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TRIGGER WARNING: THIS STORY CONTAINS ACCOUNTS OF HARASSMENT

The harassment of women doctors at hospitals is nothing new, nor is the lack of adequate measures to ensure their safety. The issue has been around for decades, all over the world, but the recent rape and murder of a trainee doctor at the RG Kar Medical College and Hospital in India’s Kolkata brought the issue back into the spotlight.

The attack was horrific, as was the emergence of an intergovernmental memo in which the government of West Bengal pledged in 2019 to curb violence against doctors by implementing better security equipment, employing female guards, and controlling entry points. Those promises never materialised.

But before we hastily point fingers at our neighbouring country, as Pakistanis are often wont to do, we must acknowledge that Pakistani women doctors don’t have an easy time of it either.

A tough job

Exhausted doctors resting with their eyes open and backs straight, sitting on a worn out sofa in a dilapidated old room without locks or proper beds after a gruelling 18- or 36-hour shift is a typical scene at Pakistani hospitals. Outside, in the chaotic emergency room of either the expensive private hospital or the overcrowded government hospital, relatives of patients argue over diagnoses or leer at female nurses and doctors as they go about their work.

At times, a patient’s family erupts in anger, their rage at an impossible situation taken out on the people working tirelessly to help their loved one. They hurl expletives or corner female medics if the news delivered to them is not what they want to hear. No one wants to hear — or deliver — bad news at a hospital.

Even if a woman doctor survives these encounters unscathed, she might face harassment at the roving hands of male colleagues — juniors, seniors, department heads, professors, even lower-ranking staff. This could be in the form of inappropriate gestures, overtly sexual comments or something so subtle that it seems almost silly to even mention it — the almost imperceptible brush of a hand, a glance that lingers a touch too long, a smile that holds something more.

These are the daily realities for women medics in Pakistan, a country where many parents dream of their daughters becoming doctors, believing their white coats will protect them from the harsher aspects of society.

Unfortunately, that’s not always true.

Luxuries or the bare minimum?

An online survey conducted via the Dawn.com and Dawn Images Instagram pages found that 47 per cent of 988 respondents who identified as female medical professionals reported not feeling safe at both government and private hospitals. Of 932 respondents, 47.2pc said they had experienced harassment while on duty, and 67pc of 637 respondents said their hospital had not provided a safe space for them to rest.

The sample size of the survey isn’t large enough to draw any major conclusions, but it does support what many women told Images about what it’s like to work at hospitals in Pakistan.

“I was working in the ward while my senior rested in the room after completing a 36-hour shift,” said Dr Sara*, a resident doctor at the National Institute of Cardiovascular Diseases (NICVD) in Karachi.

There is no separate room for women doctors to rest in — only a single space shared by both genders — and male doctors and nurses often enter the room unannounced. That means anyone resting in the room could be caught unaware.

“That day, the same thing was about to happen, but I stopped the man in his tracks before he could open the door by asking him to knock before entering,” Dr Sara recalled. “He got offended and created a scene, accusing me of ‘doubting his intentions’.”

The request, which seemed reasonable enough to Dr Sara, escalated into an argument, drawing a crowd that only dispersed once consultants and the administration intervened.

“I still don’t understand why asking for a simple knock on the door was so offensive to him,” the 28-year-old doctor reflected.

Exhausted from repeatedly requesting the management to arrange a separate resting room, the doctors at NICVD reached a compromise — they would assign one ward’s resting room for women doctors and another for the men. However, this arrangement meant that female doctors had to leave their ward to rest, which they wanted to avoid unless absolutely necessary. “There can be an emergency at any time; we can’t afford to be 15 minutes away from a patient,” Dr Sara explained.

While many doctors grapple with the idea of a shared resting space, nurses on 12-hour shifts often have no designated area to rest at all.

“We don’t get any space to rest. It’s as if they don’t consider us human beings who might need to put our feet up,” Sabrina*, a nurse at a government hospital in Hub, Balochistan, told Images.

The 45-year-old nurse, who has been working for 25 years, lamented, “Nurses are often seen as the least important, but people forget we are the ones looking after patients for hours when doctors only check on them briefly. It would be nice to have a place to eat lunch or take a break, but to the management, that seems too much to ask for.” Her complaints were echoed by nurses in Karachi and Khyber Pakhtunkhwa, who said they didn’t have a place to rest at their hospitals either.

While having a place to rest may seem like a luxury to some, after a 12-hour shift, even the most dedicated and conscientious nurses need a moment to close their eyes and take a breath.

The absence of separate restrooms for doctors is a another basic concern that remains unaddressed at many government hospitals.

Dr Maria*, a general surgeon working in KP, said that they do have a separate bathroom but the male attendants use it as often as the female attendants. The bathroom also only has a bolt instead of a proper lock.

“Patients knock on it for no reason and the lock is so flimsy we can’t risk a second knock because that might push open the door,” she said.

Dr Maryam*, who recently completed her house job at Abbasi Shaheed Hospital in Karachi, pointed out that women doctors working in the emergency room also didn’t have their own bathroom. “Our batch was not the first to raise this issue. It has existed for years. My seniors, fellow house officers, and even the Young Doctors Association have all raised the issue with the administration, but nothing has changed,” said the 24-year-old.

“I’ve endured 12-hour shifts without a bathroom break. The emergency room is almost always packed and I simply don’t have the time to go to another ward that’s a 20-minute walk away,” she explained. “At this point, I wonder: is a separate bathroom a basic necessity or a luxury?”

This very question was raised in varying forms by doctors in KP, Punjab, Balochistan and Sindh working at both government and semi-private hospitals. But the challenges faced by women in medicine do not end at a lack of bathrooms and safe spaces to rest — they only become worse.

Tensions running high

When people bring their family members to hospitals, tensions are often high and doctors are often first in the line of fire when their anger erupts.

This form of harassment is faced by every doctor, regardless of gender, according to a study conducted by the International Committee of the Red Cross that surveyed Karachi’s hospitals in 2015. The study said almost two-thirds of healthcare providers reported having experienced some form of violence.

Of those incidents, more than half took place in emergency wards as a consequence of charged reactions from attendants, the study found.

In this case, both genders experience the same harassment, for male doctors it often devolves to physical violence, while female medics often experience physical intimidation and threats of rape or sexual violence.

“It had only been a few months after I joined the hospital when I was assigned to examine three female bodies involved in a road accident,” recalled Karachi Police Surgeon Dr Summaiya Syed.

Before Dr Syed could reach the room to carry out her duties — which involved stitching up the bodies to make them presentable for burial — she was confronted by a mob of 25 men. They cornered her, demanding she not lay a finger on the bodies.

“My back was against the wall, and they refused to let me leave, even when I said I would go away without doing anything,” she recounted, her voice shaky.

The crowd quickly swelled to 50 men, none of whom would let her move an inch. It wasn’t until her male colleagues intervened and explained the necessity of her work that the men allowed Dr Syed to leave.

“In the end, they insisted that only I should handle their women’s bodies, which I did,” she sighed.

To this day, Dr Syed wonders how she found the courage to continue in the field — even two decades later, crowded places still make her anxious.

That fear is not uncommon in women doctors, and it only intensifies when the threat comes from those who are supposed to protect you.

At a government hospital in Peshawar, Dr Sameera* treated the six-year-old daughter of a hospital security guard. “The child was in mild pain but otherwise fine, so I prescribed some oral medicine,” she explained.

However, the man was unsatisfied with the treatment and took his daughter to a private hospital, where she tragically passed away 12 hours later.

“Instead of holding the private hospital accountable, he filed a case against me at the police station, threatened me, and demanded I take responsibility for her death,” Dr Sameera recalled, her voice coloured with disbelief.

The situation dragged on for a month. During that time, the guard — who worked at the same hospital — would follow her around with a gun holstered to his belt. He would make threats all while the police questioned her about her professional conduct.

“Every day of that month was an agony I will never forget,” said Dr Sameera.

In private hospitals in Karachi, the conditions aren’t too different.

“It was the middle of the night when a seven-year-old girl was brought into the emergency room with respiratory problems,” recalled Dr Asma*.

The child was accompanied by 15 stocky, intimidating men, their raised voices dripping with rage. Within minutes, the young patient passed away.

With just two female nurses in the emergency room, Dr Asma didn’t dare break the news immediately — and for good reason. When she finally delivered the tragic news — after ensuring the nurses were safe — the men began destroying everything in the emergency room. Then they turned towards her.

“They demanded I apologise, verbally abused me, and threatened me. ‘How will you get home?’ ‘I will not let you leave’,” she recalled them saying. Years have passed, but even today, Dr Asma avoids taking night shifts in the ER whenever she can.

Many other doctors in Islamabad, Sindh and Punjab shared similar stories. In KP, the patients families sometimes feel that women doctors are not “good enough” to treat their relatives.

Dr Maria* said that even if she had examined the patient and given a diagnosis, the families wouldn’t accept it unless a male doctor gave it to them. “My gender takes precedence over my capabilities as a doctor. It’s just a cultural thing,” she sighed.

It’s not just visitors that make female doctors feel unsafe. Often, the threat comes from within the hospital itself.

Leering in the hallways

A workplace free of sexual harassment has long been a demand in the never-ending fight for gender parity. In a patriarchal society such as ours, the fear of victim blaming and character assassination inhibits many women from taking action against their harassers.

A recent study conducted by the Aga Khan University Hospital in Karachi found that nearly 70 per cent of female surgeons in Pakistan had experienced some form of harassment or discrimination in the workplace.

Some women may have even quit the medical field due to harassment or discrimination, but it’s difficult to tell how many. “They would never announce that they are quitting because of harassment, they just disappear quietly,” said Dr Syed.

According to a report by Gallup Pakistan and PRIDE, there are 104,974 women medical graduates residing in Pakistan. Of the total, 21,146 or 20.1pc are out of the labour force

Last year, Dawn released a special report uncovering how an American NGO ignored complaints made by female health workers at its Pakistan offices. It went on for years until three doctors gathered the courage to speak up.

Images spoke to women doctors and nurses from all four provinces of Pakistan, both in rural areas and in urban centres, about their stories of harassment. The harassment they faced ranged from being catcalled to comments about their bodies, jokes with double entendres and passing touches. We are only highlighting a few of the stories we were told in this article. Most of the doctors we spoke to asked not to be named, because they fear that coming forward with these incidents might harm their future prospects in the medical field.

Many a time, the harassment is subtle, so subtle that it is difficult to prove or even talk about. Over time, they may even forget about it, just like Dr Maria*, a general surgeon at a government hospital in KP.

“After spending some time in the field, I grew immune to these gestures, touches and jokes — I accepted that they were part of the job. It was when my sister talked about becoming a doctor that the realisation of how ugly this is dawned upon me,” said the 32-year-old.

“When it’s a patient’s family, it ends in a few days. But when it’s someone you work with, it feels endless,” said Dr Tahira*. Even after a decade, she remembers her story of harassment as if it happened yesterday.

Having spent her entire life in a small village, moving to Hyderabad for her house job was equal parts nerve-wracking and exciting. She spent the first few months at the government hospital trying to understand its dynamics, keeping to herself and avoiding unnecessary social interactions.

“It was the middle of the night when I received a message from an unknown number complimenting my looks,” Dr Tahira recalled. The message sent shockwaves of fear coursing through her.

More messages followed, detailing her exact location and describing what she was wearing. They left her always looking over her shoulder, constantly anxious of being watched.

The messages became more frequent and she soon discovered they were sent by the head male nurse at the hospital. She did not file a complaint against him.

“I tried bringing it up with a senior, but they told me he’d been employed for eight years and was favoured by the management,” Dr Tahira recalled. “I was alone in the city. Informing my family would have only worried them.”

So, she did what many women in Pakistan are often compelled to do — she remained silent. Once her house job was over, she never went back.

“Do you really think someone who is a permanent employee of the hospital would be questioned over an allegation made by a junior doctor?” asked Dr Rida*. She was completing her house job at a semi-private hospital in Lahore and went through a similar experience.

A resident doctor would make inappropriate comments to her. She initially ignored him, but soon it escalated into deliberate bumps and brushes, and creating situations in which they were alone. She knew the doctor’s behaviour was wrong, but she stayed quiet.

“The consultants believed that female house officers complained just to avoid working late hours,” Dr Rida recalled.

That wasn’t her only challenge. “We were often instructed to walk between wards in the middle of the night, sometimes across poorly lit paths. The male staff loitering in those hallways and leering at me would make my anxiety soar every time I had to fetch something,” she recounted.

For nurses, the situation is often even worse.

“I’ve been inappropriately touched by patients and disrespected by doctors — both male and female,” said Jasmine*, a nurse of 25 years.

Early in her career, Jasmine assumed that the touches by patients were accidental. “I thought they were unintentional until a senior told me otherwise,” she said.

“The most shocking moment was when I discovered inappropriate videos of me on a 14-year-old boy’s phone,” she said. “You can’t stop it. The only thing you can do is protect yourself as best as you can.”

This is not an isolated incident. Four women doctors at the Rawalpindi District Headquarters (DHQ) Hospital complained this past May that ‘highly objectionable’ videos of them were filmed when they were performing their duties. According to one of the doctors, female doctors and nurses faced harassment and objectionable videos were filmed every day. The doctors were often blackmailed and harassed with those videos.

Police Surgeon Dr Syed emphasised how challenging it is for female doctors to report harassment by their male colleagues. “Nobody stands by your side. Everyone doubts you and questions you — whether they’re your friends or your family.”

She said it takes incredible courage for a doctor to speak up. Despite the Sindh Healthcare Commission Act of 2013, which has a zero-tolerance policy for harassment, “it is rare that any complaints are received.”

Dr Syed filed a complaint of harassment herself, but her case was never resolved. However, as someone who is often a member of the committees investigating such cases, she ensures that a conclusion is always reached.

“It doesn’t matter if you’re a doctor there to serve people, if you’re wearing a burqa, a lab coat, socks with shoes, and a mask on your face; if you have a woman’s body, you will be leered at, touched, and made to feel uncomfortable,” said Dr Farwa Khalid, who did her house job at Abbasi Shaheed Hospital in Karachi. “That’s just the way it is.”

*Names have been changed at the request of the women interviewed

Cover image generated using AI