In 2011, the Bahraini government violently crushed the kingdom’s mass pro-democracy protests, using excessive and indiscriminate force against peaceful demonstrators. The authorities went so far as to target medical personnel for treating wounded activists – a violation of the principle of medical impartiality that has continued to this day. As reported to the United Nations by Americans for Democracy & Human Rights in Bahrain (ADHRB), Defenders for Medical Impartiality (DMI), and the European Centre for Democracy and Human Rights (ECDHR), “the government surrounded and took control of Al-Salmaniya Medical Complex (SMC) and forces prevented ambulances, patients, and medical staff from entering or leaving the hospital, and fired teargas, rubber bullets, and pellet guns at the windows and entrances. Security forces created ‘interrogation chambers’ within the hospital to interrogate and torture doctors that treated injured patients.” Over 60 medics were arrested or tortured and the authorities dismissed 200 medics from their jobs. On 6 June 2011, emergency military tribunals – known as the National Safety Courts (NSC) – charged 47 of the health professionals during a closed hearing, many of whom worked at SMC.
Among those tried was Dr. Mahmood Asghar, a pediatric surgeon. He was arrested at gunpoint and was subjected to torture and other forms of cruel, inhuman, and degrading treatment. He was initially sentenced to 15 years in prison by the NSC, though the sentence was later reduced to six months. To date, the government continues to prevent Dr. Asghar from returning to work. Dr. Fatima Salman Hassan Haji, a rheumatologist, also remains suspended from work following her five-year prison sentence. During her arrest, authorities severely beat and sexually assaulted Dr. Haji in order to obtain a false confession. Bahrain’s Ministry of Health has also refused to reinstate Dr. Ahmed Omran to his previously held position. Likewise, Dr. Nabeel Hasan Tammam was suspended from work for a year and only rehired at half his prior salary upon his return. Both Dr. Omran and Dr. Tammam were arrested and tortured in 2011 before eventually being acquitted.
Dr. Ali al-Ekri, a pediatric orthopedic surgeon, was the last of these doctors to remain in prison after the 2011 mass arrests of medical personnel upholding medical neutrality. He had been in the operating room treating a teenage boy when security forces came to arrest him. Dr.al-Ekri was taken to multiple detention centers where he reports being tortured and beaten. The authorities kept him in solitary confinement for two weeks and during one interrogation he says he lost consciousness as many as five times. Dr. al-Ekri was finally released in March 2017 after completing his five-year sentence.
The government has continued to target medical personnel even after suppressing the 2011 protest movement. In 2016, for example, Bahraini authorities charged Dr. Taha Al-Derazi, a prominent neuroscientist, with “illegal gathering” for reportedly participating in the peaceful demonstrations in the village of Duraz. The police blockaded the area after hundreds of people launched a sit-in around the home of Sheikh Isa Qasim, the country’s preeminent Shia religious leader, to protest the government’s decision to arbitrarily revoke the cleric’s nationality. Dr. al-Derazi was ultimately convicted and sentenced to three months in prison on appeal.
More broadly, the government has institutionalized many of the practices it used to violate medical impartiality during the 2011 protests by virtually militarizing the country’s healthcare system. Bahrain’s public hospitals are either directly or indirectly run by military administration, with Lieutenant General Dr. Shaikh Mohammed bin Abdullah Al Khalifa – the former defense minister – leading the kingdom’s Supreme Health Council, to which the Ministry of Health is subordinate. Likewise, the nation’s ambulance and paramedic services are now under the control of the Ministry of Interior (MOI) security forces – the institutions most directly involved in the suppression of activists and dissidents. In February 2018, the king issued a decree further expanding the security forces’ authority over the ambulance services by establishing a new “rapid response National Ambulance Centre” to centralize ambulance operations for all four governorates under the MOI. Private hospitals have not avoided these developments, with the authorities typically requiring them to report patients that appear to have been injured in a protest. Security personnel are also often present in hospital facilities and can delay treatment with interrogations. These trends have had a chilling effect on emergency medical care, with those wounded by police afraid to seek treatment for fear of arrest, torture, and prosecution. Injured demonstrators increasingly seek ad hoc first-aid services from amateur paramedics or from doctors in their private homes – practices the government has also worked to suppress through criminal charges like “aiding a fugitive.”
This web of restrictions has had lethal consequences. In January 2017, masked personnel believed to be officers of Bahrain’s National Security Agency (NSA) fired live ammunition on the sit-in in Duraz, shooting 18-year-old Mustafa Hamdan in the head. Though local paramedics attempted to treat him, Hamdan required immediate emergency care to survive. A resident of Duraz rushed Hamdan to a private hospital, but staff there refused to admit him without an MOI official present. They also refused to send for an ambulance to take him to a public hospital. Eventually Hamdan’s brother arrived and took him to SMC, but once there approximately 35 security personnel interrogated the family and delayed treatment. Hamdan ultimately died from his injuries. It later emerged that the NSA arrested a paramedic that treated Hamdan at the scene; his fate remains unknown.
Once detained, individuals consistently face further restrictions on impartial medical care in Bahrain’s prison system. Prisoners – specifically political prisoners – are routinely denied access to medical care. Mohammad Sahwan, for example, was sentenced in May 2012 to 15 years in prison under the anti-terrorism law after being shot in the back, legs, and head by police armed with shotguns. He was unable to receive full treatment for these injuries and prevented from receiving medical care, despite multiple requests. He died of “sudden cardiac arrest” in Bahrain’s Jau Prison in 2017.
Other prisoners of conscience include Hassan Mushaima, a survivor of lymphoma who has been prevented from receiving regular cancer screenings; Hussain Abdulwahab Hussain Ali Ismail who suffers from sickle-cell anemia and polyradiculoneuropathy (a disorder of the peripheral nervous system) and has not been provided proper access to a doctor; and Dr. Abduljalil al-Singace, a survivor of polio who also has sickle-cell anemia and is confined to a wheelchair or crutches, but has regularly been denied access to medical care, including equipment for his crutches.
Additionally, imprisoned human rights defender Abdulhadi al-Khawaja has since March 2017 been suffering loss of vision in his right eye, which at worst might indicate emboli, with a possibility of cerebral stroke. Despite his need for emergency treatment, the authorities have denied al-Khawaja’s requests to attend his appointments without undergoing an extensive strip search and wearing shackles. Officials have also repeatedly denied him treatment for a separate medical condition that causes him chronic pain in his face. Al-Khawaja is serving a life sentence for his activism.
Nabeel Rajab, who cofounded the Bahrain Center for Human Rights with al-Khawaja, has also been denied adequate medical care since his re-arrest in June 2016. During his time in detention, he has suffered from severe skin infections, chronic gallstones, and irregular heartbeat among other ailments, leading to emergency surgery and repeated hospitalization. The government has refused to provide treatment for his gallstone, and the authorities held him in solitary confinement in unsanitary conditions. Rajab is currently sentenced to a total of seven years in prison in two separate cases pertaining solely to his peaceful exercise of the right to free expression.
Since 2011, the Government of Bahrain has actively worked to politicize and militarize healthcare, directly violating the principle of medical impartiality. Authorities continue to threaten medical personnel and their ability to provide universal medical assistance independent and professionally, while specifically denying treatment to victims of government abuse. The Bahraini government is obligated to respect the inviolable right to health, which is enshrined in the kingdom’s own constitution, and to guarantee the independence of healthcare workers. It must additionally release all prisoners of conscience, maintain minimum detention standards including the right to healthcare, and hold responsible officials accountable for torture and mistreatment.
Monica Zuraw, Advocacy Intern