Table 1
Summary of Incidents during the COVID-19 Pandemic in Pakistan.
| CHARACTERISTIC | N = 29 n (%) |
|---|---|
| Province Khyber Pakhtunkhwa [121516] Sindh [9111314] Punjab [81017] Balochistan [718] | 20 (69.0) 4 (13.8) 3 (10.3) 2 (6.9) |
| Hospital Sector Public (Government-owned) [7910111213141517] Private | N = 9 * 9 (100) 0 (0) |
| Perpetrator Attendants of Patients [91011121315] Police/Armed Forces [781418] | N = 10 * 6 (60.0) 4 (40.0) |
| Victim Doctors [7891011121314151718] Other HCWs/Hospital Staff [791011] Medical Students [18] | N = 11 * 11 (100) 4 (36.4) 1 (9.1) |
[i] * Number of articles explicitly reporting specific characteristic.
Table 2
Incidents of Violence Against Health Care Workers (HCW’s) During COVID-19 Pandemic in Pakistan (7 April to 24 June 2020).
| CASE # | DATE | CITY | HOSPITAL/ LOCATION | HOSPITAL SECTOR | PERPETRATOR(S) | VICTIM(S) | ACT OF VIOLENCE | INCITING FACTOR(S) | LEGAL ACTION TAKEN | OTHER DETAILS |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 [7] | 6 Apr 2020 | Quetta (Balochistan) | Civil Hospital/CM secretariat | Government | Police | Doctors and Paramedics | Baton charge; dragged through streets; Arrested between 60-100 HCWs including doctors and paramedics | Protests held by young doctors and paramedic staff for provision of PPE and equipment to treat coronavirus patients. | NS | Protests began after more than 16 doctors in Quetta contracted COVID-19 due to lack of PPE. Doctors face psychological stress and trauma dealing with patients without PPE (‘akin to suicide’) |
| 2 [8] | 18 Apr 2020 | Lahore (Punjab) | Office of Secretary Specialized Healthcare and Medical Education | – | Police | Doctors | Police thrashed the doctors | Protests for provision of adequate PPE, compensation for COVID-19 duty, better quarantine conditions for doctors with suspected COVID_19 | NS | Authorities claimed to have called police only to maintain order during protests; Special Secretary Health stated that during the COVID-19 pandemic was not the right time for doctors to hold such protests |
| 3 [9] | 15 May 2020 | Karachi (Sindh) | Jinnah Postgraduate Medical Centre (JPMC) Isolation Ward | Government | Around 60 people, including attendants of deceased patient (COVID-19 suspected) | Doctors and Hospital Staff | Forceful entry into premises; heavy objects thrown at staff; Hospital area ransacked and vandalised | Hospital administration refused to hand over the patient’s body to the family | Police and Rangers called to facility; arrested eight to nine people | Hospital staff directed by government to only hand over deceased body to family after conducting a COVID-19 test; Attendants refused to believe that coronavirus exists |
| 4 [10] | 20 May 2020 | Lahore (Punjab) | Mayo Hospital, COVID-19 Ward | Government | Around 30 men; attendants of 2 COVID-19 positive patients, one of whom had died. | Doctors and Hospital Staff. | Forceful entry into premises. Verbal abuse and misbehaviour; manhandled male doctor and hospital guard. | Death of COVID-19 patient; relatives believed coronavirus is a hoax | Hospital administration requested deployment of sufficient police force | A male doctor was forced by attendants to perform CPR on the patient without giving him time to wear PPE The other patients in the COVID-19 ward also started to cry and get upset. |
| 5 [13] | 28 May 2020 | Hyderabad (Sindh) | Liaqat University Hospital | Government | Attendants of deceased COVID-19 patient | Doctors | Misbehaviour | Refused to hand over body of deceased patient to family; Doctors falsely accused of labelling patients as COVID-19 positive; mistrust in doctors | Hospital administration sought police support | – |
| 6 [11] | 29 May 2020 | Karachi (Sindh) | Civil Hospital, Emergency Department | Government | Around 70 people, including attendants of deceased COVID-19 patient | Doctors and Hospital Staff | Forceful entry into premises; mob was carrying knives and rods; attempted assault on medical staff; female doctor slapped; vandalised the area | Patient was brought in critical condition and died during treatment; attendants refused to wait for completion of legal formalities including COVID-19 testing; broke in to retrieve body | Police had decided to register the case against the persons involved. | Doctors claim confusing policies of government regarding burial of suspected COVID-19 patients is a cause to such increasing incidents |
| 7 [12] | 1 Jun 2020 | Peshawar (Khyber Pakhtunkhwa) | Hayatabad Medical Complex | Government | Attendants of a suspected COVID-19 patient | Young male doctor | PPE was forcefully removed; Verbally abused and beaten; Sustained injuries to eyes and nose | Doctor was called to take nasal swab after a duty in the ICU; Attendants claimed he arrived late | Police support sought but first information report was not filed yet | Fourth such incident in the last seven days; doctors demand better security from provincial government |
| 8 [14] | 18 Jun 2020 | Karachi (Sindh) | National Institute of Cardiovascular Disease (NICVD) | Government | Counter-Terrorism Department Policeman | Young male doctor | Verbal abuse and threats; gunfire injuring both legs | Was denied sleeping pills day before; quarrelled over being asked to wear a mask | Arrested and FIR lodged; Court sent the perpetrator on a 14-day judicial remand. | Perpetrator has been labelled as mentally unstable |
| 9 [15] | 19 Jun 2020 | Peshawar (Khyber Pakhtunkhwa) | Lady Reading Hospital | Government | Attendant of deceased patient; Suspected COVID-19 | Doctors | Attempted assault on doctors; Hospital property damaged | COVID-19 test ordered to determine cause of death of the elderly patient brought in critical condition | NS | – |
| 10–27 [16] | As of 19 Jun 2020 | (Khyber Pakhtunkhwa) | – | – | – | – | There have been at least 20 attacks on medical workers; include three shooting incidents | Relatives of COVID-19 patients frustrated over lack of testing facilities and due to conspiracy theories stating doctors are killing patients and claiming they died of COVID-19; hospital refused to hand over body of deceased until COVID-19 test results returned | NS | Some conspiracy theories are made by religious clerics and widely spread on social media 20 total reported cases of violence were reported by the Young Doctors Association (two have been described earlier: Case 7 and Case 9) |
| 28 [17] | 21 Jun 2020 | Lahore (Punjab) | Jinnah Hospital | Government | NS | Senior Professor of Medicine | Physically threatened | NS | NS | – |
| 29 [18] | 24 Jun 2020 | Quetta (Balochistan) | – | – | Police | Female doctors and medical Students | Baton charge; physically assaulted and arrested | Female doctors and medical students peacefully protesting the decision of the Higher Education Commission to conduct online education in the absence of internet facilities in Balochistan | NS | – |
[i] NS: not specified; PPE: personal protective equipment.
Figure 1
Summarises general measures to reduce violence against HCWs.