Hong Kong’s crackdown on volunteer medics has triggered a rebuke from doctors providing frontline care in protests
Hong Kong, China – Last week, as police laid siege to the Hong Kong Polytechnic University, an image of volunteer medics in high-visibility vests with their hands tied with zip cords behind their backs spread rapidly through social media.
Darren Mann, who has worked as a surgeon in Hong Kong for 25 years and volunteered his services at the besieged campus, managed to leave on 17 November.
But afterwards, as the situation deteriorated, he discovered that a group of first-aiders he had been working with had been detained by police as they attempted to leave.
“What we appreciated in the medical community is that at the violent interface between protesters and police, there was obviously a very high potential for people to be injured,” Mann told Al Jazeera, adding that the role of medics is to provide care to all groups involved in conflict.
“The societal benefit and the human good of having medical aiders providing emergency care for the injured, that’s recognised… That’s the spirit of humanitarianism that we all agree to.”
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In the wake of the detentions, Mann published an article in The Lancet – a respected medical journal – arguing the temporary detention of volunteer medics by police was a breach of international humanitarian norms.
The network of first aiders have played a crucial role in Hong Kong’s protest movement since June when opposition to government plans for a proposed extradition bill to China gathered steam. As violence increased and roads were blocked, first responders have provided early treatment to those unable to access medical facilities quickly.
But the temporary detention of medics during the siege at the Polytechnic University – the most serious confrontation in nearly six months of unrest – has raised questions about the risks faced by volunteers operating within an increasingly fraught environment.
Noam Zamir, Assistant Professor of Law at City University of Hong Kong said international humanitarian law does not apply in Hong Kong, because the situation is not an armed conflict between states nor a civil war.
But he said the circumstances could be judged within the framework of international human rights law, after which Hong Kong’s code of law is closely modelled. “Under human rights law, there is a right to life,” Zamir said. “This is the right that is also enshrined in the Hong Kong Bill of Rights.”
The International Covenant on Civil and Political Rights states that the right to life is protected by law and that “no one should be arbitrarily deprived of life.”
“Hong Kong is one of the examples of good jurisdictions that incorporated many international human rights norms into their domestic legal system,” Zamir said, adding this right does not directly address first aiders on location, but applies to demonstrators and anyone else who requires first aid for potentially life-threatening injuries sustained in protest actions.
“If there are wounded people, they are entitled to receive medical treatment,” Zamir said.
In a press conference last week, Hong Kong police said volunteer first-aiders were detained because they lacked medical credentials, citing 12 examples of people wearing first aid gear who were without medical qualifications when they were questioned.
“We have no way to identify who is a first aider and how to qualify an individual as a first aider,” Cheuk Hau-yip, Kowloon West Regional Commander said.
“In this sense, I’m very worried about the standard they provide to those in need.”
Mann responded to the police statements in his Lancet article, citing five incidents where doctors were detained for more than 24 hours. “The arrest of these personnel is almost unheard of in civilised countries and is incompatible with the compact of humanitarianism,” he wrote.
Instead of encouraging a higher level of medical care, Arisina Ma, President of the Hong Kong Public Doctors’ Association, said the detention of volunteers could have the opposite effect – making trained medical professionals less likely to volunteer during demonstrations out of fear that their jobs or medical licences could be imperiled.
“They are prepared for the danger,” Ma said. “But we are not yet prepared to be arrested or to be fired.”
Ma said all healthcare workers who were held during the confrontations at Polytechnic University have been released on bail.
Events at the campus marked a new level of humanitarian need said B, a nurse by training who prefers to remain anonymous and arrived at the university on 16 November and stayed until Wednesday last week.
B and two others decided to remain on site to provide care to the demonstrators even when her team of seven first aiders heard police would label the situation a riot. She estimates there were around 20 first aiders who stayed with varying skills levels– some were full-time nurses and others had more basic first aid training.
The 30-year-old said the mood was sombre; she would get between two and three hours of sleep in designated “safe areas” on campus, usually in the library, huddled with other medics and students for protection.
The injuries B saw were mostly minor, including dislocated body parts and glass cuts. She heard from others who remained on campus, including a lone doctor, that they encountered more serious cases that required CPR.
If she and other trained medical professionals had not decided to take the risk and remain at the university, those inside would not have received sufficient care. “What I don’t want to see as a nurse is for more people to get hurt,” she said.
When B attempted to leave the campus on Wednesday, she was told by officers at various cordons that any medics, including those with professional qualifications, would be arrested, and should surrender themselves at a specific checkpoint.
She was eventually allowed to leave through an exit point with a group of journalists. She said the officer at that cordon saw she was wearing reflective gear labelling her as a nurse and told her not to come back inside.
On Monday night, with a small number of protesters still thought to be inside the university, a crowd gathered in front of a police line nearby.
Alvin L., 28, who leads a group of 36 first responders, was in the crowd.
He spent time volunteering on the campuses of both the Chinese University – the scene of violent confrontations the week before – and the Polytechnic University and said volunteers would provide help to whoever needed it – protester or police officer.
“We treat it as serious. To us, professionalism kicks in,” he said. “Regardless of if he is a cop or not, we don’t care.”
According to Hong Kong’s Hospital Authority on Monday, 280 people who were injured at the Polytechnic University had been sent to public hospitals.
Since the protests began some 2,615 patients had been treated for injuries, the authority said, but the volunteer medics said some people did not want to seek treatment in public hospitals for fear of being pegged to protest actions.
Police have also incurred injuries; a media liaison officer was taken to hospital after being shot in the leg by an arrow during the Polytechnic University stand-off.
“Police have all along emphasised two fundamental principles: peaceful resolution and flexibility,” the Hong Kong Police Public Relations Branch told Al Jazeera. “Police will assist the injured people who have left PolyU to receive treatment in hospital first before further investigation.”
At the Polytechnic University, tear gas, water cannons, and rubber bullets were frequently used by the police, while protesters created their own makeshift weapons including petrol bombs, bows and arrows, and bricks. By Wednesday, the siege appeared over.
Mann said the role of frontline first aiders was crucial to ensure on-the-spot treatment for injuries in danger zones.
He said that his expertise does not enable him to provide these basic services better than others working on the frontline, whose most important role was simply showing up.
“I’ve been a surgeon for 35 years, but I could not do a first aider’s job any better than a first aider can because of the basic skills that are needed.”
Ma from the Hong Kong Public Doctors’ Association said events at the university served to re-establish that medical personnel were a third party.
“We are neutral, we treat anyone,” she said.
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