‘Most medics faced violence over Covid-19’

Nearly half of all healthcare workers in three major cities of the country have faced some form of violence, either physical or verbal while tackling the novel coronavirus, leading to an erosion of trust between patients and medics.

This was claimed in a study conducted by the APPNA Institute of Public Health at the Jinnah Sindh Medical University in Karachi, University of Lahore and Khyber Medical University with the support from the International Committee of the Red Cross (ICRC). The study surveyed 356 health-care workers, including, doctors, paramedics and laboratory technicians, from 24 health-care facilities in Lahore, Karachi, and Peshawar. "There is an erosion of trust between patients and healthcare workers in Pakistan," said Dr Mirwais Khan, who heads the Health Care in Danger (HCiD) initiative of the ICRC. "We needed to see if Covid-19 was making it worse."

Conducted in May and June, at the peak of the first wave of the novel coronavirus (Covid19) in the country, the study showed that 41.9% of participants had experienced some form of violence during their Covid-19 response. At least six per cent reported physical assault. A third of those interviewed reported being falsely accused of causing injury or death to patients. The study defined acts of violence to include verbal and physical assault, as well as stigma and ostracization from patients, their families. A medical registrar at a hospital in Karachi said it was "demoralizing" to face a "barrage of insults" while on duty. Reasons that led to violence in hospitals included demands of attendants to hand over bodies immediately and not to mention Covid-19 as the cause of death.

"They [attendants] wanted to take the body immediately as they feared their community would otherwise not attend the funeral of the deceased," said a health practitioner from Peshawar. Issues related to patient care included the irresponsible behaviour of people and gaps in quality of care. Specific reasons included resistance to comply with the extremely strict access granted to patients and the infection prevention and control protocols at hospitals, confusion regarding treatment protocols, and lack of periodic updates on patients' condition due to high patient load. A significant proportion of health-care workers remained super-alert, felt stressed and disturbed and felt scared and threatened.

The experience of violence had a profound psychosocial impact on the frontline health-care workers, with a very high proportion of healthcare workers reporting feeling stressed, threatened, and scared, the study found. The study suggested building trust between healthcare workers and the public, dispelling myths and misinformation, enhancing institutional practices to address issues related to patient care, and improving the response to any untoward incident by enhancing security