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Ashfaq Yusufzai
Pakistani doctors protest about terrorist attack on hospital
BMJ 2008; 337: a1426 [Full text]
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Rapid Responses published:

[Read Rapid Response] Health workers need protection
Saeeda Bibi   (27 August 2008)
[Read Rapid Response] Attack Sites are as Unpredictable as Mother Nature
Shazia Qasim Jamshed   (27 August 2008)
[Read Rapid Response] Pakistani doctors protest about terrorist attack on hospital
Jasia Khan   (27 August 2008)
[Read Rapid Response] Not so surprising
Afaq Ali   (28 August 2008)

Health workers need protection 27 August 2008
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Saeeda Bibi,
housewife
Pakistan

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Re: Health workers need protection

This is indeed shocking that health facilities come under continous attacks in Pakistan. The already fragile health system has further suffered in the wake of US' war on terror in Pakistan.

Not only attacks were carried out against health facilities, but girls' schools were exploded by hardline Taliban. Lately, people have risen up against the Taliban for their suicide blasts that killed innocent people.

I, on my part, would advise the US' administration to spare hitting hospitals in the poorest areas of the country.

From where would the population of tribal areas seek treatment? There are women, children and elderly people.

Recently more than a dozen people, including seven children, died of gastroenteritis only because of staffing problems in local hospitals in Kurram tribal area. The three-month-old blockade of roads due to clashes has also resulted in shoratge of medicines and foodstuff.

We appeal to the United Nations to stop the US, NATO and Pakistan army from attacking civilians and health facilities.

Competing interests: Pakistan is my country

Attack Sites are as Unpredictable as Mother Nature 27 August 2008
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Shazia Qasim Jamshed,
PhD Scholar
Social Pharmacy, Universiti Sains Malaysia

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Re: Attack Sites are as Unpredictable as Mother Nature

Insurgency, terrorism, counter-terrorism, and internal conflicts are some of the terms which seem to creep in the cultures of many developing nations; Pakistan being one of them.

The news of “Pakistani doctors protest about terrorist attack on hospital” published on 26th August 2008 is a cause of grave concern. As a Karachite this reminds me of wave of doctors’ killings in Karachi, Pakistan during 2001-2002 when sniper firing killed more than hundred doctors. Even then following the murder of one doctor the Pakistan Medical Association (PMA) called a Karachi-wide strike of doctors and paramedics.

Similarly last month in Ahmedabad, India two blasts in and near the hospitals killed two doctors among twenty nine.

Our health care facilities and health workforce are now become soft targets for this grievous act. The logic to cripple and kill downtrodden, helpless as well as caregiver is inexplicable.

Charles Hancock from Loughborough University a leading expert in healthcare risk management stated (1) “Hospitals are very ‘un-secure’ places. Through our studies of previous hospital evacuations, we found that gaining access to a hospital was easy - terrorists could pose as visitors, agency nurses or care assistants, and hospital security, while much improved in recent years, was still far from perfect."

Protective measures in the form of updating hospital policies to avoid or deal these situations help to save both the afflicted and soother.

REFERENCES:

1. Hancock, C. & Johnson, C. Thinking the unthinkable: the NHS and terrorist action. Health care risk report. 2006; 12 (5): 16-18

Competing interests: None declared

Pakistani doctors protest about terrorist attack on hospital 27 August 2008
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Jasia Khan,
Foundation Year One Doctor
St. George's Hospital, Tooting SW17

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Re: Pakistani doctors protest about terrorist attack on hospital

It is indeed very sad when one hears about attacks such as this on a hospital, which is generally considered a safe haven for all.

Being a British Pakistani, I can relate to the problems attacks such as these pose - in a rural setting, this can negatively impact on the locals who are trying to seek medical help as well as cause fear in the hearts of the health professionals themselves.

What compounds this problem is dilemma the doctors are facing- the duty of care to their patients versus the need to protect themselves from danger. I can completely appreciate why the healthcare professionals are protesting about the attack and demanding that they are given protection. It would, however, be interesting to know whow the current situation is affecting the ethical responsibility of beneficience in the healthcare professionals that are working in the hospital.

Competing interests: None declared

Not so surprising 28 August 2008
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Afaq Ali,
student
Lahore, Pakistan

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Re: Not so surprising

Attacks on hospitals are no surprise in view of breakdown of law and order and radicalisation of the society particularly in northern Pakistan. The situation, is eaxctly the same that was in Afghanistan during the Taliban's rule, where they killed people at their own will.

The Taliban have used the local population as sheild to aviod arrests by military. They take refuge in tribal areas which are bombed by the US forces, killing innocent people.

Recently, about 300,000 people migrated Bajuar tribal area in Pakistan after the military launched an operation against the Taliban there. The migrants are now in a state of helplessness.

They are exposed to outbreaks of diseases, such gastroenteritis and even cholera.

After all, hitting health facilities is against all international norms. The US must spare the hospitals from being bombed because these are supposed to provide treatment to the people.

Competing interests: I am a Pakistani