Mahesh Shahi, B.pharm., E-MBA
Hospital Pharmacist
Nepal’s Healthcare Crisis: Struggle Against Workplace Violence and Law Implementation Failures
Being healthcare professionals, let’s be brutally honest this time. We’ve faltered, forsaken our oath and ethics, and ended up being compelled to take to the streets in protest, rather than being in the emergency room where we should be, urgently providing life-saving CPR, performing surgeries in the operating theater, fixing broken bones to ensure life continues, and welcoming newborn babies into the world, among other vital duties.
Violence in a healthcare environment, according to the Bureau of Labor Statistics, shows that healthcare professionals in hospital settings are six times more likely to encounter workplace violence, including misbehavior and attacks, than average workers in the United States. Additionally, when compared to workers in other industries, healthcare professionals face a 20% higher chance of becoming victims of workplace violence. Shockingly, nearly 50% of emergency doctors have reported experiencing assault, while almost 70% of emergency nurses have reported being attacked or kicked while on duty. This alarming situation poses serious concerns not only in Nepal but also globally, as this so-called violence-based disease is emerging and becoming deadlier. It is victimizing healthcare heroes at higher frequencies compared to past decades.
Doctors and other healthcare workers with pain at Maitighar, Nepal, gathered and shouted not for the pain-relieving medicine they used to give to the patient during treatment but, this time, in a rage on the streets, demanding that the government ensure the security of their workplace and their safety. Over the past years, there have been numerous attempts to reduce incidents of physical assault on healthcare workers and institutions. To address this violence, the government brought the Security of Health Workers and Health Organizations Act-2066, with its first amendment in 2079.
However, stringent measures and attacks against healthcare workers have dramatically increased day by day, instead of witnessing a decline in violence. Meanwhile, if we analyze the current trends and levels of violence against healthcare professionals, it becomes clear that the implementation of the law has failed, despite provisions of fines ranging from Rs. 300,000 to 5,00,000 and jail terms of two to five years, or both, for anyone violating or misconducting the law.
TO WRAP-UP, it is disheartening to observe that not only healthcare professionals but also citizens are compelled to voice their concerns about security, a mandate that should be guaranteed by the constitution. As a pharmacist, I strongly recommend that the government takes urgent and comprehensive action to address the escalating violence against healthcare professionals. The existing legal framework, such as the Security of Health Workers and Health Organizations Act-2066 and its amendments, must be rigorously enforced to deter potential offenders. Additionally, investing in enhanced security measures within healthcare facilities, especially in high-risk areas like ER, ICU, and OT, can significantly improve safety.
Public awareness campaigns should educate citizens about the critical importance of a secure healthcare environment, and healthcare workers should receive training in conflict resolution and de-escalation techniques. It is crucial to establish mechanisms to protect whistleblowers, as their insights can help identify and address issues early. Furthermore, a holistic approach to addressing the root causes of violence is essential, including addressing patient frustrations and improving healthcare accessibility. Finally, the government should consider retention strategies to retain skilled healthcare professionals in the country, ensuring continued access to quality healthcare services for citizens.
