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Hong Kong doctors decry “excessive and abusive” use of tear gas by police during protests

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5136 (Published 13 August 2019) Cite this as: BMJ 2019;366:l5136

Rapid Response:

Hong Kong Stands Alone Amidst a Humanitarian Crisis

Under the spotlight from all over the world since early June this year, the protests for freedom and democracy in Hong Kong continue to escalate in every sense. Not only we have seen the largest scale of assemblies and rallies in Hong Kong’s history, the continued mass conflict between the Hong Kong Police Force (HKPF) and the citizens is also unprecedented.

Apart from the obvious police brutalities, local health care professionals (HCP) are witnessing a humanitarian crisis.

Widespread Police Brutality

Widely reported in the global and local news, police brutality has allegedly caused multiple bone fracture, visceral organs injuries, head injuries, and even globe and pupil ruptures by beanbag round and rubber bullet, causing permanent blindness in at least one journalist (1 & 2).

Another latest example was a case on September 21st, in which around 40 police officers were filmed encircling an apparently unconscious person on the ground, with at least one officer kicking the person, in a dark ally (3). A top officer of HKPF officially claimed in a police press conference, that the officer(s) were only “kicking a yellow object” (4). Coming after the Junior Police Officers’ Association likened protestors to cockroaches in July (5), this particular incident reflects the severity of police brutality and even more disturbingly, sheds light on the fact that Hongkongers are being dehumanized by local law enforcement – a telltale sign of humanitarian crisis (6).

Ongoing Humanitarian Crisis

It is therefore almost not surprising, that soon afterwards on China’s National Day, a teenage student was shot in the chest at point blank range. As the first victim of gunfire with live ammunition in this current civil rights movement, he remains in critical condition at the time of writing (7).

Indeed it has become quite clear that the situation in Hong Kong has already escalated to a level above political stances, and beyond the discussion of pro-Beijing versus pro-Democracy. When the police force started to attack civilians and humanitarian personnel alike, and when common citizens were blocked from accessing health care services, it is humanitarian crisis that HCPs should be concerned about.

First-aiders being Attacked or Arrested

According to the Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field (8), fixed establishments and mobile medical units of the medical service may under no circumstances be attacked and must be protected.

Hong Kong is not even at war. And yet, since June attacks and raids to first-aid stations were sighted at multiple occasions (9). Tear gas canisters were fired into first-aid stations (10). Clearly identifiable first-aiders have been harassed, attacked and arrested by HKPF (11). On August 31st, after raid police attacked passengers inside the Mass Transit Railway, even official paramedics from the Fire Services Department were denied access to injured persons (12).

On top of these severe obstructions to medical and humanitarian missions on the field, access block to health care services were also observed in the community.

Access Block to Health Care Services is not Physical but Real

Police impeded health care delivery within hospitals, not only by stopping doctors or nurses from contacting patients' families for clinical reasons, but also by obstructing access to patients by psychologists or medical social workers. HCPs were forced to examine patients under police supervision, even if it involved patients’ private parts. Furthermore, due to repeated arrests made during hospitalizations (13), and the alleged breaching of patient privacy to HKPF (14), large number of patients are now afraid of seeking for medical attentions in the established local health care system. White terror spread within the society, leading to different initiatives of unofficial health care provisions, in the form of hotline services, underground clinics, or even “truck-ambulance” operated by volunteers.

The Global Health and Foreign Policy resolution, adopted by the United Nations General Assembly in 2014 (15), calls on states to reaffirm medical ethics, with obligations under international human rights and humanitarian law, and to respect and protect all medical and humanitarian personnel. The Resolution also deplored the acts and threats of violence as detrimental to the development of sustainable health systems.

Instead of tanks or troops of soldiers physically blocking the way to the hospital as in some war zones, it is the widely spread sense of fear in the city, created by HKPF, that is preventing our patients from reaching for medical attentions. The access block to health care services is not physical but real.

Standing Alone in a Humanitarian Crisis

Since June, Hongkongers have been reaching out for international help. But to this date, responses from international non-governmental organizations (NGOs) have been disappointing. We hereby urge again the international NGOs to stand with the people of Hong Kong, deploy medical teams into the city to provide protection and health care services, so that patients can exercise their basic human right of accessing medical assistance without fear. Alternatively, international NGOs should at least consider sending observers to the city to witness and document the humanitarian crisis.

And when the time comes, these established humanitarian organizations should stand up and voice out, for this is the very cause they have been established for – to speak for and walk with the helpless, in the name of humanitarianism.

Wong Yam Hong Alfred, MBBS, MRCP, FHKAM (medicine), FHKCP
Cardiologist
Spokesperson, Médecins Inspirés

Ma Chung Yee Arisina, B. Med Sci, MbChB, MRCP, FHKAM (medicine), FHKCP
Geriatrician
President, Hong Kong Public Doctors’ Association

References

1. Graham-Harrison E. (2019, October 3). Hong Kong protests: journalist blinded in one eye as attacks on media escalate. The Guardian. Retrieved from https://www.theguardian.com/world/2019/oct/03/hong-kong-protests-journal...
2. Creery J. (2019, September 13). High Court allows eye injury victim to challenge Hong Kong police over medical records warrant. Hong Kong Free Press. Retrieved from https://www.hongkongfp.com/2019/09/13/high-court-allows-eye-injury-victi....
3. HK Frontline Media. (2019, Septembe 23). “Third video showing the detained man in yellow in Yuen Long being assaulted by police on Saturday 21st September 2019.” [Video-file]. Retrieved from https://twitter.com/HKFrontline/status/1176332562081337344.
4. Crawshaw D. & McLaughlin T. (2019, September 24). Unidentified flinching object: In Hong Kong protests, police wage assault on facts. The Washington Post. Retrieved from https://www.washingtonpost.com/world/asia_pacific/unidentified-flinching....
5. Cheng K. (2019, July 29). Hong Kong police group calls people who vandalised grave ‘low lives,’ ‘cockroaches’, ‘not human’. Hong Kong Free Press. Retrieved from https://www.hongkongfp.com/2019/07/29/hong-kong-police-group-calls-peopl....
6. “Refugees, Migrants Branded ‘Threats’, Dehumanized in Campaigns Seeking Political Gain, High Commissioner Tells Third Committee, Appealing for Return to Dignity”. (2018, October 31). Meeting Coverage - General Assembly of the United Nations No. GA/SHC/4247. Retrieved from https://www.un.org/press/en/2017/gashc4247.doc.htm.
7. “Hong Kong Form Five student in critical condition after being shot in the chest amid protest”. (2019, October 1). The Straits Times. Retrieved from https://www.straitstimes.com/asia/east-asia/hong-kong-protester-shot-in-....
8. Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field. Geneva, 12 August 1949. Retrieved from https://ihl-databases.icrc.org/applic/ihl/ihl.nsf/0/fe20c3d903ce27e3c125....
9. Kwan, K. (2019, July 22). “遊行前 警充公急救站” [Police raided first aid station before protest]. Apple Daily Hong Kong. Retrieved from https://hk.news.appledaily.com/local/daily/article/20190722/20734810.
10. “Hong Kong’s Protests Explained”. (September 2019). Amnesty International. Retrieved from https://www.amnesty.org/en/latest/news/2019/09/hong-kong-protests-explai....
11. Editorial Board City University Student Union. (2019, October 1). “急救被暴力拗手拘捕[video-file]” [First-aider forcibly arrested with upper limb twisted]. Retrieved from https://www.facebook.com/cityusuedb/videos/385328608828777/ .
12. “Medics delayed by 'no casualty' claim by police”. (2019, September 12). Radio Television Hong Kong (RTHK). Retrieved from https://news.rthk.hk/rthk/en/component/k2/1480215-20190912.htm.
13. Siu P. (2019, June 23). Hong Kong police accused of harassing hospital staff during searches for extradition bill protesters as medical and legal professionals call on officers to behave. South China Morning Post. Retrieved from https://www.scmp.com/news/hong-kong/law-and-crime/article/3015743/hong-k....
14. “Cops given backdoor access to data of protest wounded, lawmaker Pierre Chan reveals”. (2019, June 17). The Standard. Retrieved from http://www.thestandard.com.hk/breaking-news.php?id=129830&sid=4.
15. “Global Health and Foreign Policy”. (2014, December 11). Resolution adopted by the General Assembly of the United Nations No. A/RES/69/132. Retrieved from https://undocs.org/en/A/RES/69/132.

Competing interests: No competing interests

20 October 2019
Yam-Hong Wong
Cardiologist
Chung-Yee MA
Médecins Inspirés
Hong Kong