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Abuse, fear, and silence: Female health workers at risk in Pakistan

A report by the US National Institutes of Health in 2022 revealed that up to 95 per cent of nurses in Pakistan had faced workplace violence at least once during their careers

rape, assault

Photo: Freepik

Nandini Singh New Delhi
In hospitals across Pakistan, female healthcare professionals face a grim reality marked by sexual harassment, violence, and verbal abuse that has become an almost daily ordeal. Women working in hospitals across the country reveal a hidden crisis that remains largely unreported due to fear of retaliation, job loss, and concerns over ‘honour and respect’. The accounts of female doctors and nurses reveal an entrenched culture of abuse, one that extends beyond the hospital staff. Patients and their families, too, contribute to the hostile environment. Yet this crisis remains largely unreported.

Across the border, a recent incident that shook India was the rape and murder of a 31-year-old trainee doctor in a Kolkata hospital. This tragic event has also intensified the fears of female healthcare workers in Pakistan, many of whom feel vulnerable within their workplace. More than a dozen female medics spoke to The BBC, sharing their concerns about safety. However, many asked to remain anonymous, fearing backlash and the societal stigma that often accompanies such disclosures.
 

Widespread harassment and fear of retaliation  
 

One particularly disturbing case involved a young doctor who approached Dr Nusrat (name changed for anonymity) after being filmed in a hospital restroom by a male colleague. The perpetrator used the video to blackmail her. Despite Dr Nusrat’s challenge to report the crime to the Federal Investigation Agency (FIA), the victim refused, fearing the video would be leaked and bring dishonour to her family. Similar cases of covert filming and harassment have been reported, but action is rarely taken.

The issue goes deeper than individual cases of harassment. A lack of accountability within the system exacerbates the problem, with perpetrators often escaping consequences. Another doctor Aamna (name changed) recounts how, five years ago, her senior doctor continually harassed her, only for her complaints to be dismissed by hospital administration. “They told me, ‘We’ve been unable to deal with this person in seven years. No one will believe you’,” she alleged. Her story is echoed by many others, who say that even when evidence exists, such as videos, the harassers are merely transferred to another ward, only to return months later.

The structural barriers to justice are significant. In many hospitals, the committees responsible for addressing complaints include individuals complicit in the harassment or their allies. This discourages victims from coming forward, knowing that their lives could become even more difficult if they do.

Rural healthcare workers face greater challenges  
 

The grim reality is not limited to urban centres. In rural hospitals, women healthcare workers face additional challenges. Dr Aamna recalls working in remote areas of Pakistan where security and even basic lighting were lacking. Female doctors and nurses are left to fend for themselves, often having to endure abusive encounters with patients or outsiders who wander into hospitals, many of whom are intoxicated or under the influence of drugs.

A report by the US National Institutes of Health in 2022 revealed that up to 95 per cent of nurses in Pakistan had faced workplace violence at least once during their careers. This aligns with findings in the Pakistan Journal of Medicine and Dentistry, which indicated that 27 per cent of nurses in public hospitals in Lahore had experienced sexual violence. In Khyber Pakhtunkhwa province, the figures were even more alarming, with 69 per cent of nurses and 52 per cent of female doctors reporting harassment from hospital staff.

Dr Summaya Tariq Syed, chief police surgeon in Karachi and head of Pakistan’s first rape crisis centre, has reportedly witnessed first-hand the systemic failures in addressing violence against female healthcare workers. She recalls a particularly disturbing case in 2010, where a nurse was raped by three doctors at a government hospital. The nurse, devastated, jumped off the roof and remained in a coma for a week. “Nothing that happened was consensual, but she chose not to pursue the case,” Dr Syed told BBC, explaining that the blame would likely have fallen on the victim.

Beyond sexual harassment, physical violence also threatens healthcare workers. Last year, Dr Syed’s team was attacked by members of the public while handling bodies in a Karachi mortuary. “Two of my colleagues had to protect me from blows,” she recounted. Despite filing a police complaint, the case remains unresolved.

Inadequate security and structural failures in hospitals  
 

In many hospitals, security measures are inadequate. There are often no security staff present, and even basic facilities like CCTV cameras are either insufficient or non-functional. Thousands of patients and visitors flood public hospitals daily, heightening the risk of attacks on medical staff. Female healthcare workers describe harrowing encounters, where they are verbally and physically assaulted by patients or their families. Nurse Elizabeth Thomas (name changed) shared her fear of drunk or aggressive patients who routinely try to grope female staff. “We’re terrified and helpless,” she said.

Religious minorities in the healthcare workforce are particularly vulnerable. Elizabeth, a Christian nurse, explained how threats of blasphemy accusations are used to coerce women. “I know nurses who were harassed, and when they didn’t comply, they were threatened with false accusations of blasphemy,” she said. In Pakistan, accusations of blasphemy can result in severe punishment, including the death penalty, making such threats especially dangerous.

Adding to the abuse, the gruelling working conditions further compound the difficulties faced by female healthcare workers. Long shifts without adequate rest facilities or even basic amenities like toilets are common. “During my house job, I worked 30-hour shifts without a place to rest. We had no access to toilets, even when menstruating,” another doctor revealed.

The fear and anxiety among female healthcare workers have only grown since the death of the trainee doctor in India. Many, like Dr Saadia, have adjusted their routines to avoid dark or isolated areas. For others, the uncertainty looms even larger, as the risks of their profession continue to weigh heavily on their minds, leaving them to navigate an environment that often feels unsafe and unpredictable.

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First Published: Sep 26 2024 | 11:59 AM IST

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