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See no evil, hear no evil?

As The Observer newspaper carries more dark rumblings on events in Bahrain, the more uncomfortable I get that the brand of Irish medicine is now so intimately entwined with the regime in that country.

Bahrain has a Shia Muslim majority ruled by a Sunni Muslim royal family. Shias have long complained of discrimination and in February 2011, pro-democracy protests took place that brought over 100,000 people onto the streets, most of whom were Shia. During the protests, the occupation of a roundabout close to Salmaniya Medical Complex was cleared by force on two occasions in February and March 2011. The following month, more then 70 Shia medics were arrested in a series of night-time raids and were allegedly tortured into giving false confessions and swearing allegiance to the regime under duress. Independent observers and international human rights organisations have consistently argued that the medics’ only crime was coming to the aid of injured protesters and giving critical media interviews.

Forty-eight health professionals were convicted before a military tribunal on a variety of charges and 20 were given sentences of between five and 15 years for — among other charges — weapons possession and threatening national security, including Irish-trained paediatric orthopaedic surgeon Dr Ali Al-Ekri, who was arrested (ironically, on St Patrick’s day in 2011) having completed surgery on a pelvic fracture. In quotes to Al Jazeera, Dr Al-Ekri said he was tortured and beaten in that time and during one interrogation he lost consciousness four or five times.

#ilooklikeasurgeon indeed.

It is customary when a publication raises these concerns that some Bahraini apparatchik puts pen to paper in a scathing riposte, painting the Arab state as the land of pluralist milk and secular honey. Save your fingertips. We’ve heard it all before. Let’s focus instead on the response of the ‘Old Money’ of Irish medicine — which we as Irish doctors fund and subscribe to — to the human rights concerns.

The RCSI invested an estimated €60 million in opening a medical and nursing school campus, RCSI Bahrain, in the Arab state. Medical graduates of the institution are conferred with the joint-licentiate of the RCSI and RCPI. The colleges have received heavy criticism in a number of publications, with the BMJ having accused RCSI of being open to charges of complicity with the regime. Ultimately, however, the arbiters of whether RCSI Bahrain’s activities are commensurate with the values of Irish medical practice are the Irish Medical Council.

In October 2014, the Council conducted a site visit to RCSI Bahrain, which was subsequently deliberated upon at the Education Training and Professional Development Committee, where a vote was taken by a margin of three-to-one (Dr Ruairi Hanley) to accept its report and recommend to Council that the institution be accredited. Of the three in favour, two took part in the site visit. The site visit team conducted extensive interviews with students and appeared reassured that human rights concerns were not impacting on the work of the college. However, the former President of RCSI Bahrain Prof Tom Collins resigned in 2013, citing restrictions on academic freedom placed by the regime, and has since gone on record with RTÉ (and this newspaper) to say that he would not be at all reassured by these interviews.

In 2011, another visit was undertaken by Professors Eoin O’Brien and Damian McCormack of UCD, former Senator Averil Power, former Foreign Affairs Minister David Andrews, and MEP Marian Harkin. With respect, hardly a group of dangerous radicals. This group arrived at diametrically opposed conclusions and were in no doubt but that medical personnel had been subjected to human rights abuses, including kidnapping, internment and torture.

Prof O’Brien offered to brief the Council on his findings but his offer was curiously declined, as was that of Prof Collins.

I cannot believe that in their dealings over this issue, the RCPI or RCSI are reflecting the values of the majority of their members, fellows and trainees. Nor do I believe that we, as sole funders of the Council’s activities, can have our concerns mollified by the manner in which the Council has approached the question. Kudos are due to Professors O’Brien and McCormack, as well as Dr Hanley of another parish, who have worked tirelessly to keep this issue prominent. One could ruminate on whether it is right or proper for what are registered charities with their roots in our democratic Republic to be heavily technically and fiscally involved with a feudal dictatorship thousands of miles away. The RCSI and RCPI will attest to the fact they can use their ‘soft power’, which recent history suggests they may overestimate, to effect change, but it would seem they are in a pretty compromised and difficult situation, albeit of their own construction. The Council, on the other hand, is surely independent, yet asserts that it ought adopt a purely technocratic approach. As a funder of the Council or a member of either college though, I would implore you to ask yourself: Does all of this smell right to you? Are you satisfied with due process, as has been revealed in the public domain?

Me neither. Let’s keep asking questions.

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