Introduction
Indeed, we can think and imagine the hardships of the health workers who have to continually risk their lives and deal with stressful situations while fighting at the front line with deadly and severely contagious viruses like Ebola or COVID-19, but it is not the complete story; unfortunately, there is much to the agonies of these healthcare workers. This paper explores the difficulties these healthcare professionals have to bear in different regions of the world and their probable root causes to understand how the severity of these attacks could be mildened. Furthermore, this paper would also highlight the chances of such incidents happening with the workers responding to COVID-19. (Lisa Reilly and Raquel Vazquez Llorente, 2015)(WHO Africa, 2019)
Ebola and growing violence against aid workers
When it comes to combatting diseases in parts of the world which are in warfare for several decades and where the writ of the insurgent groups exceeds that of local government, the job of a healthcare worker gets harder many times. As described by a doctor, Abdourahmane Diallo, working in the Eastern side of Democratic Republic of Congo (DRC);(Al Jazeera, 2019)
“The fear we feel, and that the community feels does our job ten times harder.”
Ebola Virus Disease (EVD) is a severe fatal disease that was first discovered in 1976; however, it was only recently when the massive outbreaks started to occur. As per WHO, the average fatality rate from Ebola is 50% and can be transferred to one another through human to human transmission. In 2014, the Virus out broke in Guinea, which transmitted later to Sierra Leone and Liberia. Currently, the Virus is creating severe chaos on the Eastern side of the Democratic Republic of Congo (DRC) with threats that it might be transmitted to other parts of the country, which can be lethal.What makes this situation more complicated for Aid Agencies and Non-Government Organizations is the current level of anarchy widespread in DRC. In the first six months of 2019, the number of attacks on medical facilities and healthcare professionals in the Democratic Republic of Congo reached a staggering number of 174, the highest in the world, followed by 41 in Afghanistan and 34 in Syria. The aspect which makes these attacks more worrisome is that the primary reason for pushing this violence is not merely theft or creating terror but deep-rooted hatred. As happened in an incident in Beni (DRC) in late June 2019, when a hostile mob attacked the Ebola response team and later burned down the car when the team had fled. As mentioned by Christian Bada, a medical hygienist, “People threw rocks at us; it was merely to kill us.”(Humantarian Outcomes, 2019)(United Nations, 2019)(Max Bearak , 2018)
As per the World Health Organization, these attacks can be attributed to increased armed conflict in the region, civil unrest, and community resistance caused by mistrust between the locals and authorities. Not only such rebellion and resistance are creating life threats to the healthcare professionals but also hindering the response towards Ebola, which can be lethal as the Virus can spread to other provinces of DRC and even to other countries if not contained adequately. (Adelicia Fairbanks, 2020)(BBC, 2019)
Such a situation has worried local and global institutes, including Aid Agencies and Non-Government Organizations, that why these incidents are occurring in the first place and how they could be restrained. Several studies and surveys have been conducted through research agencies to unleash the root cause of such incidents cast towards healthcare professionals as without hampering the violence, it might be severely challenging to contain and combat deadly viruses like Ebola and COVID-19. (Kinshasa/Butembo, 2019)
Why Healthcare Professionals have to deal with these attacks?
Attacks on healthcare professionals massively hinder their abilities to function correctly and effectively towards to sole goal of eradication of the disease. Not only these acts of violence put a constraint on the mobility of these healthcare workers, but also they make aid organizations and NGOs spend more money on the security and well-being of these professionals. As per the International Humanitarian Law (IHL), aid workers and healthcare professionals performing their duties in armed conflicted regions must be protected, however above mentioned incidents of attacks and violence tell another story. To make any set of solutions to curb these sorts of events, the first step should understand the reason and root causes of these attacks, only then any institute or government would be able to draft any set of solutions. (David Child, 2019)(Insecurity Insight, 2019)
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Community Distrust
One key reason for these attacks is based on the distrust between the communities which are affected by these diseases and the aid/health organizations, mostly foreigners, which are trying to curb the spread of these diseases. Reports of local people threatening and harming directly to aid workers and healthcare professionals while they carry out their duties in the Ebola-affected regions are increasing. (Catherine Saez, 2019)(Emmanuel Freudenthal , 2019)
The root cause of this distrust is the belief that is commonly found in the people of DRC that Foreigners, including non-Congolese and Congolese people who are not habitats of the affected areas, have falsely fabricated this Virus to exploit financial and political benefits. The matter gets further exacerbated as the majority of the Ebola-affected areas weren’t allowed to participate in the elections of 2018, which happened in December, and most of these aid workers and healthcare professionals don’t speak the local language. It is the local conception that the outside agencies, including aid agencies and Non-Governmental Organizations, are working for the sole agenda of further destabilizing the region. (United Nations , 2019)(Independent Oversight and Advisory Committee, 2019)
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Financial exploitation on the name of Ebola
Another reason for the rift between the locals and these aid workers is the community widespread belief that these workers and agencies are not honest with the financial aid coming from global organizations like the UN and WHO. This has been further substantiated by a research conducted by WHO through a third-party research firm, which concluded that a majority of the response community believes that the conception fuels these violent attacks that the primary reason and motivation of these aid organizations and NGOs is to gain financial benefit. (Emmanuel Freudenthal , 2019)(Rebecca Ratcliffe, 2019)
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Just to create anarchy
Rebel groups have dominated the eastern province of Congo like Allied Domestic Forces (ADF) and Mai Mai Militia, which adore creating disorder and chaos in their regions to demonstrate their writs and enforce their rulings. Attacking and using violence against foreign aid agencies provide them with much-required hype not only in the regionally but also globally. (Emmanuel Freudenthal , 2019)
Are health workers fighting COVID-19 facing the same incidents of violence?
Unfortunately, violence, abuse, and hatred couldn’t be stopped from reaching the nurses and doctors working at the frontline to defeat one of the most significant pandemics of human history – Corona Virus (COVID-19). In some countries, it is indeed true that these healthcare professionals are treated as superheroes for putting their own lives at stake to save others; doctors and nurses are getting praised from all world over the social media, but several incidents of violence and abuse have been reported too all over the world. After facing several cases of assaults and backlash from the general public in Mexico City, Fabiana Zepeda Arias, quotes that; “Please stop assaulting us. Please help us take care of you, and for that, we need you to take care of us.”(Kirk Semple, 2020)
Fabiana Zepeda is a Chief of Nursing Program in Mexico, according to her, nurses working under her have been assaulted, verbally, and physically, 21 times; people are accusing nurses of spreading Virus. She further added that many nurses now have stopped wearing their medical outfits while going to and from work as they are afraid that people might hurt them.
On April 1, as reported on BBC, a team of medical staff was assaulted and attacked by an angry mob in Indore, India. As quoted by Dr. Zakiya Sayed, “I had never experienced scenes like these before; it was indeed frightening. We somehow managed to flee away from the agitated mob.” An ambulance driver was shot earlier in April in the Quezon province of the Philippines as it was feared that the ambulance was spreading Corona Virus in the vicinity. (DAWSON WHITE, 2020)(Reethu Ravi, 2020)
Such incidents are not happening in developing parts of the world, but also in a city like New York. When nurses went to their cars in the parking lot after finishing their shifts in Hudson Valley Hospital, they found that the tires of their vehicles were slashed. (DAWSON WHITE, 2020)
Above mentioned cases of violence, abuse, and assault are just a few examples of reported hate crimes against the professional healthcare staff who are tirelessly working to help the world fight with COVID-19. Historically, it has been substantiated that during pandemics, health care professionals are targeted, whether it be Spanish flu, Yellow fever, Ebola, or Corona, people have been verbally and physically violent to them as the due false stigma that these professionals can spread the Virus to them. (Stephanie Nebehay, 2020)(Mary Beth Sheridan, Niha Masih and Regine Cabato, 2020)
These incidents can severely halt the process of containing such lethal viruses. Not only the performances of medical staff can be deteriorated by these stigmas, but also the number of these professionals will decrease with time. In India, the Association of Doctors wrote, “We, the healthcare professionals, are not as scared by the virus itself as we are afraid of the community we treat.”
What we can do to mediate between the communities and healthcare professionals
In any circumstance, hate and violence against medical professionals shouldn’t be tolerable. Without the assistance of these brave healthcare professionals and aid workers, no one can imagine the proper containment and cure of fatal diseases like Ebola and COVID-19. To find ways to mediate between the communities and these healthcare workers and to bridge the gap between them, we need to understand the beneath reason for such stigmatization and assaults; only then organizations could come up with any solid solution.
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Acknowledge, promote and glorify
The foremost step to bury the hate and xenophobia against the aid workers and the healthcare professional is to acknowledge their roles and efforts at the federal level. Governments all over the world should announce support packages, which can take several images like permanent employments or a pay raise for the medical staff who are at the front line combatting diseases like Ebola and Corona Virus. Institutions, including the general public, should renounce and promote the duties these medical professionals are performing. In the last, we need to glorify the efforts, bravery, and courage of aid workers and healthcare professionals to decimate the hate and xenophobia against them.
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Re-emphasize the punishment for assaulters and abusers
After several cases of verbal and physical abuse were reported in India, the government promulgated an ordinance to make amendments to the Epidemic Diseases Act, 1897. It introduced a new sentence for criminals who are involved in any kind of assault and violence against medical professionals. As per the new ordinance, any act of hate and violence would be non-bailable and cognizable; further to increase the intensity of the crime, the government has ordered to complete the investigation within 30 days. Moreover, the offender will also provide compensation to the healthcare professional for any injury, loss, or damage to the property.(Special Correspondent, 2020)
To reduce the number of violent cases, governments all over the world should increase their efforts to amend or introduce new laws and legislations, which will make these sorts of crimes more condemnable.
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Communication
To hinder the mistrust between health organizations and communities, proper programs of communication should be launched. The goal of such programs should be to clarify the image of aid workers and healthcare professionals in the visions of communities. These sorts of applications would be more fruitful in the case of societies like the Democratic Republic of Congo, where mistrust is so rampant that people have started to attack aid workers and medical staff directly by themselves. These programs will help in transmitting the main agendas of these organizations and try to align the interests of both communities and health institutions.(Catherine Saez, 2019)
References
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Al Jazeera, 2019. Deadly DRC protests target UN as Ebola workers pulled out. AL Jazeera, November .
BBC, 2019. DR Congo crowd burns UN base and Beni town hall. BBC, November .
Catherine Saez, 2019. New Plan For Ebola Outbreak Response To Ensure Safety Of Respondents. Health Policy Watch, June.
David Child, 2019. WHO warns Ebola could breach DRC’s borders unless attacks stop. Al Jazeera, May.
DAWSON WHITE, 2020. Slashed tires and violence: Health care workers face new dangers amid COVID-19 battle. Miami Herald, April.
Emmanuel Freudenthal , 2019. ‘Ebola Business’: How Mistrust Is Fueling Attacks on Health Workers in Eastern Congo. World Politics Review, November .
Humantarian Outcomes, 2019. Aid Worker Security Report 2019. Humantarian Outcomes.
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Kinshasa/Butembo, 2019. United Nations strengthens Ebola response in Democratic Republic of the Congo. World Health Organization, May.
Kirk Semple, 2020. ‘Afraid to Be a Nurse’: Health Workers Under Attack. New York Times, April.
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Mary Beth Sheridan, Niha Masih and Regine Cabato, 2020. As some health workers get ovations, others come under attack during coronavirus pandemic. Washington Post, April .
Max Bearak , 2018. ‘Like a horror film’: The efforts to contain Ebola in a war zone. Washigton Post, December.
Rebecca Ratcliffe, 2019. Senior WHO official accused of using Ebola cash to pay for girlfriend’s flight, s.l.: jANUARY.
Reethu Ravi, 2020. Abused, Attacked, Beaten: Frontline Workers Are Risking Their Lives Everyday In India. The Logical Indian, April.
Special Correspondent, 2020. Coronavirus | Attacks on health workers to attract up to 7 years in prison. The Hindu, April .
Stephanie Nebehay, 2020. Nurses must be protected from abuse during coronavirus pandemic: WHO, nursing groups. Reuters, April .
United Nations , 2019. Ebola emergency chief decries new attacks on frontline staff, after DR Congo worker death. UN News, November.
United Nations, 2019. Armed groups kill Ebola health workers in eastern DR Congo. UN News, November .
WHO Africa, 2019. The Ministry of Health and the United Nations condemn attack on health worker supporting the Ebola response in the Democratic Republic of the Congo. World Health Organization, November.