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Nurses exposed to harassment as law remains unenforced

KARACHI: Despite the general perception that young women medical professionals or nurses are among the groups of professionals vulnerable to ‘workplace violence’, public and private healthcare settings have largely no arrangements to prevent them from becoming targets.

Through a legal enactment in March 2010, the federal government made provisions for the protection of women against harassment, including sexual advances, sexually demeaning attitudes, causing interference with work performance or creating an intimidating, hostile or offensive work environment at the workplace, but there has been no follow-up to the move.

None of the public sector hospitals in the province have constituted a committee to inquire into such complaints as required under the Protection against Harassment of Women at Workplace Act, 2010.

A source in the Civil Hospital Karachi said that a committee was established about two years back for the implementation of policies to prevent sexual discrimination and harassment in the hospital. It comprised five female doctors and officers of the hospital and had nothing to do with relevant harassment legislation, said the source, adding that the head of the committee known as gender discrimination and harassment officer had already left the hospital.

Sharing the details of her pilot-research survey on nurses’ safety and security in hospital settings involving nurses of three tertiary care hospitals in the city, Shanila Jalaluddin, a senior lecturer at Liaquat College of Nursing, said that 31.4 per cent of respondents reported experiencing violence physically, verbally and sexually harassed in a period of 12 months.

Only 2.8 per cent respondents reported and filled the incidence forms, while 28.5 per cent of respondents did nothing at all.

Barriers to reporting

Respondents who experienced frequent physical violence or verbal abuse indicated fear of retaliation and lack of support from hospital administration and management as barriers to reporting workplace violence.

Rozina Somani, a senior instructor at the Aga Khan University School of Nursing and Midwifery, who had recently completed her research covering the prevalence of workplace violence towards nurses at two government and two private healthcare settings in Karachi, said that physical violence as well as bullying was significant in public sector hospitals, while verbal abuses (mostly peer to peer) dominated in private hospitals.

She said that altogether 458 nurses volunteered for her study aimed at identifying the prevalence of physical and psychological violence experienced by nurses in the four hospitals.

“The prevalence of all kinds of violence is quite high in both private and government health care settings. Patients, their relatives, and staff members were found the main perpetrators of workplace violence. Nurses who work in shift duties were more prone to workplace violence,” said Ms Somani. She added that sexual violence incidences were experienced equally in public and private hospitals, but these were under reported due to fear, shame and guilt.

“My study, which was undertaken under the supervision of Dr Rozina Karmaliani and awaiting a publication, provides some evidence-based recommendations to overcome the issue of workplace violence,” she said and urged the government to identify measures to provide a violence-free environment to nurses in all the healthcare settings of Pakistan, which was not only the requirement of the Harassment of Women at Workplace Act, 2010 but also was among the WHO goal of a violence-free healthcare environment.

The two researchers visited two public sector and three private sector major healthcare units for their research.

They said that it was the illiteracy on the part of the visitors, low education among the staffers, the existing long hierarchical line-up in government sector hospitals, attitudes of patients and their attendants and horizontal style of saying abuses in the private sector that contributed to the problem of workplace nastiness, which needed to be overcome through a great institutional supportive role.

Deputy secretary (technical) of the Sindh Women Development Department Musarrat Jabeen said that women did not like to speak about any sort of harassment as they feared they would not get proper support and finally would have to sit singled out. However, she said, the 2010 Act against harassment of women, which was applicable in the case of working women of Sindh as well, gave protection to women in all conditions and encouraged them to make complaint to the inquiry committee of her establishment or the ombudsman appointed under Section 7 of the Act.

She said that under the law the institutions were required first to display a code of conduct at the workplace, providing guidelines for behaviour of all employees, including management and owners of an organization, to ensure a work environment free of harassment and intimidation.

Each organisation was required to constitute an inquiry committee to inquire into complaints from a woman or man on being aggrieved by an act of harassment, she said. The committee should consist of three members of whom at least one member should be a woman, said Ms Jabeen, adding that one member of the committee should be from senior management and one should be a senior representative of the employees or a senior employee where there was no CBA.

Replying to a question, she said that the code of conduct had been printed on large cards for display at various public and private institutions, including government departments, hospitals and educational institutions, financial institutions. For some technical or coordination problem, the display of the code of conduct or formation of inquiry committee could not be ensured on a large scale or a fast track basis so far, she said, adding that a meeting of various sub-committees, including the health sector committee, formed under a watch committee of the women development department would be convened again within a month or so to expedite the matters and implement the law at hospitals as well.