Extensive new evidence released regarding Israel’s killing, detention and torture of Palestinian healthcare workers

October 9, 2024
Labour Hub Editors

In a comprehensive report, Healthcare Workers Watch (HWW) is sharing first-hand testimony from Palestinian healthcare workers who have been tortured while in Israeli detention.  The Killing, Detention, and Torture of Healthcare Workers in Gaza contains the organisation’s detailed research, compiled over the past year, regarding Israel’s killing and detention of healthcare workers, including an analysis of the devastating impact on the provision of healthcare to the population of Gaza.

Through the rigorous evidence collected as primary data by HWW, this report outlines patterns of human rights violations carried out by the Israeli Occupation Forces that are unambiguously consistent with deliberate acts to inflict upon a specific population – the Palestinians living in Gaza – serious physical and psychological harm, consistent with the intent of genocide. These patterns of conduct include the targeted killing, injuring, detention and systemic torture of healthcare workers in a manner that is leading to death and disability of the Palestinian population by depriving them of healthcare, both in the short and long term.

This report also provides evidence of a wider pattern of genocidal conduct that has led to the largescale destruction of the healthcare system of Gaza. This includes the military besiegement, invasion and deliberate destruction of hospitals and medical equipment, forcing hospitals out of service, in some cases permanently. As a direct result of these crimes, tens of thousands of Palestinians are dying entirely preventable deaths due to a lack of access to adequate healthcare.

Dr. Muath Alser, the founder of HWW says: “In this report, we use rigorous evidence to demonstrate how the Israeli Occupation Forces are systematically targeting the healthcare workforce of Gaza. The patterns of human rights violations are unambiguously consistent with the intent of genocide.”

He goes on to say: “The key message from Healthcare Workers Watch is that all healthcare workers – especially those working in areas of conflicts and war zones – must be protected, supported, and respected instead of being targeted, tortured, and detained.”

Among the report’s findings are:

• HWW has confirmed the killing of a total of 587 healthcare workers in Gaza since October 7th 2023, and are in the process of verifying the killing of a further 420 healthcare workers. One third of those confirmed killed are women (194).
• HWW data shows that 105 senior physicians were killed or detained by the Israeli military since October 7th 2023, constituting 23% of Gaza’s most experienced physicians. This includes 39 killed consultants, 41 detained consultants, 19 killed specialists and 6 detained specialists.
• As of September 20th 2024, HWW documented 264 cases of unlawful detention of Palestinian healthcare workers in the Gaza Strip by Israeli Occupation Forces since October 7th 2023. These include 73 physicians, 2 dentists, 80 nurses, 36 paramedics, six pharmacists, one optometrist, 21 technicians, 29 healthcare administrative staff, four healthcare students, three volunteers, and nine others. Four of those detained were killed while in detention, 127 remain in detention currently, 23 are missing, and 110 were released (three of them were detained twice, then released). Fifty-five were from North Gaza, 91 from Gaza City, one from the Middle Area, 115 from Khan Younis, and two from Rafah.
• Several released healthcare workers interviewed by Healthcare Workers Watch reported being subjected to systematic torture and inhumane treatment in Israeli detention.

According to messages received from several healthcare workers in Northern Gaza, and also a statement recently released by the Palestinian Ministry of Health in Gaza, Israeli Occupation Forces are now threatening all healthcare workers and patients in northern Gaza’s hospitals, ordering them to evacuate to the south or they will face the same fate as Al-Shifa Hospital, where mass graves of men, women and children were found following the withdrawal of Israeli forces.

 So far, Israeli Occupation Forces have detained a paramedic while transferring a critically ill patient from the ICU of Kamal Adwan Hospital. The fate of the paramedic is unknown.

HWW are profoundly concerned about the safety of healthcare workers and the existence of the northern Gaza population as they are “facing a serious escalation of genocidal acts that render northern Gaza unliveable due to indiscriminate military actions and the destruction of the healthcare system through the killing, detention, and torture of healthcare workers and the wanton destruction of hospitals.”

Regarding the new report, HWW say: “We release this report in memory of the hundreds of healthcare workers killed in Gaza by the Israeli Occupation Forces, given the complete absence of effective international response, utter impunity, and failure of concerned organisations to prevent or stop these crimes, let alone hold their perpetrators accountable.”

Healthcare Workers Watch is powered by dedicated volunteers committed to documenting the Israeli attacks against healthcare workers in Palestine, and taking action accordingly. For more information, see www.healthcareworkerswatch.org

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Digital healthcare, location optimization and road improvements are recommended to improve healthcare in Ho Chi Minh City

Peer-Reviewed Publication

UNIVERSITY OF EASTERN FINLAND

 

IMAGE: THE BEST AND POOREST QUALITY HOSPITALS AND CLINICS IN HO CHI MINH CITY. THE BEST HOSPITALS AND CLINICS ARE MARKED RED AND THE POOREST ARE MARKED BLUE. (HEALTHCARE QUALITY SCORE). view more 

CREDIT: THE AUTHORS.

The quality and accessibility of healthcare plays a crucial role in preventing and mitigating health problems. A study conducted in Ho Chi Minh City, Vietnam’s largest city of 9 million residents, showed that people living in the city’s established and new urban areas have access to better-quality and better-accessible healthcare than people living in the suburban areas. According to the researchers, digital healthcare, road improvements and better urban planning could be used to promote more equal healthcare in a cost-effective manner.

Conducted by the University of Eastern Finland, the University of Social Sciences and Humanities – Vietnam National University Ho Chi Minh City, and the Ho Chi Minh City Institute for Development Studies, the study showed that nearly 1.2 million people in Ho Chi Minh City live in deficiently served areas in terms of healthcare. Their travel time to the nearest hospital is more than 30 minutes, and more than 15 minutes to the nearest clinic.

Published in BMC Health Services Research, the study utilised data from public registers on hospitals, health clinics, streets, roads, population, and healthcare quality. The researchers analysed the quality and accessibility of healthcare and, relying on international studies, they also examined the opportunities of digital healthcare to improve the provision of services.

In Ho Chi Minh City, healthcare services are provided by public and private hospitals and clinics. Some hospitals are focused on specialised medical care, while clinics typically provide primary and emergency care. In the city’s new developing urban areas, healthcare facilities have been built in cooperation with private sector developers, thus aiming to improve their accessibility. In suburban areas in the outskirts of the city, however, sporadic demand and small market for healthcare have led to its poor quality and poor accessibility.

“This is a shortcoming that requires action and new solutions. Our study links digital healthcare solutions to the planning of healthcare and urban development, while also providing an example and tools for planning a more equal system of digital and physical healthcare also elsewhere,” says Researcher Khanh Hung Le of Vietnam National University Ho Chi Minh City.

The researchers recommended prompt adoption and development of digital healthcare services by hospitals and clinics capable of doing so, while also setting an example for others.

“Ho Chi Minh City has set the digitalisation of healthcare as a goal in its digital transformation programme for 2030,” Researcher Thi Xuan Phuong La of HCMC Institute for Development Studies notes.

“Remote clinics, self-monitoring, remote monitoring and healthcare applications should be developed in order to improve the quality and cost-effectiveness of healthcare services, for example in situations where the demand for healthcare services is sporadic and the supply does not adequately meet the demand. The development of remote healthcare services would also reduce the need for travel,” says Professor Markku Tykkyläinen of the University of Eastern Finland.

The map shows how patients in the urban areas of the city are most likely to receive the best-quality healthcare, and where the best-quality healthcare facilities are concentrated.

Hospital Service Areas. Maximum patient travel time 10, 20 and 30 minutes and respective distances along the street and road network to the nearest hospital at the average speed of 20 km/h. (Service Area).

Clinic service areas. Maximum patient travel time 5, 10 and 15 minutes and respective distances along the street and road network to the nearest clinic at the average speed of 20 km/h. (Service Area).

CREDIT

The Authors.

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JOURNAL

BMC Health Services Research

DOI

10.1186/s12913-022-08758-w 

ARTICLE TITLE

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City.

Administrative fellowship programs may reinforce gender disparities in healthcare leadership

Peer-Reviewed Publication

WOLTERS KLUWER HEALTH

November 11, 2022 – While administrative leadership programs positively impact the career paths of individual leaders, male leaders benefit more from these programs than female leaders do, according to a longitudinal study featured in the November/December issue of Journal of Healthcare Management (JHM), an official publication of the American College of Healthcare Executives. The journal is published in the Lippincott portfolio by Wolters Kluwer.

The study looked at the value of administrative fellowship programs on career attainment as well as whether career attainment differs by gender. Findings indicate that “although fellowships can accelerate career progression for both men and women, the effect is significantly stronger for men, suggesting that, in aggregate, there is some risk that fellowships may be widening the leadership gender gap, rather than attenuating it,” write Julie Robbins, PhD, The Ohio State University, along with Brooke Z. Graham, MBA, MS, James Madison University, Andrew N. Garman, PsyD, Rush University, Randa Smith Hall, MBA, MHSA, University of Alabama-Birmingham, and Jeffrey Simms, MSPHA, University of North Carolina at Chapel Hill, in the November issue of the Journal of Healthcare Management (JHM).

Diverse leadership can lead to higher quality of care

While women account for nearly 80% of the total healthcare workforce in the United States (and 70% globally), they represent just 30% of C-suite positions. Further, a recent survey reported 86% of women in healthcare believe change is needed to increase women in senior leadership positions. Many experts and analysts believe women leaders—and more diverse leadership in general—are critical for an efficient healthcare organization that provides high-quality care to patients from all backgrounds.

Administrative fellowship programs are highly selective and designed to help graduates move directly into healthcare leadership positions, offering practical experience as well as professional networking opportunities. Many programs focus on increasing gender diversity, yet there are few studies of the programs’ impact on career progression and on gender disparities in leadership.

The research team set out to uncover whether there is a difference in career attainment between female and male graduates, between those who graduated from an administrative fellowship program and those who did not, and between female and male administrative fellows.

Demographic and career attainment data were collected in 2018 from historical records, alumni databases, and career resources of the graduating classes of 2013, 2008, and 1998 from 15 administrative fellowship programs. The sample included 689 student records.

Closing the gender gap in healthcare leadership requires career-supporting strategies and initiatives

Among the findings, women were found to be a slight majority of graduates across the three graduating classes. Those who began their careers in administrative fellowships increased to 38% in 2013. Further, 52% of graduates across the three classes held senior management or executive positions as of 2018. Finally, while beginning a healthcare career in an administrative fellowship appears to accelerate career attainment for both women and men, the effect is significantly stronger for men.

While additional studies and efforts are needed, the authors believe “this research can help early careerists and especially women better understand their career planning steps and developmental opportunities to reach leadership positions.” It is clear that administrative fellowship programs are a valuable vehicle for leadership development.

The article goes on to suggest that administrative fellowship program directors can help reduce this gender gap by, for example, re-designing programs to be more equitable, further expanding program access to women, and tracking program application patterns by gender.

Read [Closing the Gender Gap in Healthcare Leadership: Can Administrative Fellowships Play a Role?]

DOI: 10.1097/JHM-D-21-00314

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About the Journal of Healthcare Management

The Journal of Healthcare Management (JHM) is an official journal of the American College of Healthcare Executives (ACHE). Published bimonthly, JHM is a peer-reviewed publication dedicated to providing healthcare leaders with the information they need to manage complex healthcare issues and to make effective strategic decisions. JHM provides a forum for discussion of current trends and presentation of new research as applied to healthcare management.

About the American College of Healthcare Executives

The American College of Healthcare Executives is an international professional society of more than 48,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE's mission is to advance its members and healthcare leadership excellence. ACHE offers its prestigious FACHE® credential, signifying board certification in healthcare management. ACHE's established network of 76 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its vision of being the preeminent professional society for leaders dedicated to improving health.

The Foundation of the American College of Healthcare Executives was established to further advance healthcare management excellence through education and research. The Foundation of ACHE is known for its educational programs, including the annual Congress on Healthcare Leadership, which draws more than 4,000 participants and groundbreaking research. Its publishing division, Health Administration Press, is one of the largest publishers of books and journals on health services management, including textbooks for college and university courses. For more information, visit www.ache.org.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

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JOURNAL

Journal of Healthcare Management

Autistic individuals have poorer health and healthcare

Peer-Reviewed Publication

UNIVERSITY OF CAMBRIDGE

Autistic individuals are more likely to have chronic mental and physical health conditions, suggests new research from the University of Cambridge. Autistic individuals also report lower quality healthcare than others. These findings, published in Molecular Autism, have important implications for the healthcare and support of autistic individuals.

Many studies indicate that autistic people are dying far younger than others, but there is a paucity of research on the health and healthcare of autistic people across the adult lifespan. While some studies have previously suggested that autistic people may have significant barriers to accessing healthcare, only a few, small studies have compared the healthcare experiences of autistic people to others.

In the largest study to date on this topic, the team at the Autism Research Centre (ARC) in Cambridge used an anonymous, self-report survey to compare the experiences of 1,285 autistic individuals to 1,364 non-autistic individuals, aged 16-96 years, from 79 different countries. 54% of participants were from the UK. The survey assessed rates of mental and physical health conditions, and the quality of healthcare experiences.

The team found that autistic people self-reported lower quality healthcare than others across 50 out of 51 items on the survey. Autistic people were far less likely to say that they could describe how their symptoms feel in their body, describe how bad their pain feels, explain what their symptoms are, and understand what their healthcare professional means when they discuss their health. Autistic people were also less likely to know what is expected of them when they go to see their healthcare professional, and to feel they are provided with appropriate support after receiving a diagnosis, of any kind.

Autistic people were over seven times more likely to report that their senses frequently overwhelm them so that they have trouble focusing on conversations with healthcare professionals. In addition, they were over three times more likely to say they frequently leave their healthcare professional’s office feeling as though they did not receive any help at all. Autistic people were also four times more likely to report experiencing shutdowns or meltdowns due to a common healthcare scenario (e.g., setting up an appointment to see a healthcare professional).

The team then created an overall ‘health inequality score’ and employed novel data analytic methods, including machine learning. Differences in healthcare experiences were stark: the models could predict whether or not a participant was autistic with 72% accuracy based only on their ‘health inequality score’. The study also found worryingly high rates of chronic physical and mental health conditions, including arthritis, breathing concerns, neurological conditions, anorexia, anxiety, ADHD, bipolar disorder, depression, insomnia, OCD, panic disorders, personality disorders, PTSD, SAD, and self-harm.

Dr Elizabeth Weir, a postdoctoral scientist at the ARC in Cambridge, and the lead researcher of the study, said: “This study should sound the alarm to healthcare professionals that their autistic patients are experiencing high rates of chronic conditions alongside difficulties with accessing healthcare. Current healthcare systems are failing to meet very fundamental needs of autistic people.”

Dr Carrie Allison, Director of Strategy at the ARC and another member of the team, added: “Healthcare systems must adapt to provide appropriate reasonable adjustments to autistic and all neurodiverse patients to ensure that they have equal access to high quality healthcare.”

Professor Sir Simon Baron-Cohen, Director of the ARC and a member of the team, said: “This study is an important step forward in understanding the issues that autistic adults are facing in relation to their health and health care, but much more research is needed. We need more research on long term outcomes of autistic people and how their health and healthcare can be improved. Clinical service providers need to ask autistic people what they need and then meet these needs.”

The research was funded by the Autism Centre of Excellence, the Rosetrees Trust, the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the Queen Anne’s Gate Foundation, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.

Reference

Weir, E., Allison, C., & Baron-Cohen, S. Autistic adults have poorer quality healthcare and worse health based on self-report data. Molecular Autism (2022).

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JOURNAL

Molecular Autism

DOI

10.1186/s13229-022-00501-w 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Autistic adults have poorer quality healthcare and worse health based on self-report data

ARTICLE PUBLICATION DATE

26-May-2022

Hand hygiene is focus of updated advice to prevent healthcare-associated infections

Only 7% of healthcare personnel fully clean their hands

Reports and Proceedings

SOCIETY FOR HEALTHCARE EPIDEMIOLOGY OF AMERICA

Five medical organizations are recommending updated best practices for hand hygiene to protect patients and staff in healthcare settings. The recommendations emphasize the importance of healthy skin and nails and easy access to alcohol-based hand sanitizers.

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update, one in a series of expert guidance documents known collectively as the Compendium, was published today in the journal Infection Control & Hospital Epidemiology.

“Hand hygiene is a basic function of healthcare safety,” said lead author Janet Glowicz, PhD, RN, CIC, with the Centers for Disease Control and Prevention. “By engaging healthcare personnel and establishing reliable processes described in the Compendium, we can achieve effective, consistent hand hygiene. Commitment by healthcare leadership is also necessary to establishing a culture of safety.”

The document addresses how facilities can train healthcare personnel in proper technique, monitor their compliance, engage them in the selection of products to keep their skin healthy, and properly use gloves. It also discusses where facilities should place and how they should maintain alcohol-based sanitizer dispensers and sinks.

The guidance reviews the evidence around nail polish, gel, and shellac, which shows that short, natural nails with standard polish or no polish are easiest to clean. The authors found no new evidence specific to chipped nail polish and artificial nails but note previous findings that they can harbor germs. The guidance leaves specific policies about nail polish, gels, shellac, and artificial nail extenders to the discretion of infection prevention programs at each facility, with the exception of policies for those who scrub for surgery or work in high-risk areas. These personnel should maintain short, natural fingernails free of polish and nail extenders.

Citing research that shows only 7% of healthcare personnel effectively clean the entire surface of their hands, the guidance recommends ongoing training in handwashing and proper use of sanitizer. Thumbs and fingertips were most frequently missed.

The authors recommend that healthcare personnel not be provided with individual, pocket-sized hand sanitizers in lieu of wall-mounted sanitizer dispensers and emphasize that hand sanitizer dispensers always be widely available and never prohibited, even in situations when washing with soap and water are indicated. When healthcare personnel suspect organisms that are difficult to remove, such as C. difficile and noroviruses, healthcare personnel should wear gloves and follow structured techniques for hand washing and hand sanitizing.  In addition, facilities should not top-off sanitizer dispensers meant for single use or provide antimicrobial soaps that contain Triclosan. Facilities also should discourage the use of double gloves, except in certain circumstances.

To encourage compliance and to support healthy skin and nails, facilities should include healthcare personnel in the selection of hand sanitizers and moisturizers, while ensuring the products are compatible with antiseptics and gloves used on site. Maintaining healthy skin is a crucial element of hand hygiene.

Surgical settings require special care, but waterless hand hygiene with surgical hand rubs is acceptable, especially as it improves compliance. Brushes should be avoided in surgery prep due to their negative impact on skin health.

This document updates the 2014 Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. The Compendium, first published in 2008, is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, with the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The Compendium is a multiyear, highly collaborative guidance-writing effort by over 100 experts from around the world.

Upcoming Compendium updates will include strategies to prevent catheter-associated urinary tract infections, Clostridium difficile infections, methicillin-resistant Staphylococcus aureus infections, and surgical site infections. Strategies for preventing central line-associated bloodstream infections and pneumonia were updated earlier in 2022. Each Compendium article contains infection prevention strategies, performance measures, and example implementation approaches. Compendium recommendations are derived from a synthesis of systematic literature review and evaluation of the evidence, practical and implementation-based considerations, and expert consensus.

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About ICHE
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 24th out of 94 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at shea-online.org, facebook.com/SHEApreventingHAIs and twitter.com/SHEA_Epi.

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JOURNAL

Infection Control and Hospital Epidemiology

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update

ARTICLE PUBLICATION DATE

8-Feb-2023

What’s it like to be a healthcare worker in a pandemic?

POSTED APRIL 08, 2020, 2:30 PM

Robert H. Shmerling, MD
Senior Faculty Editor, Harvard Health Publishing

We all know that some jobs are more dangerous than others. Truck drivers, loggers, and construction workers are more likely to die on the job than most others. Firefighters and police officers also face more than the average amount of risk while at work. It’s expected that people who take on these jobs understand the risks and 

follow guidelines to stay as safe as possible.

But what would you do if your job suddenly became much more dangerous? And what if your workplace was unable to follow recommended guidelines to reduce that increased risk?

That’s the situation now facing millions of healthcare workers who provide medical care to patients, including nurses, doctors, respiratory therapists, EMTs, and many others. They have a markedly higher risk of becoming infected with the coronavirus that causes COVID-19, especially if they are exposed to a high volume of sick patients (such as in the emergency room) or respiratory secretions (such as intensive care unit healthcare providers). Early in the outbreak in China, thousands of healthcare workers were infected, and the numbers of infected healthcare workers and related deaths are now rising elsewhere throughout the world.

While consistent use of personal protective equipment (PPE), such as N95 medical masks, reduces the risk of becoming infected with the new coronavirus, PPE is in short supply in many places.

The challenges now facing healthcare workers

Outside of work, people who have healthcare jobs have the same pandemic-related stressors as everyone else. On top of these worries come added challenges, including

• the fear and uncertainty of a heightened risk of infection
• worry that they may carry the COVID-19 coronavirus home and infect loved ones
• a dwindling or already inadequate supply of PPE needed to minimize the risk of infection
• ever-changing recommendations from local leadership, medical and public health experts, and political leaders
• unusually high and increasing demands to work longer hours as their colleagues become sick or are quarantined
• balancing their commitment to help others (which likely led them to their current profession in the first place) with an understandable commitment to protect themselves and their loved ones.

And when ICU beds, ventilators, or staffing prove inadequate to meet demand, some healthcare workers will have to make enormously distressing and difficult ethical decisions about which patients get lifesaving care and which do not.

An echo from the AIDS crisis

I remember well the uncertainty and fear surrounding the earliest days of AIDS decades ago. There were healthcare professionals who were reluctant to treat (or even touch) people with HIV infection. Soon, it became clear that HIV was transmitted primarily by blood exposure or sexual contact. As a result, simple precautions made it quite unlikely that healthcare workers would become infected with HIV by treating patients with AIDS.

But this new coronavirus is a respiratory virus. Because personal protective equipment is being rationed in some cases and has not even been universally adopted, it is far easier for healthcare workers to be infected with the new coronavirus. And it’s terribly frightening to be on the front lines of treating a new — and potentially deadly — contagious disease about which so much is uncertain.

How have healthcare workers responded?

By all accounts, healthcare workers have responded exceedingly well. They are showing up. They are putting in long hours. They have rapidly adapted to the situation by changing how they provide care, revising schedules, embracing telehealth, and even repurposing facilities — for example, turning operating rooms into intensive care units — or creating improvised protective equipment, though that’s far from ideal. And they have continued to demonstrate compassion and a brave front despite the fears they may harbor.

Remarkable stories are circulating about the lengths to which healthcare workers are going in order to protect themselves and their families: doctors staying in the garage, hotels, or rental apartments rather than returning home to risk unwittingly infecting a family member; healthcare workers avoiding their small children when they come home until they can change out of their work clothes. And I learned of a nurse who had recently given birth and decided to self-quarantine out of concern she might infect her newborn; she pumped breast milk and left it outside her door for her husband to feed to their baby. (See this link for more information about pregnancy and breastfeeding during the COVID-19 pandemic)

All of this takes a toll, of course. Already, reports are surfacing describing the significant psychological distress healthcare workers are experiencing.

The bottom line

We know how to protect healthcare workers from this new virus. Fixing the lack of masks and other protective equipment must be a priority: not only is the healthcare system obliged to protect its workers but, importantly, if enough healthcare workers get sick, our healthcare system will collapse. This will become even more important in the coming weeks, when the volume of COVID-19 cases in many areas is expected to peak.

Nurses, doctors, and other healthcare workers did not sign up for such a dangerous job. So, take a moment to recognize the healthcare workers you know personally or see for medical care (as this man did). Dealing with this pandemic is not easy for anyone, but it’s especially hard on healthcare workers. Let them know you are glad they’re there for you.

When life has returned to some sense of normalcy, I am hopeful that the bravery, commitment, and yes, heroism of healthcare workers throughout this crisis will be recognized and appropriately acknowledged.

Follow me on Twitter @RobShmerling

Related Information: Harvard Health Letter

HEALTHCARE STAKEHOLDERS DISSECT HAVEN DISBANDMENT

ANALYSIS | BY MELANIE BLACKMAN | JANUARY 07, 2021

The disbandment comes only three years after Amazon, Berkshire Hathaway, and JPMorgan Chase formed Haven Healthcare "to create better outcomes, greater satisfaction, and lower costs for their U.S. employees and families."

Haven Healthcare, the joint venture of Amazon, Berkshire Hathaway, and JPMorgan Chase & Co., will disband at the end of February, the company announced earlier this week.

According to the Haven website, which has since been taken offline, the company's original vision was "to create better outcomes, greater satisfaction, and lower costs for their U.S. employees and families."

Despite the end of the much-heralded project, which was first announced in 2018, the three companies will continue to “collaborate informally to design programs tailored to address the specific needs of their own employee populations."

Although Haven initially aimed to disrupt the healthcare sector, the company faced turbulence from the beginning, including losing multiple C-suite leaders in a short timeframe.

COO Jack Stoddard resigned for personal reasons in May 2019, after serving for only nine months. Dr. Atul Gawande stepped down as CEO in May 2020 to serve as chairman of the company's board of directors, after serving for almost two years in the role. Megan McLean resigned as chief of staff in May 2020, after serving for almost 10 months.

LACK OF TRACTION TOWARDS GOALS

Jeff Becker, a senior analyst serving eBusiness and channel strategy professionals for Forrester Research told HealthLeaders that the inability to maintain a stable C-suite was "damaging to [their] ability to set a strategy, and then execute on that strategy.” He added that the strategic issues served as a “big red flag” for outsiders looking at the company.

"I think a lot of people saw [the disbandment] coming," Becker said. "There were certainly enough signs that things weren't going as planned. Haven's at three years now and we haven't seen any tangible evidence of traction towards its established goals."

But, while Haven struggled to gain traction, Becker said that Amazon continued to innovate in the healthcare sector.

"[This] led people to start questioning, what's actually coming from Haven?" Becker said. "While Haven was relatively quiet, you saw Amazon Pharmacy, Amazon Care, [and] quite a few things that we would have thought were going to be coming out of Haven, ended up coming out of Amazon proper."

"The Amazon in healthcare story isn't over," he added.

While Haven is wrapping up its operations, Becker said other companies are still interested in disrupting the current healthcare system.

"The cautionary tale is that healthcare is a $3.6 trillion market in the United States, and it's appealing to tech companies, large enterprise organizations to come and try and do better," he said. "But what we see time and time again, is that outside organizations come to healthcare and stake a flag in the ground and try and do better and they just end up turning tail a few years later. There's been a sense among outsiders that they're going to be able to come in and do it better, but I see no evidence or reason why we should continue to think that outsiders will be able to come in and fundamentally do this better."

LACK OF FOCUSED EXECUTION

Elizabeth Mitchell, president and CEO of Pacific Business Group on Health (PBGH) told HealthLeaders that she's disappointed in the news of Haven’s disbandment.

"[Haven] certainly arrived with a lot of fanfare and promise,” Mitchell said. “I do think it was important that three leading CEOs of private businesses said that the current U.S. healthcare system isn't working for employers and for their employees, and something needs to change. I think that was the right position.

Mitchell added that Haven’s most significant hurdles to addressing the institutional issues in healthcare was a lack of “focused execution and, apparently, political will.”

"There is as much demand as ever for new entrants who can tackle the growing problem of lack of affordability, variable quality, and poor experience in the healthcare system,” Mitchell said. “It is going to take concerted effort, not bright shiny objects, [to] figure out how to change an entrenched system that, quite frankly, is happy with the status quo.

Mitchell continued: "That said, there are a lot of innovative provider partners out there who are ready for change. Clearly the pandemic is consuming providers, appropriately so. They need to be focused first and foremost on patient care, but we're also seeing the pandemic put unbearable pressure on primary care when we need it most. We are going to have to rethink the U.S. healthcare system coming out of this pandemic."

TRANSFORMING HEALTHCARE IS COMPLEX

HealthLeaders also received written statements from stakeholders about Haven's disbandment.

Will Hinde, managing director and leader of healthcare and life sciences at West Monroe said in a statement: "Only those directly involved in the joint venture know the exact reasons why the effort was abandoned. That being said, the venture was always light on specifics—including how it was going to tackle historic and incredibly complicated issues like insurance coverage and prescription drug prices.”

Hinde continued: “The fact that three large, successful, and intelligent organizations faced significant challenges in solving these issues illustrates just how complex they are. The venture was an interesting concept in an ecosystem ripe for disruption, but it’s not entirely surprising that it didn’t work out and will join many others who have attempted to evolve and improve healthcare in the U.S."

Paddy Padmanabhan, CEO of Damo Consulting said in a statement: "Haven’s problem may have been internal issues and execution gaps, complicated by the competing interests of its major shareholders. That said, it isn’t easy to simply ‘disrupt’ healthcare by throwing tech and dollars at the problem. I believe a combination of market-driven change and policy action at the federal government level will transform healthcare eventually. This is already happening, as we have seen with the rapid rise in telehealth adoption during the pandemic.”

Padmanabhan added: "Transforming healthcare requires a full-time commitment. The shareholders of Haven are in very different businesses and were not in a position to dedicate themselves completely to the success of the initiative. It is possible that they will individually succeed through a piecemeal approach by addressing specific aspects of the healthcare value chain. For instance, Amazon has made significant progress in the pharma distribution aspect of healthcare services."

Editor's note: This story has been updated.

Related: Amazon-Backed Healthcare Venture Gets Much-Needed Name: Haven

Related: As Amazon builds new health ventures, Haven struggles to gain ground

Related: Haven was supposed to reimagine healthcare. An exodus of talent has gutted it

Related: Reset! Former Haven COO Shares 4 Ways Startup Eden Health Is Changing Healthcare Delivery

Related: Head of Healthcare for Amazon Business on Meeting PPE Demand Amid Flu, COVID


Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand

Healthcare Unions Must Take Up the Fight for Abortion Rights

Healthcare unions must take up the fight to make sure everyone has a right to free, safe, legal abortion on demand. Abortion is healthcare and healthcare is a human right.

Mike Pappas May 12, 2022
Luigi Morris

The recent leak of a draft Supreme Court decision confirmed what many have expected for some time: the Supreme Court plans to overturn Roe v. Wade. The Democrats, meanwhile, have proven time and time again they will not protect the right to abortion. As a healthcare worker who previously worked in a primary care clinic providing abortion care, I know that abortion care is life-saving health care, and it should be available to all as a human right.

The only way to protect this right is by mobilizing in the streets and in our workplaces. Healthcare worker unions throughout the country must mobilize their members to fight back against this decision.

As we have written,


This monumental decision will make abortion illegal or all but illegal in dozens of states across the country as soon as it is announced, making access to an abortion almost impossible for tens of millions of people overnight. This decision is an attack on all people who can get pregnant; in many states they will be forced into illegal and unsafe abortions, expensive trips out of state, or be forced to give birth. Working people, working people of color, and poor people in particular, who often do not have the means to travel several hundred miles to reach a clinic willing to perform an abortion will be most affected.

“Abortion is healthcare and healthcare is a human right!” This refrain, chanted in the streets just last week, cannot be more accurate. As healthcare workers who strive to protect the heath of our patients, a threat to abortion rights is a threat to patient health, especially to the health of the poor and oppressed.

However, while some unions, like Starbucks Workers United, have put out statements condemning the leaked decision, healthcare worker unions — many of whom literally provide abortions — have been silent. Unions like National Nurses United (NNU) — the largest nurses union in the nation — or the Service Employees International Union (SEIU) — the largest union of healthcare workers — have been silent on this issue. The union I was previously part of, the Committee of Interns and Residents (CIR), which represents thousands of resident physicians around the country, has also been largely silent. There has not been so much as a statement condemning the recently leaked decision — just a single retweet from the SEIU account — and certainly not even close to any call for members of these unions to act.

It is absolutely inexcusable that the largest healthcare unions in the U.S. have been completely absent. High school students are walking out of classrooms and actions are being called by various organizations because they all understand the threat that overturning Roe v. Wade poses. So why have the major institutions of labor in healthcare not come to the same conclusion?

While unions in the U.S. have historically focused on issues restricted to their workplaces, such as increased wages, shorter work hours, or improved working conditions, labor organizations have helped to win the right to abortion internationally. Polish workers went on strike in 2016 pressuring the government to vote down an abortion ban. Unions in Ireland launched a coalition in 2016 to help win the right to abortion and same-sex marriage in 2019. Rank-and-file union members organized actions as part of the “green wave” in Argentina to help win the right to abortion in 2020. Workers organizations have been at the forefront internationally to win these rights. We should be seeing similar mobilizations in the U.S.

As Left Voice member Olivia Wood wrote in October,


Because of its controversial nature, the bureaucrats in union leadership are unlikely to take up this fight without pressure from the rank and file, and even then, they will likely work to contain the militancy of their members. This makes it even more important for workers to take matters into their own hands, remember that we are the union, and stick up for our fellow workers, both in our own workplaces and across the country. “Workers of the world unite” is not simply a slogan: it’s a call to action and a strategic imperative.

Since the leaderships of the healthcare unions clearly won’t take these steps, rank-and-file healthcare workers should force their unions to mobilize. To be clear, unions using their power to fight for the right to abortion would not mean giving a donation here or there toward a “pro-choice” politician’s campaign or calling members to “vote next cycle.” It means using the vast resources these unions possess to actually mobilize and support members who take action.

It also means workers potentially calling for work actions or strikes to protect the right to abortion, and healthcare workers organizing workplace committees to discuss how to protect abortion rights. For example, each healthcare center could have committees discussing and organizing around how healthcare workers could take tangible steps to defend the right to abortion. In states where abortion would be immediately outlawed as a result of this decision, it would also mean healthcare workers actively defying abortion ban laws and keeping clinics open. It would be crucial for healthcare worker unions to support and back these efforts in whatever ways possible.

Mobilizations obviously should not be limited to healthcare sectors. Healthcare worker unions should fight across labor sectors with, for example, teachers’ unions and other labor unions. As workers, we make the world run and our power lies in our workplaces and our power to shut shit down. This is how fighting labor institutions could take a role in tangibly interevening to protect the right to abortion — as part of a mass movement to protect abortion rights.

Winning the right to safe, legal abortion on demand will come from the streets and workplaces — not the offices of capitalist politicians. Healthcare labor institutions have so far been quiet, but they should take up this fight head on today.



Mike Pappas is an activist and medical doctor working in New York City.