Health workers reported serious shortages of personal protective equipment (PPE) in nearly all of the 63 countries and territories surveyed by Amnesty International.
This includes countries which may yet see the worst of the pandemic, such as India and Brazil and several countries across Africa. A doctor working in Mexico City told Amnesty International that doctors were spending about 12% of their monthly salaries buying their own PPE.
In addition to a global shortage of supply, trade restrictions may have aggravated this problem. In June 2020, 56 countries and two trade blocs (the European Union and the Eurasian Economic Union) had put in place measures to either ban or restrict the export of some, or all, forms of PPE or its components.
“While states must ensure there is sufficient PPE for workers within their territories, trade restrictions risk exacerbating shortages in countries that are dependent on imports,” said Sanhita Ambast.
“The COVID-19 pandemic is a global problem that requires global cooperation.”
In at least 31 of the countries surveyed by Amnesty International, researchers recorded reports of strikes, threatened strikes, or protests, by health and essential workers as a result of unsafe working conditions. In many countries, such actions were met with reprisals from authorities.
The authorities are forcing doctors to choose between death and jail.
In Egypt, for example, Amnesty documented the cases of nine health care workers who were arbitrarily detained between March and June on vague and overly broad charges of “spreading false news” and “terrorism”. All those detained had expressed safety concerns or criticized the government’s handling of the pandemic.
Another Egyptian doctor told Amnesty International that doctors who speak out are subjected to threats, interrogations by the National Security Agency (NSA), administrative questioning, and penalties. He said:
“Many [doctors] are preferring to pay for their own personal equipment to avoid this exhausting back and forth. [The authorities] are forcing doctors to choose between death and jail.”
In some cases, strike action and protests have been met with heavy-handed responses.
In Malaysia for example, police dispersed a peaceful picket against a hospital cleaning services company. The picketers’ complaints centred around what they said was the unfair treatment of union members by the company as well as a lack of sufficient protection for hospital cleaners. Police arrested, detained and charged five health care workers for “unauthorized gathering” in violation of their rights to freedom of association and assembly.
“Health and essential workers have a right to raise their voices against unfair treatment,” said Sanhita Ambast.
“Health workers can help governments improve their response to the pandemic and keep everyone safe – but they can’t do this if they are in prison, and they can’t do it if they are afraid to speak up.”
There have also been reports in several countries of health and essential workers being fired or facing disciplinary action for speaking out about their concerns.
In the USA for example, certified nursing assistant Tainika Somerville was fired after posting a video on Facebook where she read out a petition calling for more PPE. Tainika says staff at the nursing home in Illinois where she works were not informed that they were working with COVID-19 patients and found out through the media. The nursing home had reported 34 infections and 15 COVID-19 related deaths as of May 29.
In Russia, Amnesty International highlighted the cases of two doctors, Yulia Volkova and Tatyana Reva, who are facing retaliation after complaining about a lack of PPE. Yulia Volkova has been charged under Russia’s fake news laws and faces a fine of up to RUB 100,000 (USD 1,443), while Tatyana Reva is facing disciplinary proceedings that may result in her dismissal.
Unfair pay and lack of benefits
In addition to unsafe working conditions, Amnesty International has documented how some health and essential workers are being unfairly paid or in some cases not paid at all.
In South Sudan for example, doctors on the government’s payroll have not received their salaries since February and do not receive welfare packages or medical cover. In Guatemala, at least 46 facilities staff were not paid for the two-and-a-half months they spent working at a COVID-19 hospital.
In some countries, there are no additional benefits for health and essential workers in the context of the Covid-19 pandemic, and in other countries benefits exclude certain categories of workers.
Amnesty International is calling on states to consider COVID-19 an occupational illness.
As part of this they must ensure that health and essential workers have access to compensation and other support in case they contract the infection. They must also be included in priority groups for COVID-19 testing.
Stigma and Violence
Amnesty International documented several cases where health and essential workers experienced stigma and violence because of their jobs. For example, a nurse in Mexico was reportedly drenched with chlorine while walking on the street, and in the Philippines, attackers poured bleach in the face of a hospital utility worker.
These incidents point to a climate of misinformation and stigma and underscore the importance of governments providing accurate and accessible information on the spread of COVID-19.
We call on all states affected by COVID-19 to carry out independent public reviews into their preparedness for and responses to the pandemic
In Pakistan, Amnesty International has recorded several instances of violence against health workers since April. Hospitals have been vandalized, doctors have been attacked, and one was even shot by a member of the Counter Terrorism Force.
There have been several statements from ministers in Pakistan claiming that hospitals have the necessary resources, despite reports that hospitals have been forced to turn away even critical patients, due to the shortage of beds, ventilators and other life-saving equipment. This puts health workers in danger as people don’t believe them when they say they do not have room for more patients.