For treating protesters, Bahrain’s government made me an enemy of state

Despite constant government repression, Bahrain’s pro-democracy movement will soon enter its fifth year. Each day, demonstrators take to the streets, calling for reform; each day, security forces violently respond, showering them with tear-gas and rubber bullets. According to local activists, the government arrests almost a dozen protestors a day. Those not arrested are often left bloodied and suffocating on the street. I know from experience, having treated many of them myself.

The creeping militarisation of Bahrain’s healthcare system has ensured that the plight of the wounded protestor does not conclude in a hospital bed. Since 2011, when the government crackdown began, those injured at the end of the nightstick have faced severe obstacles to receiving even the most basic medical treatment. The government has subsumed the entire healthcare infrastructure within its greater security apparatus.

As Bahraini medical professionals, we have watched as this process doubly criminalises the victims of state violence - first for exercising their public freedoms, second for suffering physical harm - as it has also criminalised our profession, making us, their caregivers, accomplices in the broader, illicit enterprise of non-violent dissent.

In the immediate aftermath of the uprising, security forces assumed control of Salmaniya Hospital, the largest public hospital in Bahrain. They beat physicians and even arrested them as they performed surgery. Over the next four years, the government systematically forced all hospitals, health centres, and public clinics to monitor their patient intake for possible protestors, dissidents, and members of the opposition. Security forces pressured medical professionals to deny service to anyone potentially associated with "the criminal activities currently facing Bahrain". Should any of my colleagues encounter a possible victim of police violence, it is now mandated that we immediately alert the authorities. 

Moreover, should a doctor or nurse observe a colleague treating a suspected individual, they are required to report both the name of patient and the staff member. Personnel who fail to report are subject to questioning, arrest and imprisonment.

This increasing control of the security apparatus over the medical system has forced the most vulnerable members of Bahraini society to seek treatment in underground clinics that lack medical equipment and supplies to effectively treat injuries. The government has worked to guarantee that demonstrators and activists, those who exercise their “public freedoms,” are paradoxically relegated to the margins of public life - even in injury. 

The unlucky bystander, inevitably caught in the crossfire of the constant and often indiscriminate deployment of "riot control" devices, is "guilty" by mere association. In this context, the government has transformed its victims into enemies of the state. For this special class of Bahraini "criminal," an emergency hospital visit has become synonymous with a prison term.

The severity of these regulations notwithstanding, many of us have decided to risk government retaliation rather than abandon our fellow citizens to death and disease. In order to ensure some fundamental access to basic healthcare, we have subverted the ban and treated injured people in their communities and in their homes.

The resulting healthcare subsystem - a fluctuating network of underground clinics staffed by an ever-changing set of medical personnel - has managed to provide an illegal yet tenuous safety net for the men, women and children most exposed to recurrent state violence.

The government, for its part, rejected our fragile subsystem altogether. Once reports of underground clinics began to emerge, the security forces started raiding buildings and communities where the injured were rumoured to have undergone treatment. If they discovered medical equipment in these raids, the authorities confiscated the gear and arrested the owners of the house.

In 2011, the security forces even raided offices of the international medical aid organisation Médecins Sans Frontiéres (Doctors Without Borders). The government has justified their invasions of private homes - to interdict desperately needed medical supplies - as a public security necessity.

The government has also taken institutional measures to combat the impartial administration of healthcare, targeting myself and my colleagues in the process. After the Arab Spring uprisings, officials mandated that a government committee must first approve any scholarship, employment or promotion in the medical field.

Militarisation of healthcare

Although the committee technically reports to the Ministry of Health, it is chaired by members of the Ministry of Interior, which oversees Bahrain’s internal security apparatus. These officials have failed to reveal any of the criteria in their decision-making process, allowing the government to arbitrarily determine the future of any doctor’s career. Furthermore, the committee has targeted and dismissed doctors known to assist the underground clinics, many of whom remain unemployed.

Ultimately, the militarisation of healthcare further belies the government’s claims of its method of “non-lethal” crowd control. Those crowds “controlled” by Bahraini security forces are not dealt with in a “non-lethal” manner; rather, participants are beaten, battered and gravely wounded. Instead of allowing these men and women access to open and impartial medical service, the government employs an illusion of prospective treatment in a final act of state-sanctioned extortion: seek care in prison, or die.

When we, as medical professionals, risk our own freedom to provide a third option, we become immediate "security threats" to the militarised healthcare system and are pulled into the same cycle of repeated government violence.

If the government is so insecure that it has recast the provision of basic medical care as an act of criminal destabilisation, it has also recast it as an act of defiance. We have no better way to demonstrate the corruption of a regime so deeply threatened by fair medical care, than to continue vigorously defending just that. 

- Sayed Abu al-Shifa is the pseudonym of a medical professional currently working in Bahrain. The author, who asked to remain anonymous for fear of government reprisal, is a consultant for Defenders for Medical Impartiality.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Eye.  

Photo: Bahraini protestors take cover during clashes with police following a demonstration (AFP)