Sir, – I would like to reply to Prof Eoin O’Brien’s Opinion piece (November 29th).
The February 2011 unrest led to the arrest of tens of Bahraini healthcare workers, their detention and alleged mistreatment for months.
The turbulence of this period has led to the emergence of two overarching narratives of the role of medical personnel in the unrest.
It is insufficient and inaccurate to report and accept only one narrative without analysing the second (a record of unethical medical misconduct and breaches of neutrality and impartiality in the treatment of patients) as this conceals the real tragedy of the healthcare situation in Bahrain today wherein once amicable colleagues in the profession are divided, non-trusting and discredited in the larger community.
Sadly, the findings of the UN-styled Bahrain Independent Commission of Inquiry (BICI) were unreported in their entirety by Prof O’Brien. The BICI report concluded that healthcare workers at the Salmaniya Medical Complex (SMC) breached multiple medical, ethical and moral codes in a manner that can, only in the very lightest of terms, be described as professional misconduct (Conclusions Findings; Chapter V (C), Paragraphs 828-847: 1. “. . . among the medical personnel . . . some had political ties with the opposition and pursued a political agenda. Among them were some who were seen leading demonstrations and chants against the regime both outside and inside SMC. These persons moved in and out of their roles as political activists and medical personnel, the latter being expected to carry out their professional, ethical and legal duties and responsibilities” (paragraph 834). 2. “The commission considers that the involvement of some doctors and medical personnel in various political activities on and around the SMC premises was clearly difficult to reconcile with the full exercise of their medical responsibilities and highly disruptive to the optimum operation of an important medical facility in a time of crisis” (paragraph 847). 3. “. . . some of the medical personnel controlled the Emergency Section, the Intensive Care Unit (ICU) and most of SMC’s ground level” (paragraph 833 847). 4. “The Commission finds that the occupation and control of the area by protesters [led by medical personnel] hampered general access to the hospital and created a perception of an unsecure environment for those requiring medical care” (paragraph 847). 5. “. . .the manner in which some of the doctors treated some injured expatriate persons [first attacked by protesters in different locations in the city and that they were also assaulted by the protesters in front of the Emergency Section . . . thought to be part of the security forces] rises to a level of human insensitivity and professional disregard for medical ethics” (paragraph 838).
Medical personnel in the SMC allowed their personal beliefs to become entangled with their healthcare provision. In doing so (whether inadvertently or otherwise), patient care, at times, was not their first concern. Daily politicised protesting imposed the beliefs of medical personnel on their patients causing distress and alienation as a result of inappropriate and insensitive expression of religious beliefs and political views. Medical neutrality was jeopardised to the extent that the healthcare provided, both inside and outside the hospital, was seriously disrupted until March 16th, 2011. To ignore these violations in serving a political message is irresponsible. – Yours, etc,