Hospitals Under Siege as Cultures Clash
In South Italy, hospital doctors had to barricade themselves in a service room in order to fend off angry family members of a patient who died under emergency surgery
Surgeons and nurses were attacked by a large group of relatives after a patient died during emergency surgery at the polyclinic in the city of Foggia, in Apulia (Puglia in Italian) in the far south of Italy. Three hospital staff were injured, according to local online news site CerignolaViva reporting on-site. A surgeon got repeatedly fisted to his face, another doctor had her hand broken by a door slammed on it when she attempted to escape. The staff had to barricade themselves in an office until the police arrived at the scene.
Still from video on social media, shown on many sites, including Corriere del Mezzogiorno.
This happened on the night of 5 September, but the complicated trauma of the patient were from a traffic incident in the provincial town of Cerignola back in June. The young woman involved, Natasha Pugliese, 22, was badly injured in a traffic accident just before midnight on 18 June. She was on an electric scooter and exited from a side street to the major road Via Napoli when she was hit by a car passing in that moment. A person in the car was also injured and treated at the emergency response center.
The vehicle was a ‘monopattino’ roller. This kind of light-weight, stand-up electric scooters have become very popular in European cities. In many places, they stand in clusters at the side of the road and are available for rent via an app. It is also cheap to buy one, as they are quite simple yet also able to go as fast at many normal bicycles. Most countries say the bicycle laws covers these scooters, so they must drive on the road or bicycle lane, not on the pavement. They must have lights just like bicycles, but in practice that is not common. And obey the same traffic rules as bicycles, such as rights of way and precedence, speed limits etc. But over the last few summers, the scooters have been used in reckless manners with several deaths and injuries to both riders and pedestrians as a result, all over Europe. Many cities have banned the leasing companies from placing their vehicles in the most crowded parts of town, because of the perceived risk, and some insurance companies have introduced restrictions.
The young woman was lifted by helicopter to the Policlinico Riuniti hospital in Foggia, the main city of the province. Doctors had to bring her into an induced coma with breathing by tracheotomy (surgically opening the windpipe and inserting a temporary tube for breathing and evacuating secretions) and three broken vertebrae, plus other injuries. It took weeks for her to recover to a point where the doctors deemed it possible to bring her out of the induced coma. That involved removing the tube and restoring normal breathing. But surgeons failed in this latter attempt, allegedly because the damages to the trachea were irreparable. All this is tragic in itself, but the reaction of the family and friends of the deceased led to more tragedy.
"Our Natasha enters the operating room at 5:45 p.m. We wait behind her door to see her: at 7:00 p.m. 2 doctors come out: 'We need to talk to a family member'". The doctors explain that there are complications in progress, and that certain things can happen. "Then he tells us 'Now we have to go back in, the girl is losing blood' ... this is absurd, the girl is losing blood and they come to talk to us", Tatiana considers.
No more news arrives until 10:30 p.m., when some police patrols arrive on the scene. "Maybe we had already understood everything but we didn't want to believe it... We ask the policemen 'Why are you here?'. The police ring the bell in the ward but no one opens". When the door swings open, Tatiana enters the ward: "I find the doctor in front of me and I ask in cold blood: 'Is she dead?' He makes a sign to me... I didn't understand anything anymore, I screamed and put my hands on everyone", says the victim's sister. (Il Giornale)
The authorities have initiated two investigations in the case. One to find what went wrong at the hospital and one into the violent attack on the staff.
Described on the newspaper Corriere del Mezzogiorno, the sister writes on her public Facebook page:
"My family waged war worse than Gomorrah, because my sister was killed by them." These are the words contained in a long post published on the Facebook profile of Tatiana Pugliese, sister of Natasha, the 23-year-old who died on Wednesday 4 September during an operation at the Riuniti hospital in Foggia and whose friends and family responded to her death by attacking the medical staff at the Riuniti hospital in Foggia. Dozens of people in fact flocked to the hospital to attack the doctors, who were forced to barricade themselves in a room in the operating block as can be seen in a video that went viral on the web, raising a wave of indignation.
The staff was shocked by the assault and have raised concerns over what happened, and if it is becoming a trend. Doctors’ and nurses’ unions in Italy have called for authorities to consider bringing the military into hospitals in response to an increase in attacks by patients and their relatives that provoked outrage across the country. Italy has seen a number of similar attacks recently, including two others in the Puglia region, one in the same hospital in Foggia, as well as two other physical attacks in the province of Naples, where health workers said patients and their families turned on emergency room doctors after being asked to wait their turn.
Antonio De Palma, chairman of one of the major nurses’ associations, says on their website that he urgently wants the military deployed to protect the safety of hospital personnel:
In the absence of an adequate number of law enforcement officers, it is essential to think of a "Safe Hospitals" modality, with the presence of our army in healthcare facilities, starting with those in the capital cities and those with the largest catchment area. We cannot wait! "
Patients are impatient - System under pressure
Many European countries are seeing an increased number of violent incidents directed at medical personnel. In lack of a comprehensive overview, we can still list a two major contributing factors.
Hospitals are understaffed because of cost-cutting in combination with increasing demand, like in Italy where in certain zones migrants top up the general increase of elderly and sick persons. The pandemic already caused many healthcare professionals to find alternative occupation. It is a vicious circle because once under pressure, doctors and nurses start to leave and thus make the insufficiency even worse.
The culture clash with relatively uneducated people not being able to understand concepts such as risk, prioritization, cautions that are common in health care. Lack of confidence in authorities, including medical experts and police officers is not unusual in many places, such as Southern Italy, but aggravated by culture conflicts. Desperation in extended families leads to the kind of attacks we are seeing, trying to solve grievances with mass presence, threats and ultimately, physical violence.
Finally, a philosophical viewpoint that probably is recognized by now, that general education and decent behavior is on the decrease, not just in marginal groups, but more widespread in geography and demography. In need of respect for people who serves society.