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Unfortunately, we found Richard Sollom and Vince Iacopino's account of the medical situation in the Kingdom of Bahrain during the period of unrest very one sided.
The Government of Bahrain is fully committed to the policy of "all residents in the country enjoy the right to access comprehensive health care". Figure 1 shows some health indicators from 1995 until 2009. The ethics of medicine demand the fulfilment of humanitarian goals irrespective of any social, political or religious agendas.
Primary health care is the cornerstone of health care available in the Kingdom of Bahrain. There are 23 health centers in Bahrain distributed all over the country. Secondary and tertiary care is provided solely by Salmaniya Medical Complex (SMC), the main governmental hospital in Bahrain.
Here are some facts about what happened in Bahrain during the period of unrest.
The photos show the exploitation of the largest hospital in the Kingdom by the protesters and medical personnel and its occupation for more than a month. The hospital was used for political demonstrations, seminars, and microphones were used (Photos 1, 2 and 3). All took place in front of the entrance of Accident and Emergency department, obstetric emergencies, cardiac units and Oncology Department, which prevented access of patients to the hospital and delayed their treatment. Unfortunately, and with the blessing and facilitation of a number of doctors and staff, correspondents and news agencies were allowed into the hospital at all times and in all places even in the operating rooms breaching the international law of safety and hygiene and patient confidentiality1.
Protestors occupied the parking lot in front of the emergency department to demonstrate and launch political slogans demanding to bring down the regime. Tents were set up for lectures, press conferences, political seminars, and ceremonies, as well as demonstrations in the corridors of the hospital by medical staff, as documented in the photos and video (Photos 4 and 5) 2,3.
Treatment was denied based on ethnicity and religion. Patients with chronic illnesses and serious conditions such as oncology cases and patients requiring kidney dialysis were refused to be treated by some doctors on a sectarian basis.
Ambulances denied treatment on a sectarian basis There was also a documented and proved lack of response of ambulances to emergency calls intentionally to some patients on a sectarian basis. Only Shei'a patients were treated, whereas Sunni and expatriate patients were turned down. This has resulted in two deaths and many complications for many patients. One of which was a teenage girl known to have type 1 DM on insulin therapy diagnosed with hypoglycemia but the ambulance refused to transport her because of her ethnicity. Sadly this resulted in her death. This case is document in Ministry of Health Records.
There are a lot of injuries and number of deaths that have occurred among security men and some citizens and non-citizens by the protestors, but that group of physicians refused to treat them, purely because of their ethnicity. Those patients had to be transferred to Bahrain Defense Hospital to receive treatment.
Fabricating stories Some doctors disseminated news through certain channels like Al Alam, Al Manar and PresTV (extremist Shea'i channels) and forums, claiming that a group of children were attacked by the army, which turned out to be false and fabricated news. This has been discredited by the parents of the children live on Bahrain TV channel 4. When the truth was revealed on Air, the doctor involved in this fabricating news came live on the same TV show admitting that he fabricated the story to mislead the international media and generate political pressure on the government5
Nerve gas claim and use of Moxal In a television interview with Dr. Nabil Ansari, Consultant Emergency, he pointed out the disappearance of more than 500 vials of the drug atropine, which was used by protestors with the help of some doctors and nurses, to mimic signs of exposure to nerve gas. The inhalation of nerve gas is known to lead to mortality in large numbers but this did not happen. There were no records of deaths resulting from the inhalation of gases. The medical staff used the anti-acid (Moxal) to increase the frenzy of protestors by smearing their bodies with the purpose of excitement through the media, as clearly shown in photo 6.
Some expatriate workers were attacked by protestors because of their religion and nationality. Furthermore, they were assaulted by protesters, and some doctors and nurses gathering outside the emergency entrance. They were pushed out of the ambulance by paramedics who hand cuffed them and kicked them while they were bleeding profusely6. Their treatment was refused by some healthcare staff, who considered them prisoners of war, resulting in some deaths.
Reports from Amnesty International, Human Rights Watch and Physicians without Borders, unfortunately ignored all the above information and evidences. They ignored the injured and victims who were attacked by the protesters and focused on the demonstrators themselves. Mr. Sollom ignored the deaths due to medical neglect and denial of treatment. He did not investigate all of the above and produced a one sided report based on false information and narratives but no truthful evidences.
Presence of the army After all that has been mentioned, it was necessary to take a step to restore safety and security to the only governmental hospital in the kingdom of Bahrain. The army's presence within the hospital was primarily intended to protect the hospital, which was under the control of the protesters who prevented the arrival of many patients to emergency and clinics for treatment, fearing for their lives by these protestors or ill-treatment of some hospital staff. Those patients have complained to the Complaint Department in the Ministry of Health because of ill-treatment and neglect of some doctors who were treating patients based on their race and ethnicity. Ambulances were retrieved after being kidnapped by protestors and used to transport weapons. The Acting Minister of Health Dr Al Balooshi revealed the ministry's intention to appoint a private company for running security in the hospital. Lately, the National Safety Law ended on 2nd of June after which there is no presence of the army next to or around the hospital. And since the evacuation of protesters from the hospital, its doors are open to all and there is nothing to prevent the entry of patients from any ethnicity, race and nationality.
Are doctors, nurses and medical staff above the law? The minister of justice pointed out that the number of medical staff defendants who have been interrogated amounted to 47 defendants so far, including 24 doctors and 23 nurses and paramedics. The reasons why these doctors and nurses are detained are criminal causes as the investigations revealed and anyone who has not been proven guilty has been released. Forces did not abduct a surgeon operating in the operation room. The only doctor who was arrested from the operating room, was not performing any operations, however, used the theater as a hide out. Additionally, any nurses or doctors who were performing their humanitarian duty during the unrest period have not been arrested. The most pressing question is, if those doctors were proved guilty of obscuring treatment to a sector of patients resulting in fatalities, should they face a lawsuit or even jail, or should they left to continue as normal?
The biased involvement of some doctors, nurses, and allied health professionals, in recent political events in Bahrain has unfortunately tainted the white fabric of the Bahraini medical community and pitted the country into the darkest era of its medical history. These healthcare professionals have not gone missing as alleged by the media that are looking to sensationalize the story. Despite the crimes these medical professionals have been accused of, the Bahrain Medical Society feels responsible to ensure that these doctors, nurses and paramedics receive a fair trial.
Figure 1 Comparison of some health indicators in Bahrain (Health statistics, 2009)
Photos 1, 2 and 3: Doctors, nurses and other health personnel protesting with political slogans and banners in front of Accident and Emergency entrance.
Photo 4: Health personnel, including doctors, used the parking area to launch political speeches every night during the unrest period in front of A/E department.
Photo 5: Doctor holding the Quran to bless the protestors in case of Martyrdom at Salmaniya Hospital
The truth about the medical situation in Bahrain: Are doctors above the law?
Unfortunately, we found Richard Sollom and Vince Iacopino's account of the medical situation in the Kingdom of Bahrain during the period of unrest very one sided.
The Government of Bahrain is fully committed to the policy of "all residents in the country enjoy the right to access comprehensive health care". Figure 1 shows some health indicators from 1995 until 2009. The ethics of medicine demand the fulfilment of humanitarian goals irrespective of any social, political or religious agendas.
Primary health care is the cornerstone of health care available in the Kingdom of Bahrain. There are 23 health centers in Bahrain distributed all over the country. Secondary and tertiary care is provided solely by Salmaniya Medical Complex (SMC), the main governmental hospital in Bahrain.
Here are some facts about what happened in Bahrain during the period of unrest.
The photos show the exploitation of the largest hospital in the Kingdom by the protesters and medical personnel and its occupation for more than a month. The hospital was used for political demonstrations, seminars, and microphones were used (Photos 1, 2 and 3). All took place in front of the entrance of Accident and Emergency department, obstetric emergencies, cardiac units and Oncology Department, which prevented access of patients to the hospital and delayed their treatment. Unfortunately, and with the blessing and facilitation of a number of doctors and staff, correspondents and news agencies were allowed into the hospital at all times and in all places even in the operating rooms breaching the international law of safety and hygiene and patient confidentiality1.
Protestors occupied the parking lot in front of the emergency department to demonstrate and launch political slogans demanding to bring down the regime. Tents were set up for lectures, press conferences, political seminars, and ceremonies, as well as demonstrations in the corridors of the hospital by medical staff, as documented in the photos and video (Photos 4 and 5) 2,3.
Treatment was denied based on ethnicity and religion. Patients with chronic illnesses and serious conditions such as oncology cases and patients requiring kidney dialysis were refused to be treated by some doctors on a sectarian basis.
Ambulances denied treatment on a sectarian basis There was also a documented and proved lack of response of ambulances to emergency calls intentionally to some patients on a sectarian basis. Only Shei'a patients were treated, whereas Sunni and expatriate patients were turned down. This has resulted in two deaths and many complications for many patients. One of which was a teenage girl known to have type 1 DM on insulin therapy diagnosed with hypoglycemia but the ambulance refused to transport her because of her ethnicity. Sadly this resulted in her death. This case is document in Ministry of Health Records.
There are a lot of injuries and number of deaths that have occurred among security men and some citizens and non-citizens by the protestors, but that group of physicians refused to treat them, purely because of their ethnicity. Those patients had to be transferred to Bahrain Defense Hospital to receive treatment.
Fabricating stories
Some doctors disseminated news through certain channels like Al Alam, Al Manar and PresTV (extremist Shea'i channels) and forums, claiming that a group of children were attacked by the army, which turned out to be false and fabricated news. This has been discredited by the parents of the children live on Bahrain TV channel 4. When the truth was revealed on Air, the doctor involved in this fabricating news came live on the same TV show admitting that he fabricated the story to mislead the international media and generate political pressure on the government5
Nerve gas claim and use of Moxal
In a television interview with Dr. Nabil Ansari, Consultant Emergency, he pointed out the disappearance of more than 500 vials of the drug atropine, which was used by protestors with the help of some doctors and nurses, to mimic signs of exposure to nerve gas. The inhalation of nerve gas is known to lead to mortality in large numbers but this did not happen. There were no records of deaths resulting from the inhalation of gases. The medical staff used the anti-acid (Moxal) to increase the frenzy of protestors by smearing their bodies with the purpose of excitement through the media, as clearly shown in photo 6.
Some expatriate workers were attacked by protestors because of their religion and nationality. Furthermore, they were assaulted by protesters, and some doctors and nurses gathering outside the emergency entrance. They were pushed out of the ambulance by paramedics who hand cuffed them and kicked them while they were bleeding profusely6. Their treatment was refused by some healthcare staff, who considered them prisoners of war, resulting in some deaths.
Reports from Amnesty International, Human Rights Watch and Physicians without Borders, unfortunately ignored all the above information and evidences. They ignored the injured and victims who were attacked by the protesters and focused on the demonstrators themselves. Mr. Sollom ignored the deaths due to medical neglect and denial of treatment. He did not investigate all of the above and produced a one sided report based on false information and narratives but no truthful evidences.
Presence of the army
After all that has been mentioned, it was necessary to take a step to restore safety and security to the only governmental hospital in the kingdom of Bahrain. The army's presence within the hospital was primarily intended to protect the hospital, which was under the control of the protesters who prevented the arrival of many patients to emergency and clinics for treatment, fearing for their lives by these protestors or ill-treatment of some hospital staff. Those patients have complained to the Complaint Department in the Ministry of Health because of ill-treatment and neglect of some doctors who were treating patients based on their race and ethnicity. Ambulances were retrieved after being kidnapped by protestors and used to transport weapons. The Acting Minister of Health Dr Al Balooshi revealed the ministry's intention to appoint a private company for running security in the hospital. Lately, the National Safety Law ended on 2nd of June after which there is no presence of the army next to or around the hospital. And since the evacuation of protesters from the hospital, its doors are open to all and there is nothing to prevent the entry of patients from any ethnicity, race and nationality.
Are doctors, nurses and medical staff above the law?
The minister of justice pointed out that the number of medical staff defendants who have been interrogated amounted to 47 defendants so far, including 24 doctors and 23 nurses and paramedics. The reasons why these doctors and nurses are detained are criminal causes as the investigations revealed and anyone who has not been proven guilty has been released. Forces did not abduct a surgeon operating in the operation room. The only doctor who was arrested from the operating room, was not performing any operations, however, used the theater as a hide out. Additionally, any nurses or doctors who were performing their humanitarian duty during the unrest period have not been arrested. The most pressing question is, if those doctors were proved guilty of obscuring treatment to a sector of patients resulting in fatalities, should they face a lawsuit or even jail, or should they left to continue as normal?
The biased involvement of some doctors, nurses, and allied health professionals, in recent political events in Bahrain has unfortunately tainted the white fabric of the Bahraini medical community and pitted the country into the darkest era of its medical history. These healthcare professionals have not gone missing as alleged by the media that are looking to sensationalize the story. Despite the crimes these medical professionals have been accused of, the Bahrain Medical Society feels responsible to ensure that these doctors, nurses and paramedics receive a fair trial.
References
1http://www.youtube.com/watch?v=sDAMOzD4us4&feature=related
2. http://www.youtube.com/watch?v=E0_UeyCazfk.
3. http://www.youtube.com/watch?v=Humg7WTPDuY&feature=related
4. http://www.youtube.com/watch?v=rGTTIbZosYg&NR=1
5. http://www.youtube.com/watch?v=FxE1Yl2HO-g
6. http://www.youtube.com/watch?v=aMLsiAMGvdU&feature=related
Figure 1 Comparison of some health indicators in Bahrain (Health statistics, 2009)
Photos 1, 2 and 3: Doctors, nurses and other health personnel protesting with political slogans and banners in front of Accident and Emergency entrance.
Photo 4: Health personnel, including doctors, used the parking area to launch political speeches every night during the unrest period in front of A/E department.
Photo 5: Doctor holding the Quran to bless the protestors in case of Martyrdom at Salmaniya Hospital
Competing interests: None declared
Competing interests: No competing interests