• Situation at ATH largely unchanged; impractical solutions taken and discontinued
• ATH says it has requested resources to improve situation
• GMOA request for Police post at ATH has not been answered
• GMOA report on safety of healthcare staff to be completed this week  

The sexual assault of a female doctor at the Anuradhapura Teaching Hospital (ATH) earlier this year, despite shocking the nation and driving urgent calls for reform, has seen little meaningful change. Things at the hospital continue as before, with the incident having all but receded from memory.

In the immediate aftermath of the incident, prominent medical bodies and healthcare stakeholders issued urgent calls for action. In a strongly worded letter, the Ceylon College of Physicians condemned the assault and called for enhanced safety measures, stating that the “deplorable incident not only violates the sanctity of a medical institution but also undermines the safety and morale of healthcare professionals who dedicate their lives to serving the public”.

Accordingly, it urged the President to mandate the implementation of comprehensive security protocols across all hospitals, including 24/7 surveillance systems, adequate lighting in and around hospital premises, deployment of trained security personnel, and controlled access to sensitive areas such as doctors’ quarters and on-call rooms, as well as to form a dedicated task force comprising representatives of the Ministry of Health, hospital administrations, law enforcement agencies, and medical professional bodies to assess and reinforce the safety of healthcare workers.

‘Back to square one’

Yet on the ground, such changes appear to have been temporary. “Nothing much has changed with regard to safety,” said a doctor who works at the hospital, speaking to The Sunday Morning on condition of anonymity.  

“Minor changes were made, which is appreciated, but there is a lot that can be done. However, I understand that most demands made by the doctors’ association at the hospital cannot be met due to financial or logistical issues.”

Detailing the attempts at providing greater security, he noted: “Following the incident, the director and hospital administration installed some floodlights for areas in the dark, like the car park and staff quarters. There were also some safety measures taken, like having minor staff accompany doctors coming from the on-call room, etc. However, it wasn’t practical, and it is not practised now.” 

Moreover, while security personnel had been increased initially after the incident, things have now returned “back to normal”. While he noted that the hospital may have increased the amount of private security personnel, he observed that these weren’t trained professionals capable of handling serious threats. 

However, one positive outcome has been the restriction of the shops that were operating 24/7 outside the hospital premises. A magnet for drug addicts and intoxicated individuals at night, these shops no longer operate after 6 p.m. “The idea of having a hospital square like at the National Hospital of Sri Lanka didn’t bear fruit because there were some logistical issues, such as opposition from street vendors.”

With these being the only real changes, the doctor noted that they were “back to square one in a way”.

Part of the difficulty lay in the sheer size of the hospital premises, the doctor noted. Implementing security infrastructure such as CCTV cameras are likely to be expensive and will only function as a preventative measure, while cordoning off the main hospital block and staff quarters block remains unlikely due to logistical issues.

Measures to ensure safety 

The question of the safety of healthcare workers has long been a concern for industry bodies. 

According to Government Medical Officer’s Association (GMOA) Executive Committee Assistant Editor Dr. Charuni Kohombange, in attempting to enhance the safety of such workers, the association has also had a discussion with the Inspector General of Police and requested for strengthening the Police force at hospitals. 

The request involves establishing a Police force in major hospitals, from general hospitals to base hospitals. She noted that although this request had been made in January, it was yet to manifest.

According to ATH Director Dr. Nimal Ariyaratne, whose appointment to the post is fairly recent, measures had been taken in the aftermath of the incident, with a security council being established at the hospital and attempts at improving lighting systems. Meanwhile, additional safety measures are in the pipeline.

Accordingly, the hospital has requested additional security personnel from the Ministry of Health. “We have installed some lights and have cleared the roads. We are also planning to install CCTV cameras,” he added.

He noted that they would be requesting support at an upcoming District Development Committee meeting for clearing the roads, given the presence of many unauthorised shops in front of the hospital. “The municipal council is also operating a parking space in front of the hospital, so it has some responsibility to remove these,” he said, noting that the presence of three-wheelers and unauthorised shops posed a threat.

Moreover, the hospital plans to build quarters for the staff, especially for consultants and other medical officers, in order to improve accommodation. “The problem is that quarters are scattered everywhere, which means we can’t provide security properly,” Dr. Ariyaratne said. “We are going to place the doctors’ quarters, nursing quarters, and other quarters in separate locations. We have also awarded contracts to build protective boundary walls surrounding the hospital and quarters.”

Several of these initiatives have received ministry approval and will commence next year, pending budget allocations. 

GMOA policy measures 

Meanwhile, Dr. Kohombange shared that the association, which was previously reported to be compiling a report on healthcare workers’ safety to be presented to the Prime Minister, Health Ministry, Women and Child Affairs Ministry, Justice Ministry, and Police, would be convening a subcommittee on healthcare worker safety.

“The subcommittee is currently compiling a policy framework regarding healthcare worker safety, which will be launched in a week’s time. It will be finalised and launched by next week,” she said, speaking to The Sunday Morning on Wednesday (17).

The policy framework will include all safety issues currently being faced by all healthcare workers, both male and female, including nursing officers, minor staff, etc. It identifies risks and steps that can be taken by institutions and local governments, as well as national policies that need to be refined and the legal framework required.

According to Dr. Kohombange, who described the incident in Anuradhapura as an “eye-opener,” in the aftermath of the incident, hospital directors and hospital staff had taken maximum efforts to ensure safety, but this has not been sufficient. 

“There are still places without basic safety and nonaccessible places where healthcare workers have to travel through. The transport issue is also part of this, mainly in remote areas. Even in Colombo there are places that are unsafe. All this has to be addressed,” she said. 

Dr. Kohombange therefore stressed the need for provisions from the Government and greater focus to address the situation. She also pointed out that beyond immediate safety, the issue had broader implications such as retaining doctors in the country in a context where their safety was not guaranteed. 

Attempts by The Sunday Morning to contact the Deputy Minister of Health and Ministry of Health Secretary regarding measures taken to address the safety of healthcare workers proved futile.