LAHORE: It`s business as usual in the Services Hospital -patients being carried on stretchers, and worried attendants crowding inside to see their sick or injured relatives. Only now while the system is mechanically chugging along, there is a kind of underlying unease among everyone: the tension after a murder cannot be dispelled that easily.

Late on Monday night, Sunil Saleem who had brought his sister for a gynaecological checkup got into a tussle and even though the issue was defused at first, it resurfaced again soon after. The family claims that the duty doctor called in more doctors, and some guards also joined in to beat Sunil in a separate room till he was critically injured.

He died soon after.

The security situation in hospitals in specifically those run by the government -seems to have several loopholes as in the recent past there has been all sorts of violence in hospitals. Saleem`s lynching was an extreme case, and one off, but aggression and hostility is rampant. Often enough there have been incidents wherein groups of doctorshave ended upin serious clashes, and while verbal fights between doctors and attendants are an everyday business, there have also been incidents where they have come to blows with each other.

In a normal situation, hospital security should be two pronged: security for doctors on duty, and security for attendants.

However it seems that the security measures are either not fully implemented or are not foolproof. Both doctors and visitors complain of different problems.

King Edward Medical University`s Prof Dr Irshad Hussain says there are multiple reasons why violence is occurring in hospitals.

`Such incidents occur partly because ofdoctors,` he says. `We have tried to explain to young doctors that they must remain in constant communication with the patients and their relatives and not to lead them on about the patients` situation, but often they do not listen. At the same time, relatives often bring in the patient at the eleventh hour, when the situation has worsened but their expectations are still high, and if not met, it is the doctor who gets it first.

Dr Sulman Kazmi part of the Young Doctors Association (YDA) Pakistan, blames much of the underlying stress from the doctors` side on the extensive duty hours given to them.

`Doctors are asked to work continuously for long periods of time, and the stress and irritability in their attitude is exacerbated because of workload,` he says. `Obviously many fights occur because of this, even though whatever happened is not being condoned by anyone. But this workload is a direct cause of a bad attitude towardspatients,` he says.

A doctor from the Services Hospital points out how many doctors are politicised and are even involved in crime cases. `The secretary of one of the YDA groups active in Services has been nominated in a kidney transplant scandal, and is currently serving jail term,` he says. `Others have a history of corruption cases while so many others are well 1(nown for being involved in physical clashes. They act like goons of the medical community, and many don`t have clean hands.

One other aspect is the problem of untrained security guards. Guards who are appointed by the government tend to be politicised, says a doctor, which is why the hospitals under IDAP (Infrastructure Development Authority Punjab) have been involving third-party security agencies to provide guards. Unfortunately though while some companies have done a good job, doctors complain that many guards do not have proper professional training.

Besides, he says, they do not know how to deal with public that is traumatised.

`The guards are rude and rough with families who have come to see patients,` says a woman, who has only just had a verbal altercation with one of the guards at the door.

`If they behave politely the public will also cooperate, after all no one comes here to fight.

Attendants are often at fault though. When rules specify that meeting hours are closed, they still try to push through, or even giveward boys some money (Rs50 to 100) to let them through. More than one person often ends up inside and disturbs procedure by confronting the doctors.

`But at the same time doctors should also be limited to their own area of work,` says Dr Arshad Siddiqui. `Shaukat Khanum is perhaps the only hospital where without a digital pass a doctor cannot cross into another department. This is the way security should be designed and implemented. With these passes the attendants` entry and exit will also be recorded.

Meanwhile, by Wednesday the situation had escalated to the extent that certain minority rights groups held a protest in front of the Lahore Press Club. They shouted slogansand carried placards to protest violence against the Christian community and demanded justice for the victim`s family.

But there are some `detractors`.

`We condemn the terrible murder of Sunil,` says National Commission for Justice and Peace head Cecil Chaudhry Jr. `However we are following the incident and before making sweeping statements we want to be sure why the incident took place.

At this point we do not believe that this is a religiously motivated crime, and we would like the Christian community not to turn this into something that it may not be.

MPA Shunila Ruth has urged Chief Justice of Pakistan Justice Mian Saqib Nisar to take notice of the murder of Sunil Saleem.