How coronavirus related incidents triggered violence against health workers in 2020 - Report

Nigeria recorded no less than 62 attacks on healthcare workers and health facilities all over the country between January 1, 2020 and December 31, 2020, a new report says.

The report states that, globally, at least 1,195 such attacks took place against healthcare workers and their workplaces.

The report especially focused on healthcare workers on the front lines of the fight against the COVID-19 global pandemic who have continued to face difficult working conditions, including insufficient and inadequate personal protective equipment, increased working hours, psychological distress, burnout, and mass traumatisation.

According to the new report by the Geneva-based Insecurity Insight and the University of California, Berkeley’s Human Rights Centre, at least 1,195 threats or acts of violence were perpetrated against healthcare workers and facilities last year.

The report spanned January 1 to December 31, 2020 and is titled, ‘Threats and Violence against Health Care during the COVID-19 Pandemic in 2020.’

Researchers found that about 400 of those attacks were related to COVID-19, many motivated by fear or frustration, underscoring the dangers surrounding health care workers at a time when they are needed most.

Insecurity Insight defines a health care attack as “any physical violence against or intimidation of healthcare workers or settings,” and uses online news agencies, humanitarian groups and social media posts to track incidents around the world.

Out of the 1,195 reported incidents of violence or threat of violence against healthcare workers between January 1, 2020 to December 31, 2020, 62 of such incidents were reported to have happened in Nigeria from the south to the north.

According to the report, while the attacks lasted, 11 health facilities were damaged, eight health workers were killed, 18 health workers were kidnapped, while eight of them were injured.

Alleged perpetrators of the attacks include the police, National Security Agency, protestors and the military.

Alleged weapons used included arson, firearms, Improvised Explosive Devices and others.

“In most COVID-19-related incidents, abuse or violence was triggered by people opposing health measures intended to contain the spread of the virus,” the report stated; adding, “Health workers also faced abuse or violence while travelling to and from work, and for speaking out against difficulties they experienced in their work, including the lack of Personal Protective Equipment.”

Threats or violence directed at health workers was frequently triggered by opposition to medical tests for COVID-19 diagnosis or by decisions to hospitalise an individual, the report says.

The following are some of the incidents of violence against health workers and facilities, as reported by Insecurity Insight:

January 4, 2020: In Lakare Ward, Yola South Local Government Area of Adamawa State, unidentified perpetrators abducted a doctor of the Federal Medical Centre from his private residence. A ransom of N10m was demanded for his release.

January 31, 2020: In Kilangar village, Askira/Uba Local Government Area of Borno State, Boko Haram/IS looted and burnt a health post.

April 18-19, 2020: In Akasssa-Brass-Nembe waterways, Bayelsa State, suspected sea pirates injured a health worker returning from a coronavirus sensitisation campaign.

April 22, 2020: In Ode-Irele town, Irele Local Government Area of Ondo State, Nigerian Armed Forces injured a nurse at a coronavirus checkpoint.

April 26, 2020: In Esanma community, Bomadi LGA, Delta State, a male staff member of the British missionary organisation, the New Foundation Clinic, was killed by unidentified gunmen. One suspect was reportedly arrested.

May 18, 2020: In Dapchi town, Yobe State, Boko Haram terrorists set fire to a local hospital, forcing patients undergoing treatment to flee the facility.

May 26, 2020: In Port Harcourt city, Rivers State, some Nigerian Air Force officials reportedly slapped a doctor in the face while she was on duty, before driving her to a COVID-19 isolation centre.

May 31, 2020: In Ojobo community, Burutu Local Government Area of Delta State, a male doctor was abducted from the Central Hospital by eight unidentified gunmen disguised as patients. He was freed on June 7, 2020.

June 3, 2020: In Jibia Local Government Area of Katsina State, unidentified gunmen abducted the Jibia Local Government Area chairman of Medical and Health Workers Union on his way back from Katsina.

June 9, 2020: In Yantumaki district, Dan-Musa Local Government Area of Katsina State, unidentified gunmen abducted a local health worker and his daughter.

August 11, 2020: In Mahuta village, Danudume Local Government Area of Katsina State, unidentified perpetrators abducted a health worker.

August 17, 2020: In Magumeri Local Government Area of Borno State, suspected Boko Haram insurgents set fire to a hospital during a wider assault on the area.

August 31, 2020: In Idoani town, Ondo State, unidentified gunmen kidnapped the Chief Medical Director of General Hospital and two other health workers while they were on their way to Owo town for an official engagement.

September 21, 2020: In Mairuwa town, Faskari Local Government Area of Katsina State, gunmen abducted a male health worker from his residence.

October 6, 2020: At Ankpa, Ankpa Local Government Area of Kogi State, a medical doctor at Zonal Hospital was abducted in his private clinic by unidentified gunmen who demanded a ransom. The victim was rescued by the National Police either on the 9th or 11th October.

November 1, 2020: In Calabar city, Cross River State, unidentified perpetrators kidnapped a doctor of the University of Calabar Teaching Hospital from his residence at Bateba Street for ransom. In response, on November 4, the Nigerian Medical Association embarked on an indefinite strike until the victim is released.

December 10, 2020: In Garin Gabas village, Rafi Local Government Area of Niger State, a group of 20 unidentified gunmen kidnapped a nurse and her two children during a wider attack on the village and neighbouring Yakila.

December 12, 2020: In Ogoja town, Cross River State, two armed Fulani herdsmen attempted to abduct a physician working with the Monaya Hospital as he returned home. The physician escaped but suffered a gunshot wound.

26th or 27th December, 2020: In Abeokuta city, Ogun State, approximately 12 armed robbers stormed the Lekfad Hospital, stealing vehicles, medications, and valuables from patients. A physician was also beaten by the attackers.

Among others, the report urged the government at all levels to work with health workers to develop detailed measures for their protection and include these measures in national pandemic response plans.

It advised healthcare associations and civil society association to strongly condemn acts of violence perpetrated against anyone by any person and express solidarity with and support for health workers who have been targeted by or are at risk of violence.

Healthcare workers associations are also advised to advocate for law reforms to better protect health workers; and to collaborate with governments to take meaningful action to support the protection of health workers and the prevention of violence against them.

Speaking with PUNCH HealthWise in response to the report, the National Association of Resident Doctors said a minimum of four doctors are assaulted daily while on duty.

NARD President, Dr. Uyilawa Okhuaihesuyi, said the perpetrators of the violent acts are the patients’ relatives and the Nigerian Police Force.

“Our members are assaulted verbally and sometimes, physically, while on duty. On average, four doctors are assaulted per day.

“Over time, accounts of both verbal abuse and physical assaults on health personnel, especially frontline staff emanating from both public and private hospitals in Nigeria, have been on the increase, yet underreported.

“The chief perpetrators are members of the Nigerian Police Force and the patients’ relatives who, in the course of care for loved ones, misunderstand hospital protocols as being insufficient and make unnecessary demands on available health resources, of which when not granted, some might take the unfortunate path of aggression.

“The demise of a loved one is also an important stimulus for assaults on health personnel, mostly out of confusion, disbelief, and a primitive need to express grief.

“In some instances, patients are the perpetrators of these heinous crimes, in circumstances of both illicit drug involvement and psychiatric disorders, mostly observed in psychiatric hospitals.

“Besides, there is an increasing event of the kidnap of health personnel, mostly in their places of residence,” Okhuaihesuy said, confirming the Insecurity Insight‘s findings.

He, however, said the NARD has been proactive in the handling of the issues.

“This has entailed liaising with heads of health institutions, with improved security in their hospitals to curb or immediately address such matters at the earliest opportunity before the escalation of the problem.

“Furthermore, numerous interfaces with heads of state police forces have led to arrests of some people who got involved in the assault of healthcare personnel, in a bid to curb the act.

“We are hopeful that criminal prosecution would, in future, be meted to any person who assaults healthcare personnel under any guise whatsoever,” he added.

In the same vein, President, Pharmaceutical Society of Nigeria, Sam Ohuabunwa, said pharmacists also suffer a moderate number of attacks on duty.

“The attacks occur sometimes once every month. The perpetrators are a mixed bag, but primarily robbers, security personnel, and other criminals, including the assassination of pharmacists in the call of duty by unknown persons. Cases are with the Police,” Ohuabunwa said.

He, however, noted that aside from issuing safety and preventive guides to members, the association protests crimes at the Police stations in the bid to seek justice.

“We’ve also taken group insurance on members, supported families of affected members financially, and intensified prayers for increased security in Nigeria,” he enthused.

Also, the Acting Chairman, National Association of Nigerian Nurses and Midwives, Lagos Council, Mrs. Mary Lateef-Yusuf, said workplace violence is a regular occurrence within healthcare facilities across the state and is usually underreported.

“It consists of various acts of physical violence, threats, verbal abuse and perpetrated by patients, their relatives or their visitors, including professional colleagues of other cadres working within the health facilities, who often do not remember that rendering healthcare services is a collaborative process and not a master-servant relationship,” she noted.

According to Lateef-Yusuf, some of the perpetrators of workplace violence are genuinely disturbed physically and psychologically and, sometimes, agitated, because of their ill state, the stress of carrying out tests, and the cost of management that they just want to lash out.

“And because nurses are distinctively attired and accessible, they become objects of attack.

“On the other hand, some deliberately hide under the excuse of their illness to settle scores with nurses by picking on them as scapegoats.

“They do this because they have watched movies over the years on how nurses perpetrate various crimes and evils; ranging from child-snatching, marketing to drug theft, and unsound behaviours, such that those fallacies have been engraved in their brains as absolute truth.

“The damage some films makers are doing to our profession is incalculable,” Lateef-Yusuf lamented.

She added that most health facilities have little or no preventive strategies in place to shield nurses, stating, “At the association level, we are empowering our nurses to know how to react in these threatful and violent situations as well as fight for them because we know that exposing nurses to workplace violence could result in negative consequences for the care of both the threatful or violent person and other patients.

“We have stated this to several employers; be it government or private, that nurses have a right to safe work environment.

“I am sure that workplace violence and poor remuneration are the main reasons for brain drain and high turnover of nurses in Nigeria generally,” she said.

May 26, 2020: In Port Harcourt city, Rivers State, some Nigerian Air Force officials reportedly slapped a doctor in the face while she was on duty, before driving her to a COVID-19 isolation centre.

May 31, 2020: In Ojobo community, Burutu Local Government Area of Delta State, a male doctor was abducted from the Central Hospital by eight unidentified gunmen disguised as patients. He was freed on June 7, 2020.

June 3, 2020: In Jibia Local Government Area of Katsina State, unidentified gunmen abducted the Jibia Local Government Area chairman of Medical and Health Workers Union on his way back from Katsina.

June 9, 2020: In Yantumaki district, Dan-Musa Local Government Area of Katsina State, unidentified gunmen abducted a local health worker and his daughter.

August 11, 2020: In Mahuta village, Danudume Local Government Area of Katsina State, unidentified perpetrators abducted a health worker.

August 17, 2020: In Magumeri Local Government Area of Borno State, suspected Boko Haram insurgents set fire to a hospital during a wider assault on the area.

August 31, 2020: In Idoani town, Ondo State, unidentified gunmen kidnapped the Chief Medical Director of General Hospital and two other health workers while they were on their way to Owo town for an official engagement.

September 21, 2020: In Mairuwa town, Faskari Local Government Area of Katsina State, gunmen abducted a male health worker from his residence.

October 6, 2020: At Ankpa, Ankpa Local Government Area of Kogi State, a medical doctor at Zonal Hospital was abducted in his private clinic by unidentified gunmen who demanded a ransom. The victim was rescued by the National Police either on the 9th or 11th October.

November 1, 2020: In Calabar city, Cross River State, unidentified perpetrators kidnapped a doctor of the University of Calabar Teaching Hospital from his residence at Bateba Street for ransom. In response, on November 4, the Nigerian Medical Association embarked on an indefinite strike until the victim is released.

December 10, 2020: In Garin Gabas village, Rafi Local Government Area of Niger State, a group of 20 unidentified gunmen kidnapped a nurse and her two children during a wider attack on the village and neighbouring Yakila.

December 12, 2020: In Ogoja town, Cross River State, two armed Fulani herdsmen attempted to abduct a physician working with the Monaya Hospital as he returned home. The physician escaped but suffered a gunshot wound.

26th or 27th December, 2020: In Abeokuta city, Ogun State, approximately 12 armed robbers stormed the Lekfad Hospital, stealing vehicles, medications, and valuables from patients. A physician was also beaten by the attackers.

Among others, the report urged the government at all levels to work with health workers to develop detailed measures for their protection and include these measures in national pandemic response plans.

It advised healthcare associations and civil society association to strongly condemn acts of violence perpetrated against anyone by any person and express solidarity with and support for health workers who have been targeted by or are at risk of violence.

Healthcare workers associations are also advised to advocate for law reforms to better protect health workers; and to collaborate with governments to take meaningful action to support the protection of health workers and the prevention of violence against them.

Speaking with PUNCH HealthWise in response to the report, the National Association of Resident Doctors said a minimum of four doctors are assaulted daily while on duty.

NARD President, Dr. Uyilawa Okhuaihesuyi, said the perpetrators of the violent acts are the patients’ relatives and the Nigerian Police Force.

“Our members are assaulted verbally and sometimes, physically, while on duty. On average, four doctors are assaulted per day.

“Over time, accounts of both verbal abuse and physical assaults on health personnel, especially frontline staff emanating from both public and private hospitals in Nigeria, have been on the increase, yet underreported.

“The chief perpetrators are members of the Nigerian Police Force and the patients’ relatives who, in the course of care for loved ones, misunderstand hospital protocols as being insufficient and make unnecessary demands on available health resources, of which when not granted, some might take the unfortunate path of aggression.

“The demise of a loved one is also an important stimulus for assaults on health personnel, mostly out of confusion, disbelief, and a primitive need to express grief.

“In some instances, patients are the perpetrators of these heinous crimes, in circumstances of both illicit drug involvement and psychiatric disorders, mostly observed in psychiatric hospitals.

“Besides, there is an increasing event of the kidnap of health personnel, mostly in their places of residence,” Okhuaihesuy said, confirming the Insecurity Insight‘s findings.

He, however, said the NARD has been proactive in the handling of the issues.

“This has entailed liaising with heads of health institutions, with improved security in their hospitals to curb or immediately address such matters at the earliest opportunity before the escalation of the problem.

“Furthermore, numerous interfaces with heads of state police forces have led to arrests of some people who got involved in the assault of healthcare personnel, in a bid to curb the act.

“We are hopeful that criminal prosecution would, in future, be meted to any person who assaults healthcare personnel under any guise whatsoever,” he added.

In the same vein, President, Pharmaceutical Society of Nigeria, Sam Ohuabunwa, said pharmacists also suffer a moderate number of attacks on duty.

“The attacks occur sometimes once every month. The perpetrators are a mixed bag, but primarily robbers, security personnel, and other criminals, including the assassination of pharmacists in the call of duty by unknown persons. Cases are with the Police,” Ohuabunwa said.

He, however, noted that aside from issuing safety and preventive guides to members, the association protests crimes at the Police stations in the bid to seek justice.

“We’ve also taken group insurance on members, supported families of affected members financially, and intensified prayers for increased security in Nigeria,” he enthused.

Also, the Acting Chairman, National Association of Nigerian Nurses and Midwives, Lagos Council, Mrs. Mary Lateef-Yusuf, said workplace violence is a regular occurrence within healthcare facilities across the state and is usually underreported.

“It consists of various acts of physical violence, threats, verbal abuse and perpetrated by patients, their relatives or their visitors, including professional colleagues of other cadres working within the health facilities, who often do not remember that rendering healthcare services is a collaborative process and not a master-servant relationship,” she noted.

According to Lateef-Yusuf, some of the perpetrators of workplace violence are genuinely disturbed physically and psychologically and, sometimes, agitated, because of their ill state, the stress of carrying out tests, and the cost of management that they just want to lash out.

“And because nurses are distinctively attired and accessible, they become objects of attack.

“On the other hand, some deliberately hide under the excuse of their illness to settle scores with nurses by picking on them as scapegoats.

“They do this because they have watched movies over the years on how nurses perpetrate various crimes and evils; ranging from child-snatching, marketing to drug theft, and unsound behaviours, such that those fallacies have been engraved in their brains as absolute truth.

“The damage some films makers are doing to our profession is incalculable,” Lateef-Yusuf lamented.

She added that most health facilities have little or no preventive strategies in place to shield nurses, stating, “At the association level, we are empowering our nurses to know how to react in these threatful and violent situations as well as fight for them because we know that exposing nurses to workplace violence could result in negative consequences for the care of both the threatful or violent person and other patients.

“We have stated this to several employers; be it government or private, that nurses have a right to safe work environment.

“I am sure that workplace violence and poor remuneration are the main reasons for brain drain and high turnover of nurses in Nigeria generally,” she said.