Bahrain Continues Aggressive Action Against Its Health Care System

Abstract

IN THE MIDST OF THE ARAB SPRING UPrising that took hold across the Middle East last year, civil unrest erupted in Bahrain, fueled by longrunning tensions between Sunni Muslims, who rule this small island kingdom in the Persian Gulf, and the Shia Muslim majority, who are demanding political reform and an end to discrimination against their sect. The government of Bahrain swiftly responded to the uprising by calling in the military to crush protests by demonstrators. A year and a half later, the government security forces in Bahrain continue to attack protestors with tear gas, bird shot, and other weapons and to abuse civilians seeking medical treatment and the health care personnel who give them care. These ongoing violations of medical neutrality are detailed in Under the Gun: Ongoing Assaults on Bahrain’s Health System, a report released in May from Physicians for Human Rights (PHR). Medical neutrality refers to the ethical duty of health professionals to treat any individual in need of medical assistance, regardless of his or her race, religion, or political affiliation, and to have a safe place provided by the state to carry out their work. This is PHR’s second report on this issue. The first was released in April 2011 (Friedrich MJ. JAMA. 2011; 306[5]:475-476), and another covering the Bahraini government’s use of toxic chemicals against its citizens is due out in the fall. In a whirlwind visit to Bahrain this April, Richard Sollom, MA, MPH, deputy director at PHR, and Holly Atkinson, MD, assistant professor of medicine and director of the human rights program at Mount Sinai School of Medicine, in New York City, worked around the clock to conduct 102 in-depth interviews, examine medical records, and make site visits to document the abuses the government is carrying out on its citizens. “Among those I spoke with, there is uniform fear among a certain part of the population—the Shia Muslims—to go to any health care facility, in particular Salmaniya Medical Complex,” said Sollom. In what has become an integral strategy in its crackdown on the antigovernment protests, the government of Bahrain sent light infantry tanks and security forces to besiege Salmaniya, the nation’s largest hospital, during the antigovernment demonstrations last year. Now, security forces occupy each of the entrances of this once highly regarded medical institution, and anyone seeking to enter the hospital undergoes what amounts to triage by 18year-olds with guns, said Sollom. If there’s any sign of physical injury, the person is immediately sent inside the hospital to higher-ranking security officials and interrogated before being treated—if he or she isn’t detained further or “disappeared,” as many people have been, he said. The Shia community has responded by creating an underground clinic, a very loose network of health care personnel and members of the community who are working together unofficially and secretly to deal with injuries in an offhospital setting, said Atkinson. Atkinson noted that she met with government officials Saeed Mohamed Al-Faihani, the Human Rights Under Secretary, and Houda Nonoo, Bahrainian Ambassador to the United States. Both denied any wrongdoing by the Bahrainian government. “It was, to say the least, a very disappointing meeting,” she said. Amal Al Yusuf, MD, an ophthalmologist who worked in Salmaniya Medical Complex, witnessed the events from the beginning. She was trapped along with many colleagues inside the hospital when the military took over the institution in March 2011.