update: a short video about the incident in Rajbiraj Zonal Hospital https://youtu.be/TdgVjSCPpXg
This will be brief. And this blog entry does not take sides in the current Andolan. It is my prayer for Nepal that everyone will live long and prosper.
The above photo was taken in Terai. When I copied it, I forgot to note the source – I apologize for not citing it. The photographer was brave.
The Problem #1: In Terai, victims of thrashing, tear gas, shooting with bullets (“rubber” or lead), and other trauma are brought to the nearby hospital. (warning, link shows events in Birgunj, it’s graphic)
The Problem #2: Some cases have been reported that people from other groups have followed in to the hospital and looked for victims, then thrash them some more.
The Goal: maintain security of hospital, treat all patients regardless of political affiliation, keep staff safe.
September 5th update: I wrote a blog about the riot control squads and latest developments in Birgunj, in a separate website. click here. http://www.dailykos.com/story/2015/09/05/1418672/-Five-Police-Killings-in-Nepal-and-cremating-the-dead-Sept-5th
- review the physical construction of the building. Limit number of access points, install steel grates, lighting, etc so that it’s not so easy to get in. see the previous blog for a long list of ideas. It has a checklist from “Secure by Design” that is excellent. Put locks on internal doors such as the ones between wards, and develop internal escape routes.
- Develop a system to alert people if a problem occurs, not just the other staff, but also the chowkidars, administrators, and police.
- If the Army is there, meet with the in-charge so they know who you are, before trouble starts.
- put phone numbers in your smartphone on speed dial.
- secure anything that might be grabbed and used as a weapon.
- discuss ways to de-escalate angry persons and run a practice drill.
- learn about treatment of tear gas exposure, the types, and decontamination. (it’s a powder and if it’s on the patient you may get exposed).
- develop a triage plan for mass casualties. There are some excellent videos on triage! Be advised, the system to process wounded people is not the usual. You can’t just start with first-come, first-served. You need an Incident Command System.
There are many places on the internet where you can get advice about personal safety. I recommend “Safeguarding Health.” They work in countries where there is an actual war zone – let’s hope Nepal never gets that way!
On their website it gives the following statement:
During armed conflict or civil disturbances, assaults on health facilities, health workers, and the patients they serve are all too common. Aside from the human toll they take, these attacks compromise the ability to deliver care to populations in great need, impede efforts to reconstruct health systems after war, and lead to the flight of health workers whose presence in a time of great social stress is essential.
The risks of being a health worker on the frontline
During periods of armed conflict, health workers are at risk of:
- Torture, abuse, kidnapping, and other human rights violations for treating patients on either side of the conflict
- Poor mental health and well-being due to living in troubled locations with the constant threat of attack
- Lack of supplies and vital equipment due to systematic raids
- Forced displacement due to attacks and fear of continued violence.
These dangers contribute to critical shortages in human resources in areas where care is most needed, as well as decreased efficacy of health professionals, wastage of millions of dollars in aid, and loss of human capital through migration.
Obstructions to routine health care delivery
Assaults not only result in obstructed access to health services but pose a formidable challenge to health systems, limiting the effective operation of health systems during instability and impeding the development of health infrastructure and meeting human resources needs once stability returns.
The legal framework for protection (editor’s note: see the comments section. The current Terai events are “internal violence” – go to the Terai Human Rights Defender’s Alliance site and learn about THRDA )
The Geneva Conventions of 1949 and the Additional Protocols of 1977 mandate the protection of medical facilities, personnel, and patients; the humane treatment of civilians; the right of access to care; and the nondiscriminatory treatment of the ill and wounded in time of war. International Human Rights Law is the only international legal framework governing situations of internal violence and continues to apply during armed conflicts.
My novel, The Sacrament of the Goddess, is set in Nepal during the Civil War. Yes, there is a love story, and the reviewers so far have focused on that aspect. But the setting is a hospital, and the book tells how the people there deal with being caught in the middle of conflict. One of the key questions is “If this is a Buddhist country, why and how can such violence take place?” When I wrote it, I was not thinking we’d have a flare-up in Nepal again, but those sections are now more timely than ever. It’s on Amazon. There is a separate blog for The Sacrament of the Goddess.