When the place of work is not safe for a health worker

Priscah* was sobbing uncontrollably. She was afraid, very afraid. She was heartbroken on so many levels, it was impossible to imagine what she looked like when whole. Through puffy desperate eyes, she implored me to discharge her home from hospital, for the sake of world peace. 

Priscah had been admitted two days before, bleeding a torrent. She was 34 weeks pregnant and hysterical about her baby. Unfortunately, by the time she got to us, the little angel was gone. The fight was to prevent a similar outcome for Priscah. We were on a tea break in theatre when the labour ward team barrelled in with Priscah on a stretcher. 

We were galvanised into action like a conveyor belt on steroids, getting the barely conscious Priscah on the operating table in under five minutes. We had already lost the baby, we were not going to lose Priscah, so help us God! 

Priscah’s placenta had separated from the uterine wall, a condition called abruption placentae, causing massive bleeding in the womb and effectively snuffing out baby’s oxygen supply. We delivered the baby and the offending placenta in record time then turned the focus on the real trouble spot — the angry, splotchy purple uterus. 

With every stitch, we chanted a prayer that the uterus would contract into a hard ball and put a stop to the torrent. Everyone held their breath, the grave silence only punctuated by the beeps from the monitors. Priscah furiously fought for her life, with her heartbeat dancing insanely on the monitors. 

Two hours later, Priscah was wheeled out of surgery under cover of multiple tubes and an ongoing blood transfusion. She was going to mend! I met her husband at the bay and conveyed the painful news regarding the baby but reassured him about Priscah. 

Barely 48 hours after cheating death, I was called by the nurses to see Priscah in the postoperative ward. She was out of the woods but not ready to go home. Her husband had requested for her discharge. It took a lot of gentle convincing for her to open up about the abuse. 

Priscah got married to escape poverty. Orphaned at birth and tossed from one relative to another, she thought she had found a break in love. 

She had no idea she had stepped right into the furnace. Soon after, the husband turned her into a punching bag. She had suffered so many beatings she had lost count. He was a police reservist and she felt that reporting him to the police would not help. 

Being pregnant did nothing to mellow him. He beat her into a miscarriage the first time round and when the doctors questioned her injuries, he discharged her from the hospital. He had beat her into the abruption placentae and had the guts to accuse her of killing his son. The pain that seared through her heart pushed her to the edge and she told him she was done with the torture. 

The bully had turned up at the hospital, replaying the circus, demanding to take his wife home. I tried to reason with him about Priscah’s need to stay on and recover but my explanation hit a wall. 

When I held my ground, he got nasty and attempted to rough me up. This was the signal the security officers needed to step in. The police were also on the way. His 40 days were over. Not only did he find himself facing assault charges but also murder charges for the unborn baby. 

The World Health Organization (WHO) defines workplace violence as incidents where staff are abused, threatened, or assaulted in circumstances related to their work, challenging their safety, well-being, or health. This includes both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment; occasioned by the patients or their kin. 

A systematic study by Vento et. al. published last year revealed that the prevalence of workplace violence for health workers was 61.9 per cent, with 42.5 per cent reporting non-physical violence, and 24.4 per cent experiencing physical violence in the past year. Verbal abuse (57.6 per cent) was the most common form of non-physical violence, followed by threats (33.2 per cent) and sexual harassment (12.4 per cent). The highest risk departments include the emergency and psychiatric departments and attacks have been known to result in death. 

Last year, WHO condemned attacks against healthcare workers treating patients with Covid-19, revealing the impact of the pandemic on the problem. 

The World Health Association has declared violence against health care workers a disaster. What health care workers need are strong policies protecting their safety in the workplace and a supportive system in handling the matter. 

Without healthcare worker protection, the patient remains the loser!

Dr Bosire is an obstetrician/gynaecologist