RCPI and RCSI and Bahrain

The Irish Times – Saturday, June 25, 2011
Treatment of medics in Bahrain

Sir, – The Royal College of Surgeons in Ireland (RCSI) fully respects the unequivocal right of all doctors to practise as enshrined in the Geneva Convention. We are very aware of and concerned about the plight of those detained in Bahrain.

RCSI is a not-for-profit organisation. Our mandate is to focus on education in the health sciences. We are internationally-focused, working in Africa, the Middle East and Far East as well as in Ireland. Many of the countries have very different cultures and are at different stages in their political evolution. This diversity is a challenge that faces all organisations that work overseas.

Since the beginning of these events we have endeavoured to ensure the safety of our 900 students and 100 staff in Bahrain, to enable our students to complete their programmes and to advocate for the rights of the arrested healthcare professionals. Our approach has been guided by what we have judged to be most effective in Bahrain. In support of this approach we have chosen to minimise public statements in Ireland.

We have attached considerable importance to ensuring the continuity of the education of our students. When the situation first escalated in February, we temporarily suspended teaching and staff continued to attend the university maintaining it as a focus for our students. We developed an evacuation plan and when the situation deteriorated we evacuated students and staff who wished to leave. A core group of staff remained in Bahrain to maintain the university and to set up and staff a temporary AE unit for the local population in Muharraq. We developed contingency plans to ensure that irrespective of political unrest, our final medical year students would graduate on time. A delay in graduation for this class would mean a full year of lost employment at a pivotal time in their careers.

Last week 53 medical doctors and 70 nurses graduated as originally scheduled. It was important that the graduation take place as a tribute to the commitment and courage of these young people. Many of these students are the first members of their family to attend a university and to obtain a degree. This degree is an avenue to an infinitely better future for them and their families.

Medical practice is a privilege which carries rights and responsibilities. Doctors have a responsibility to treat all patients, irrespective of their background, to the highest possible standard, under all circumstances.
Hospitals must be politically neutral. Society has a responsibility to allow doctors and nurses to treat all patients in need. The protection and care of people wounded in conflict is a basic right guaranteed by the Geneva Convention. Punishing doctors or nurses for treating patients, irrespective of their background, is completely unacceptable. The World Medical Association’s International Code of Medical Ethics and its Medical Ethics Manual define the duties of physicians as including the administration of emergency care and adhering to principles of non-discrimination.

Governments should not infringe upon the duties of medical professionals and should not target or punish those who seek to uphold these internationally recognised principles.

On six separate visits to Bahrain since February I have met senior Bahraini government ministers. The focus of these meetings was to express our deep concerns for the rights of the detained medical personnel.

The future for Bahrain has to be one of dialogue and reconciliation. Our own national story tells us that this will not be resolved quickly. We will continue to contribute through education and continue to advocate for just outcomes. – Yours, etc,

Chief Executive/Registrar,
Royal College of Surgeons in
St Stephen’s Green, Dublin 2.

Sir, – The Royal College of Physicians of Ireland (RCPI) is supporting calls for justice for doctors arrested in Bahrain.

Within the past week, the president of RCPI visited Bahrain with two specific objectives. First, to attend the conferring ceremony for graduating students of the RCSI medical school in Bahrain. These young doctors have managed to complete their undergraduate medical studies in extremely difficult, even dangerous circumstances.

Second, it was hoped that this visit to Bahrain would provide an opportunity for RCPI to gather some first-hand, albeit limited, knowledge within Bahrain itself, rather than basing an opinion solely on third-party and media reports.
In doing so, RCPI believes it may be better-positioned to understand the situation in Bahrain, and less likely to place others in danger as a result of ill-informed commentary.

Based on the conclusions we reached as a result of this visit, our communication with RCSI, and the range of recent international coverage of the situation in Bahrain, RCPI would like to make the following comments: It is clear that there are conflicting and trenchantly-held views on what actually happened in Salmaniya Hospital and the reasons for the arrest of the doctors in question. On the one hand, there are allegations that doctors abused their position and refused to provide care to patients because of their ethnicity. On the other hand, many respected international bodies, including the Office of the UN Commissioner for Human Rights, have rejected this position and have strongly asserted these doctors are innocent and that they were arrested for providing medical care to protesters.

Either position, if proven, is unacceptable. A doctor’s first and most important responsibility is to care for all patients equally, regardless of their political or religious views. This responsibility is at the core of their professional obligation. Equally, it is unacceptable that a state would arrest and prosecute doctors and other healthcare workers for carrying out their professional duty of care to any patient.

The events of the past few months in Bahrain have been shocking. Unquestionably, this has damaged the international reputation of Bahrain and, sadly, has undermined the efforts towards modernisation and reform, particularly in relation to healthcare that have been underway in Bahrain in recent years.

Hospitals should be neutral sanctuaries for the care of the ill and the injured and should not be used as political platforms or targets for military activity. Doctors, nurses and all healthcare professionals should be free to treat the sick and injured in accordance with professional ethics without fear of intimidation, assault or imprisonment.

In the interests of all the people of Bahrain, and in particular those awaiting trial, it is essential that the judicial process now underway is unequivocally fair and just, and clearly seen to arrive at the truth of what happened.

Anything less than this will do irreparable damage to Bahrain, its international reputation and the practice of medicine there. – Yours, etc,

President; Prof JOHN CROWE, President-Designate; Prof FRANK MURRAY, Registrar; Prof CONOR O’KEANE, Treasurer; LEO KEARNS, Chief Executive Officer,
Royal College of Physicians of Ireland,
South Frederick Street,
Dublin 2.