Neglected, detained, silenced... Around the world, health workers have not always been applauded

Every night at 9:00 p.m., during the partial lockdown, the people of Switzerland would gather at their balconies and windows to applaud the health workers. In other parts of the world, however, the same health workers were neglected, underpaid, detained, even assaulted — either for pointing out flaws in their respective health systems or simply for doing their jobs.

Why we’re talking about this. According to the account of Amnesty International, 3,000 health professionals as of 13 July, are believed to have died from Covid-19 across 79 countries. This is one of the few data available that underlines the heavy toll paid by the sector. And it is far from enough to seize the magnitude of the attacks and mistreatment that the pandemic has reinforced or exacerbated. This article provides a brief overview of the countries that abused their caregivers and their rights during Covid-19.

Lack of protection. Many people who are working in the health sector reported serious shortages of personal protective equipment (PPE) in nearly 63 countries and territories monitored by Amnesty International. Few countries were prepared for the crisis. At the epidemic’s beginning, many countries, including France and Switzerland, lacked PPE. In several countries in Africa, Latin America and Central Asia, such shortages persisted.

Health workers were not only disarmed from a health perspective: in the spillover effects of the crisis, some health workers were not provided with adequate remuneration and social protection. Cases of unpaid workers have been reported in India and Guatemala, among others. This overlaps with demands for more resources for public health even before the crisis. In Europe, French and British health workers have, in recent months, complained about the lack of support from their governments.

In addition to having to fight the disease, health workers had to face the hostility of some of their fellow citizens.

• In Pakistan, dozens of hospitals have been vandalized and an "incalculable" number of medical staff have been attacked on a daily basis, according to the Young Pakistani Doctors Association. Attacks often come from the families of patients who could not be saved, in a context where hospitals are overwhelmed and in short supply.

• In the Philippines, the treatment of health workers has also been questioned: they have been excluded from restaurants and public transport. In a previous incident, a nurse was attacked with bleach thrown on his face, damaging his sight.

• In Mexico, assaults and threats were such that the senior nurse asked the citizens of her country on national television to stop attacking her brothers and sisters.

The list of countries where attacks and stigmatization of health workers occurred during the pandemic is still long and includes countries such as the United States, France and Australia. As The Lancet reminds us, these attacks are sadly not new.

Some of the mentioned countries have since taken a stand to protect health workers. Metro Manila, the capital of the Philippines, now punishes discrimination against medical personnel with fines of up to 100 dollars and six months in jail.

Caregivers silenced and punished. The crisis has exacerbated the flaws of some health systems. To avoid serious consequences for themselves and the ones they heal, health workers have publicly denounced and sometimes questioned their leaders. These criticisms were not always well-received.

In the United States, a caregiver working in a nursing home was reportedly fired after posting a video on Facebook in which she read a petition calling for more protection. Similar cases have been observed all over the world in the private sector. Even in Switzerland, an employee of an EMS was reportedly fired for disagreeing with management.

Such reprisals are sometimes widespread and emanate from the state.

• In Russia, healthcare workers have received threats from their employers and public authorities for speaking out about the lack of adequate safeguards to deal with Covid-19 cases. According to Human Rights Watch, one of them, Yulia Volkova, has been charged on false information under Russian laws and faces a fine of up to 100,000 roubles (about 1,250 francs).

• In Zimbabwe, where Covid-19 is undermining an already stretched healthcare system, the many dissenting voices continue to be ignored by the government. In early July, 12 nurses were arrested during a demonstration in the capital Harare as they demanded a pay rise and adequate medical protection.

• In Turkey, doctors are under investigation for "making threats aimed at creating fear and panic among the public" after expressing concerns about the lack of protective equipment and about the management of the pandemic, including on social networks.

• In Egypt, nine people working in the health sector who expressed security concerns or criticized government management were detained "arbitrarily" between March and June on charges of "spreading false news" and "terrorism", according to Amnesty International.

This list of situations of concern is far from exhaustive. There are concerns over whether human rights have receded during Covid-19. The crisis had after all started with doctors being silenced and applauded too late.

The story of Dr. Li Wenliang, the Chinese ophthalmologist who was among the first doctors to sound the alarm in Wuhan, illustrate the whole story. After talking to his colleagues in online groups about seven patients with SARS-like cases, he was accused by local authorities of spreading false news and silenced. He died as a result of Covid-19, after being rehabilitated by Beijing and finally — all too late – made a national hero.