The rape of a medical doctor at the Anuradhapura Teaching Hospital sent shockwaves across the country in March, earlier this year. Returning from the hospital after work, the doctor was threatened at knifepoint and sexually assaulted in her own doctors’ quarters, located a short walking distance from the hospital. 

The incident highlighted the safety and security concerns that doctors have been raising for years, especially those working in the peripheral areas. Months later, industry bodies are finalising their reports for recommendations on safety for healthcare workers. 

SLMA stance 

The Sri Lanka Medical Association (SLMA) is currently compiling a report on measures to address the safety concerns faced by healthcare workers. 

“This report will address many things, including security, risks from disease, and verbal and physical abuse faced by healthcare workers. We feel it’s not just enough to talk about doctors’ safety; we need to address it for all healthcare workers, including nurses and midwives. 

“Midwives especially move from home to home in rural places. I was a Medical Officer of Health in Balangoda in the early 2000s and have witnessed the risk they take to report to their duty,” SLMA President Dr. Surantha Perera told The Sunday Morning. 

The SLMA plans to present its report to the Health Ministry in the coming months. 

Following the incident in Anuradhapura earlier this year, the SLMA organised a policy forum to discuss safety in healthcare settings. The points raised are to be included in the policy report that the association plans to present to the ministry. The discussion saw a number of wide-ranging issues surface, including:

• Challenges faced by healthcare workers, especially women, in their respective workplaces 
• Global frameworks and local interventions regarding healthcare worker safety
• Need to establish a grievance mechanism for healthcare workers to report their concerns and Standard Operating Procedures (SOPs) to address them in healthcare settings 

At the time, the SLMA also noted that unsafe working conditions were contributing to the brain drain, causing professionals to migrate overseas. The crisis is aggravated by insufficient mechanisms for lodging complaints, poor administrative responses, a lack of institutional accountability, and political interference. 

Although the SLMA developed a set of guidelines on workplace sexual harassment in 2016, its implementation remains poor as some administrators are unaware of their obligations and staff are underusing and undertrusting reporting pathways. 

In the short term, the SLMA noted the importance of activating visible protective mechanisms such as regular Police patrols and structured chaperoning systems. The body’s longer term recommendations include:

• Incorporation of workplace safety and responsiveness as key evaluation criteria in the accreditation process for institutions 
• Integration of Continuous Professional Development (CPD) modules on violence prevention, interpersonal skills, safeguarding, and legal literacy into standard training across the sector 

GMOA report 

The Government Medical Officers’ Association (GMOA) is also compiling a report on healthcare workers’ safety, due to be finalised by the end of next month. 

“This report isn’t limited to recommendations like building doors and repairing locks in healthcare institutions. We are recommending policy decisions and legislative measures that would include everyone inside a healthcare institution, such as conducting security checks and forming security committees,” GMOA Spokesperson Dr. Chamil Wijesinghe told The Sunday Morning.  

The GMOA has also had a discussion with the Acting Inspector General of Police (IGP) regarding the matter. Currently, only base hospitals have Police posts, and therefore the discussion had centred around strengthening these and having effective emergency response systems in place.  

At the discussion, the issue of human resources in the Police had been brought up, and discussions had considered utilising officers of the Civil Defence Force where Police are not available. 

“However, we haven’t reached a decision on the matter yet,” said Dr. Wijesinghe. 

Once the report is finalised, it is to be presented to the Prime Minister, Health Ministry, Women and Child Affairs Ministry, Justice Ministry, and Police. The GMOA hopes the report will serve as a starting point for further policy instructions. 

Midwives 

A few days before the incident in Anuradhapura, a midwife in Medagama was verbally and physically assaulted by the father of a baby who had been brought in for weight measurements by her mother to a Family Health Bureau (FHB) clinic. 

Government Midwifery Services Association President Devika Kodithuwakku said they had not been called in for any discussions about healthcare workers’ safety following the Anuradhapura incident, although midwives faced serious safety concerns in the line of duty. 

“At the very least, we need a place where we can register our complaints and where the institution supports us in seeking justice when we lodge a complaint. There is no place where we can go to with our complaints and concerns. There is no institution dedicated for the safety of healthcare workers, be it a doctor, midwife, nurse, or junior staff member – man or woman,” said Kodithuwakku. 

Health Ministry Secretary Dr. Anil Jasinghe said the ministry had held a meeting with all hospital directors to recognise gaps in safety for workers, and had asked them to address those gaps. 

“The Director General of Health Services also issued a circular regarding the matter,” said Dr. Jasinghe.