Tina D Purnat

Public health

Health misinformation

Infodemic management

Digital and health policy

Health information and informatics

Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat

Public health

Health misinformation

Infodemic management

Digital and health policy

Health information and informatics

Blog Post

Information ecosystem disrupting health, Ex #8: Exacerbating violence against health workers

A never event is the “kind of mistake (medical error) that should never happen” in the field of medical treatment.

That’s also how I feel about the occurrence of violence, harassment, and intimidation of health workers when they’re doing their jobs. They’re also a never event. Health policy, workplaces and society should treat them as such.

As I write the last in the series of notes about how pushing buttons in the information environment plays out on health and well-being, my thoughts circle to the “Peshawar incident” in 2019. It is one of the first stories I heard from my UNICEF colleagues in early 2020 when we were comparing experiences and notes on misinformation affecting health services. It refers to the national polio immunization campaign in Pakistan that was suspended within 24 hours of its start because an inaccurate video gone viral on WhatsApp spurred attacks on hospitals and massive resistance in communities.

Rise of social media, social disharmony and intensified violence against health workers

I think that the intolerance and aggression started jumping from social media platforms into the physical real world during the 2010s, and have only gotten worse since.

The polio Peshawar incident in 2019 was definitely not the first acute health event where health workers were attacked while doing their jobs, where social media misinformation played a role. Some other examples are:

Violence against health workers has been increasing dramatically since before the pandemic

In other examples I’ve discussed in this series of notes, I’ve tried to explain the context of how the information environment is punching holes at the health system’s ability to deliver on its mission.

When it comes to violence against health workers, this is a larger and more complex trend, although confusion, misinformation, distrust, and lack of resources, protections and policies are not helping prevent the harm to health workers.

We are not talking enough about the rapidly escalating levels of attacks, harassment and intimidation of health workers that we are recording across the globe. I was shocked when I read that American hospitals are distributing panic buttons to hospital workers. I was able to find other concerns from all over the world:

When health workers are harassed, doxxed and attacked, this should ring highest-priority alarm bells for the health system

Every worker deserves to work in a workplace free of violence, harassment and intimidation.

When there are attacks against the health workforce, this should be the lastminute wake up call for the health system that something has gone really wrong between the health system and communities it serves.

To observe such egregious treatment of health workers, many things needed to have fallen short in the health system: its services to patients and communities, trainings and support to its staff, and its policies.

At the very least, measures must be put in place to protect health workers from harm and create protective systems and capacities to prevent violence.

In addition, any preventive measures would require the health system to rethink what has eroded people’s trust and confidence to the point where people feel that they can attack and harass health workers.

Bottom line, more needs to be done to protect health workers from harm and foster safe and fulfilling workplaces in the health system

I always try to end my notes with recommendations on what could be done to address the identified problem. In this case, you might have better and more ideas than me, and I’d like to hear from you.

I somehow don’t think that staff trainings and police forces in hospitals will solve this crisis or address the underlying reasons why violence keeps pouring over health workers.

The strongest and most coherent policy action there is to address violence against workers in the health sector is to strengthen and implement occupational safety and health programmes. These are important because they not only define direct prevention and protection action, but also impact worker’s compensation and insurance, and address systemic failures and capacities.

1/ Strengthening occupational safety and health programmes

To protect health workers against violence, WHO and International Labor Organization, it published a “Guide for the development and implementation of occupational health and safety programmes for health workers“.

  • It recommends creating and implementing sustainable programs to protect the health and safety of healthcare workers. These programs should cover various workplace hazards, including infections, physical strain, chemicals, and mental well-being.
  • Reading the guide left me feeling that health policymakers have a major blindspot in understanding where there’s a lack of tools and policies in relation to the protection of health workers from the dynamics of the digital information environment. This is especially important at a time when health workers are encouraged to go online and engage their patients and communities in online spaces they participate in. They should be protected by the health systems if they experience retaliation from trolls and harassers.
  • Tools for occupational health and safety planning would therefore need to consider doxing, online harassment and measures health organizations would even need to put in place to protect their own staff from digital identity and reputational harm. For example, Harvard’s Digital Safety Kit for Public Health Workers is a start. But other institutional policies are needed to define actions of digital communications and legal and safety teams to respond when healthcare staff are in such situations.

2/ Signing on to the ILO convention 190 on violence and harassment

In 2019, ILO Member States agreed the international convention number 190 on Violence and Harassment Convention, and an accompanying Recommendation (No. 206). In 2022 the International Labour Conference strengthened this commitment by including a safe and healthy working environment among the fundamental rights covered in the ILO Declaration on Fundamental Principles and Rights at Work.

Unfortunately, only 39 countries have ratified the convention to date.

One concrete action that countries can do is to take steps to ratify and implement it.