them from being infected.

It's not just the risk of pandemic infection but over the lockdown chilling stories of assaults and insult, harassment and halt on health-care workers, have been reported throughout country.

Just on last Friday night, a mob of at least 70 people vandalized Civil Hospital Karachi, post to demise of a COVID-19 infected patient. They harassed, abused and tortured, doctors and medical staff on duty. It's consecuent third incident in a week.

Recently, doctors at JPMC Karachi were attacked and brutally beaten after patients died of COVID-19 in two different cases just because authorities didn't immediately handed over the deceased body to the heirs. Doctors end with protest and demand for security as usual, to continue their services.

Earlier, clash of Doctors and police in Quetta is unforgettable tragedy ; Police baton charged and arrested many. Violence and humiliation to doctors by authorities and policemen are completely unmindful of the many risks health-care workers take on, merely doing their work in a pandemic situation such as this.

Visuals beamed in of angry policemen at roadside checkpoints of Larkana near Chandka hospital refusing to allow duty doctors and allied healthcare workers to reach hospitals. Their disrespect to noble professionals is traumatic. It happened right after the day doctors being saluted by police squad.

Though medical staff are being honored for someday but very next day the table is turned to be tortured. It's like being chief of Pelegostos tribe of remote Caribbean island -- who is prayed and worshipped, only later to be sacrificed.

Health-care workers as heroes who must be protected. If health protectors are looked upon as the enemy, it only allows the true foe — the disease — to gather strength resulting collapse of health system. Doctors are working under a great duress. The responsibility of restoring order whether with personal protective equipment, or against attacks from the public ultimately rests with the hospital admin and government, also in equal measure, the civil society including media. They must run awareness campaigns for sensitizing the masses to support frontline workers.

The Department of Health Services must issue rules aimed at protecting doctors, nurses, and paramedics against such threats by allowing providers to deny health care to certain patients: when doctors are subjected to harass and abusive treatment. And when a doctor lack essential protective gears to cope with infectious diseases, or when providing the requested treatment would otherwise violate one’s duties as a physician, such as the Hippocratic mandate to “first do no harm.”

The government must ensure the safety and protection of healthcare workers. As deterrent for attacks on, and harassment of medical staff, harsher punishment and its strict enforcement should serve.
• Criminalize attacks on healthcare personnel, including doctors, nurses, paramedics.
• Make them a non-baillable offense.
• The guilty can be sent to jail for 3 months to 5 years, with a fine of Rs 50,000 to Rs 2 lakh.
• If there is grievous injury, the guilty could be sent to jail for 6 months to 7 years and fined Rs 1 lakh to Rs 5 lakh.
• Filming of duty doctors, lady doctors, nurses and duty staff in hospital in name of social work or so called journalism and putting it on social media must be banned and violator should be charged with cyber crime act and criminal act as facts and views are molded to cause chaos.

The safety of front line warriors battling with deadly disease is paramount. Pakistan's shortage in healthcare manpower already places a heavy burden on the existing workforce. The pandemic has compounded this burden many times over. If it ends up seeing the infection spread and hospitalization numbers projected for it, that will need every healthcare hand available. The government must look at a more permanent way to protect healthcare workers so that, the battle against the disease could truly be won.

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