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Thanking the nurse

"New York Daily News" on abuse of �Pakistani nurses

Unconscious Pakistani nurse 
August 5, 2012 -- Today a New York Daily News piece (based on one in the Dawn (Pakistan)) reported that research showed Pakistani hospitals had made little progress in reducing the violence and sexual abuse that nurses suffer, despite a 2010 law aimed at curbing sexual harassment of women in the workplace. The short article was based mostly on two recent studies conducted by instructors at Karachi nursing schools. A survey by Shanila Jalaluddin of the Liaquat College of Nursing reportedly found that more than 31 percent of nurses at three Karachi hospitals had experienced "physical violence, and verbal and sexual harassment" in the preceding year, but only three percent reported the incidents, because they "feared retaliation and lack of support." Similarly, a study of Karachi hospitals by Rozina Somani of the Aga Khan University School of Nursing and Midwifery found that nurses tended to suffer violence and bullying at public hospitals, while verbal abuse "dominated" at private hospitals. According to that study, the perpetrators of the violence were patients, families, and other staff. But the incidents were "under-reported due to fear, shame and guilt." The Daily News commendably names both lead researchers, although the report does not explore possible reasons for the abuse or the atmosphere of impunity, such as gender bias and the low level of respect for nurses in particular. Pakistani nurse with police escortEven so, we thank those responsible for this troubling piece, which suggests that abuse of hospital nurses is common and that the nurses reasonably believe reporting it would result only in retaliation against the nurses themselves.

The Daily News begins by noting that according to the Dawn, "young women medical professionals and nurses in Pakistan are among the many groups vulnerable to workplace violence and sexual harassment," yet hospitals have made "no arrangements" to address the situation. The piece also says that a 2010 law called the Protection against Harassment of Women at Workplace Act included provisions to combat sexual harassment in the workplace, but there has been "no follow-up" and "many public sector hospitals have not yet constituted committees to inquire into such complaints." The piece might have provided some specifics about the law, including what it requires and what remedies it envisions for violations, as well as whether any other sectors of the economy have done better than the hospitals at implementing it.

Liaquat Nursing SchoolThe rest of the piece summarizes the findings of the two studies. The report says that Shanila Jalaluddin, a "lecturer at the Liaquat College of Nursing in Karachi," surveyed nurses at three Karachi hospitals. Her findings were not encouraging:

She found that over 31 percent of respondents reported experiencing physical violence, and verbal and sexual harassment over a period of 12 months. Only three percent of respondents reported the incidents, while 28.5 percent did nothing at all. The respondents who experienced frequent physical violence or verbal abuse said they feared retaliation and lack of support from the hospital administration.

The second study, by Rozina Somani, an "instructor at the Aga Khan University School of Nursing and Midwifery," focused on violence against nurses at two public and two private hospitals in Karachi. The piece reports that Somani

said physical violence as well as bullying was significant in public sector hospitals, while verbal abuse dominated in private hospitals. Patients, relatives, and staff members were found to be the main perpetrators of workplace violence against nurses, she said. But the incidents were under-reported due to fear, shame and guilt.

Pakistani nurses protestingCommon themes in these studies seem to be that many regard nurses as acceptable targets for violence and sexual abuse in the hospital, and that the targeted nurses believe, apparently correctly, that reporting the incidents will have no positive effect but will invite more abuse from the perpetrators. Of course, the piece might have included more detail about these problems, including possible causes and solutions. The report suggests that the nurses are predominantly female and that abuse of women has been identified as a major issue, so we wonder if gender bias is a key factor here, and if nurses are at particular risk because, as earlier reports have suggested, many see the profession as being something like prostitution. (See 1, 2, 3) We also wonder if understaffing and other resource shortages may increase the risk of abuse. And the piece might have explored what proportion of the abuse is committed by the nurses' own colleagues, such as the Pakistani physician who reportedly raped a nurse and was never held accountable. The piece might also have been clearer about exactly what the studies found, since physical violence is not easily distinguished from other abuse in this account.

In any case, although the report might have done more, it is still a helpful look at the troubling situation nurses appear to face in these hospitals. We thank those responsible for the report.

See the article "Pakistani nurses vulnerable to sexual harassment," posted August 5, 2012, on the New York Daily News website.


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