The Rising Tide of Violence Against Health Care Workers

The first time I saw a doctor cry was when I was a young resident student during my O&G rotation first. Back then, I was a wide-eyed idealist who believed that the white coat conferred upon its wearer some measure of invincibility, some shield against the raw, unvarnished cruelty of the world we had sworn […]

The first time I saw a doctor cry was when I was a young resident student during my O&G rotation first. Back then, I was a wide-eyed idealist who believed that the white coat conferred upon its wearer some measure of invincibility, some shield against the raw, unvarnished cruelty of the world we had sworn to serve.

We had lost a patient, a young mother who had come in with complications from childbirth, her life slipping away despite everything we threw at it. Blood transfusions, Oxytocin, Misopristol, everything. The doctors were preparing to remove her uterus when the woman passed out from severe blood loss. The Senior resident doctor who had fought for her life for six straight hours, refusing  to give up long after hope had become a luxury we couldn’t afford any more, stood in the corner of the ward with his shoulders shaking and tears streaming down his face in a manner that seemed almost indecent, almost unprofessional, almost human.

The man was sad and tired, but he was also scared. How was he to face the patient’s relatives? I didn’t think much of it, until I saw the woman’s husband swing a blow in his direction when he was breaking the news to him. 

O boy!

There was alarm as some people came to hold the man, dragging him away while he was raining curses and abuses. That was the day I realised that no security guard, no hospital administrator, and no law enforcement officer could stand between healthcare workers and the fury of a family searching for someone to blame.

That was more than twelve years ago.

Today, things are worse. Much, much, worse.

A while back, at the Federal Medical Centre in Owo, a resident doctor was assaulted at the hospital’s Accident and Emergency Unit after relatives of a surgical patient allegedly attacked the physician while he was on duty. At the University College Hospital, Ibadan, emergency unit personnel were attacked following the death of a patient. At the Kwara State University Teaching Hospital, a female doctor and a nurse were assaulted by a patient’s relative who allegedly attacked them while the doctor was simply explaining hospital charges for a medical procedure. At the Central Hospital in Warri, two doctors were assaulted by the father of a deceased newborn in the Special Care Baby Unit. At Olabisi Onabanjo University Teaching Hospital in Sagamu, a female House Officer was assaulted after being identified as one of the team members who attended to a patient who died in the Accident and Emergency unit.

Over 90 per cent of the victims in these attacks are doctors who have suffered not only physical injuries but also emotional trauma, destruction of their personal belongings, and lasting psychological scars that may never fully heal. And in most of these cases, the victims received nothing more than mere apology letters as if a piece of paper could compensate for a broken jaw or a traumatised mind or a career cut short by fear.

The reasons for this violence are as varied as they are predictable, and they are deeply intertwined with the broader failures of our healthcare system. When patients and their relatives are forced to wait for hours in overcrowded casualty wards, when they are confronted with unaffordable medical expenses that they cannot hope to pay, when they watch their loved ones die because essential equipment is unavailable or because there are simply not enough doctors to go around, their frustration is understandable even if their violent response is not. The Nigerian health system, with its one doctor for every 3,871 patients, its dilapidated infrastructure, its chronic shortages of medications and supplies, and its underpaid and overworked staff, is a pressure cooker waiting to explode.

And when it does explode, the ones who bear the brunt of the blast are the doctors and nurses who had nothing to do with creating this system in the first place, the same doctors and nurses who chose to stay in Nigeria when they could have left, who continue to show up to work despite being paid months late, who use their own money to buy medications that the hospital cannot provide, who work 48-hour shifts because their colleagues have fled the country for better opportunities elsewhere.

The Nigerian Medical Association and NARD are now pushing for the criminalisation of assaults on doctors and other healthcare workers, arguing that healthcare professionals need special laws protecting them from violence. They want assaults on healthcare workers to be treated as aggravated offences, as is the case in many countries around the world, because violence in hospitals endangers not only staff but also patients and public safety.

But laws alone will not solve this problem. We need hospitals with proper security. We need zero-tolerance policies that are actually enforced. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to pay our doctors well enough that they don’t need to work three jobs just to survive. And most importantly, we need to fix the system that creates the frustration in the first place the long waiting times, the unaffordable medical expenses, the lack of equipment, the shortages of staff, the dilapidated infrastructure.

When a patient dies in a Nigerian hospital, it is almost never the fault of the doctor standing there with blood on their scrubs, their face etched with exhaustion, their voice hoarse from shouting orders that no one can hear over the chaos. They are the final link in a broken chain, a chain that starts with corruption at the highest levels of government, continues through decades of underinvestment in healthcare infrastructure, and ends with a stretched-thin health care worker doing the work of ten people while praying that today will not be the day someone decides to take their anger out on them.

We are not the enemy.

We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen.

We need hospitals with proper security. We need zero-tolerance policies that are actually enforced. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen. We need hospitals with proper security. We need zero-tolerance policies that are actually enforced. We need to prosecute attackers the same way we would prosecute anyone who assaults another citizen.