News / Middle East

What Went on in Bahrain During the Night of March 16?

Chief physician Nabeel al Ansari offers his version of events at Manama’s Salmaniya Hospital - one that contradicts the opposition’s

Dr. Nabeel al Ansari at VOA studios in Washington, DC
Dr. Nabeel al Ansari at VOA studios in Washington, DC

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The Kingdom of Bahrain has released more than 500 detainees who were arrested in the aftermath of anti-government demonstrations in February and March. However, the royal family's Sheikh Fawaz al-Khalifa, head of Bahrain’s Information Affairs Authority, says 46 doctors and nurses remain detained, 29 of whom will go on trial on charges of promoting efforts to topple the Sunni monarchy.

Human rights groups have criticized the announcement, saying Bahrain is targeting doctors and medical staff who treated wounded protesters during anti-government demonstrations. They say they have credible evidence that soldiers occupied the hospital, detaining and torturing medics who treated the protesters.

However, the government denies these allegations. Dr. Nabeel al Ansari, chief of emergency medicine at Salmaniya Hospital and newly-appointed head of the Bahrain Medical Society, recently visited Washington, D.C. In an interview with VOA’s Cecily Hilleary, he insisted that the hospital was held under siege not by the military, but by the protesters themselves. Specifically, they discussed events of March 16, when injured demonstrators converged on the hospital in search of care.

Hilleary: Were you at the hospital that night?

Al Ansari: That night? No, I wasn’t at the hospital. But I was monitoring.

Hilleary: It’s my understanding that enough people presented themselves for medical care that doctors and nurses very quickly ran out of supplies.

Al Ansari: You surprise me with this question - or with this statement.

Hilleary: Why?

Al Ansari: Because again, we have enough evidence, not taken by us - by the extremists, a group of demonstrators - which shows how ample the supplies were there. Again, it is available for public review.

Hilleary: On a normal night in an emergency room, though, in any major city, any place in the world, if you suddenly have hundreds of people running in, covered in tear gas, coughing, gagging - are you saying that the hospital - any hospital - would be staffed to cope with something like that?

Listen to Cecily Hilleary’s interview with Dr. Nabeel al Ansari:

Al Ansari: That’s a good question. I am trained in disaster medicine. We are actually very well-staffed and equipped and trained to handle emergencies. At one time, we can handle up to 250 to 300 emergencies, if they come in - urgencies and emergencies. Tear gas exposure is usually not an emergency. It can be, depending on the condition of the patient. What happened that day, our plan was not activated the right way. There were people who were non-emergency physicians [who] took over the Emergency Department, and they started running the department and the disaster plan according to what they thought should be appropriate. Those physicians were orthopedic surgeons, dentists, neonatologists, with totally no background in emergency medicine.

Hilleary: What brought them to the emergency room that night, then? Was it understaffed, was it the sudden emergency?

Bahraini doctors and medical personnel at Manama's Salmaniya Hospital
Bahraini doctors and medical personnel at Manama's Salmaniya Hospital

Al Ansari: No, we had enough staff. But those who came in with the demonstrators, they forced themselves on the staff. And this is, I’m telling you, not a hearsay [sic], I was in contact with the people. Our people were put aside. If they were needed to handle any real emergencies, then they were brought in to help. Otherwise, the other doctors were taking over the place. We were occupied by physicians who were not trained in the speciality to handle all these things.

Hilleary: But they were physicians who worked in the hospital?

Al Ansari: Yes.

Hilleary: They were. So, if I’m understanding you, there’s an emergency, the protesters come to the hospital, and doctors from the outside came in. Are you saying that they were organized to take over the hospital?

Al Ansari: They did not come alone, the protesters. They came with the doctors. A lot of doctors were with them at the GCC Roundabout or what they call the Pearl Roundabout (a congregation point of anti-governments protests in Manama).

Hilleary: Participating in the protests?

Al Ansari: Yes, they were with them, and I think, as I said, initially, in the beginning, the plan was if there was an attack by the government on the roundabout, to come to the hospital. And again, it is on YouTube, and one of the leaders stated this, that at that time, they were going to come to the hospital and stay there.

Hilleary: For what purpose, though?

Al Ansari: Protesting. Moving their center of protests from the roundabout to the hospital. So they made the hospital as “Roundabout Number Two.”

Hilleary: Has anybody presented any evidence to this?

Al Ansari: Oh, a lot of evidence! A lot of evidence. I have it with me now. I can show it to you. But you could just go to YouTube.

Hilleary: So the reports that protesters were prevented from getting treatment, that protesters were being beaten, were completely false?

Al Ansari: Well, you can, I mean - you can look at the YouTube.

Hilleary: Well, I have, and I’ve seen so much video at this point -

An ambulance draped in a Bahraini flag
An ambulance draped in a Bahraini flag

Al Ansari:: The thing that you see is that the protesters were in control of the hospital. They were at the hospital, in front of the Emergency Room, shouting slogans and this and that, and they were in control of the whole area. So nobody else was really in control of that. So how is it possible that they cannot get care if they were controlling there?

Hilleary: We’ve heard stories that Bahraini security forces stole ambulances, posing as medical personnel – EMTs (emergency medical technicians) as we would say, to try and get the protesters as a means of trapping them. We’ve heard stories of doctors and nurses arrested; dozens of doctors and nurses and medical staff disappeared. It’s natural that we would start asking questions at this point.

Al Ansari: First of all, I’ll get back to the EMTs. I am by training -- I have a fellowship in pre-hospital care. So this is my job; EMTs and all of that. The emergency medical technicians and the ambulances were under the control of people at the Roundabout. No ambulance was being dispatched through the regular channels to go to patients, unless there was approval from somebody at the – I won’t mention his name – a doctor at the Roundabout who would say the ‘yes’ or ‘no.’ And again, that doctor is a medical doctor with no background in emergency medicine or anything like that. But he was running the ambulance services. And this statement – I take responsibility for it – and it was in coordination – it was the head of the EMTs who told me so. The ambulances were run by the doctor at the Roundabout, and they were dispatched according to his request.

Hilleary: I am confused, but I have several questions. Presumably, the night when all of this pandemonium started in the emergency room – there were emergency room staff on duty, who were not working -

Al Ansari: They were there -

Hilleary: But were they all working for the protesters?

Al Ansari: There was nobody else but the protesters there. Few patients could access care at that time. Care was denied to patients. I am a witness to people who died at home. I went to them, because they could not access care, because they could not get ambulance services. And that’s why – there was a member of parliament who approached me, and he said: we have to do something for the rest of the people who cannot access care – and we did organize a few ambulances through other services, the Bahrain Defense Hospital and the Bahrain Specialist Hospital, which is a private hospital. We took their ambulances and we organize special EMT and ambulance services to respond to some calls where we can help. And that’s what we did, because we could not access the government ambulance service

Hilleary: So the reports that protesters were being prevented from getting treatment, that protesters were being beaten are completely false -

Al Ansari: You can look at the video -

Hilleary: I have seen so much video at this point -

Al Ansari:: What you see is that protesters where [in] control of the hospital. They were at the hospital, in front of the emergency room, shouting slogans and this and that, and they were in control of the whole area. So nobody else was really in control of that – so how is it possible that they [could] not get care if they were controlling the area.

Hilleary: Say, you were out for a stroll, you saw the protesters at the Roundabout, and you had been nearby at the time that police began shooting teargas and ammunition, and you saw injured. As a doctor, what would your response have been at that moment?

Al Ansari: I would help.

Hilleary: You would help.

Al Ansari: Definitely. But, as I told all my staff, first protect yourself. There is no point in me [getting myself killed] and then not helping anybody. I’ll secure my staff – so that it is secure for them to get to the patient – and then I would help, but I will not go in the middle of the -

Hilleary: This makes sense, but if you saw somebody bleeding, battered, with a bullet wound -

Al Ansari: Definitely, I would help -

Hilleary: And the doctors at the hospitals would not –

Al Ansari: They were; they wanted to help. There are again some videos which show you: the emergency staff are standing aside in the resuscitation room; they cannot do anything – they were just on one side; and the others – journalists, mullahs – they were there talking to certain patients, who were on the other side of the resuscitation room, and these patients who were not critically ill were assisted and treated by specific doctors from the demonstrators.

Hilleary: I’ve seen  video of almost everything at this point. I’ve seen video that substantiates what all sides claimed. I think I’m approaching this from a standpoint – is it possible that in all the chaos, that doctors and nurses and lab technicians could have simply been so angered at what they saw that it created that kind of divide.

Al Ansari: I would not agree with that. Me, as a physician or somebody [in] the health care profession – suppose somebody was drunk, driving a car, and he hits somebody. Meanwhile, after he hits another car and he gets also hurt – I will be angry at him, probably because he injured somebody, a bystander, but will that prevent me from treating him? No, I would be treating him and the bystander, even though deep inside my [mind] I might be thinking that he was the reason for hitting the other guy. So, for us physicians and those that are working in health care – to use our emotions in terms of making them affect the way we provide care, it should not be there. And it’s not there.

Hilleary: You say it’s not there, yet that’s exactly what these doctors are being charged with. They are being charged with promoting the overthrow of the government, spreading false information, embezzling public funds, assault and death in the case of two patients. The doctors are being accused of inflicting additional wounds to one and mistreating the other, leading to their death, in order to exaggerate claims – do you know these staff?

Al Ansari: I’m saying that as doctors and nurses we shouldn’t -

Hilleary: But you’re saying they did -

Al Ansari: Well, there is evidence that they did. I have testimonials from doctors and nurses who saw things happening. I have testimonials from some nurses – six of them, actually, from the ICU (intensive care unit) – stating that one of these doctors switched off the oxygen of an ICU patient, because he was an expatriate and she wanted him to be dead.

Hilleary: There are two cases in particular that have been cited by the Bahraini News Agency, and Ali Ahmed Abdullah, who sustained an injury to the thigh, and in the presence of media, for media drama, the surgeon, it is said, added several wounds, cut extra wounds into the patients body, deliberately expanding, making the injury worse. And the patient was transferred to the ICU and died. That’s the one report -

Al Ansari: I was not a witness of this. I cannot say anything about it, but if I tell you that I have a testimonial – when the military came in to clear the area, there was one of the religious people who was there, and he was taken by two ICU doctors to the intensive care unit, he was shaved – they shaved his beard and his hair – and they made a cut wound on him and they stitched him, and they dressed him as a patient and they kept him in the intensive care unit two days –

Hilleary: They being -

Al Ansari: The two doctors.

Hilleary: I’m taking – on the side of the protesters -

Al Ansari: I presume they were. And after two days the patient was taken out, well he was not a patient -

Hilleary: Somebody else has apparently administered atropine. What is the standard – I’ll keep this very short – but a man presents in your ER (emergency room), he’s got tear gas poweder all over him, he’s burning, he’s gagging. How do you treat him?

Al Ansari: Tear gas does not produce this powder that you have seen, to start with. And if you have seen the pictures, it was amoxil or milk of magnesium which was used to cover these people with. Atropine is a very strong medicine that we use in resuscitating somebody who was dying from a cardiac arrest. When the heart stops, we use atropine to stimulate the heart; it makes it beat fast. That’s during an arrest.

Hilleary: It’s also used against nerve gas -

Al Ansari: The other use [for] atropine is for nerve gas. In the military they use it. You don’t use only atropine. There is another substance which is called prodexim. It’s combined with atropine in one syringe, and it’s given to the military, and they inject themselves intramuscular if there was nerve gas -

Hilleary: But if you have doctors who you say are not emergency specialists – you said you had plastic surgeons, gynecologists trying to help the protesters – and tear gas burns – is it possible that they would have used whatever they thought would reduce the acidity -

Al Ansari: Atropine, no, it will not cause -

Hilleary: No, the aluminum hydroxide -

Al Ansari: Why was it not used all over the body. It was used only over the face and part of the chest -

Hilleary: That part that’s exposed by clothing? I’m playing devil’s advocate here, doctor -

Al Ansari: Under the clothing, a little bit. And it was drunk (?). We have tons of amoxil that disappeared. Now, can I elaborate a little bit? If you want to create a story – nerve gas is a killer. Nerve gas does not know [the difference between] [Shi’ites] or Sunnis or policemen or non-policemen. If you get exposed to nerve gas, you have to have your protective suit on. Otherwise you are dead in a few minutes. And [during] the first few minutes you might have some symptoms which we call cholinergic symptoms, which are sweating, salivating, lacrimating, maybe some shortness of breath. These symptoms were already caused by the tear gas, but if you want to induce hallucination, seizures – then either you give them milk of magnesium or amoxil in big quantities, it causes a state which is called alcalosis. Alcalosis leads to hyperventilation, hyperventilation leads to twitches, and twitches can simulate seizures. [That’s] one way or you give them atropine is high doses. Atropine is an anti-cholinergic, which has got side effects. It can cause supraventricular tachycardia – the heart beat very fast – it can cause hallucinations, seizures -

Hilleary: I leap. Is it possible that these doctors who were not specialists – a assume a plastic surgeon has never had to treat someone for tear gas exposure in his life – is it possible that these were the kinds of mistakes that physicians would make who did not have that specialty?

Al Ansari: No. I would clearly state ‘no.’ Because atropine is such a substance that only few people know how it works – which are emergency physicians and intensive care doctors. These are the two {kinds of] people – or the two specialities [sic] which usually know how atropine works and they way we use it. Not atropine as drops, which is used by the ophthalmologist. So, whoever used atropine, he had some exposure, some knowledge of what it does. And we did have emergency physicians with the demonstrators, by the way. A few of them. Not everybody. And we did have intensive care doctors who were involved. So, I personally cannot accept that atropine would be used by anybody just like that, because it’s not available [to] everybody. It’s a drug that we keep in a secure area for cardiac arrest [cases]. But when you get thousands of ampulls (ampullae) missing -

Hilleary: Were they missing?

Al Ansari:: Oh, yes, they were. They were used.

Hilleary: We could probably go case by case by case, but let’s pull it out to the broader picture. Why? How? How was this organized, as you’re saying.

Al Ansari: You told me Al Jazeera was already there. Where did Al Jazeera come from?

Hilleary: Well, covering the protests, I assume. They had taken over the Pearl Roundabout for sevaral days, hadn’t they?

Al Ansari: How come they were at the hospital?

Hilleary: If I were a journalist, I would have been there the minute they started firing.

Al Ansari: Well, Press TV, Iran TV –

Hilleary: So, you’re suggesting -

Al Ansari: I cannot suggest anything, but what I have seen and witnessed, and what I have seen through videos and personal communication, I cannot interpret it in any other way that there was something planned. Again it’s not for me to comment -

Hilleary: But you’re a doctor. You’re brothers – and I know the code of doctors is the same all over the world – you really do believe that they were part of a plot?

Al Ansari: Not everybody.

Hilleary: But these individuals that are being charged.

Al Ansari: A few were, especially if I have testimonials already from those who witnessed all of this, telling us that this doctor and this doctor did so and so -

Hilleary: Forty doctors and nurses?

Al Ansari: You know, the Ministry of Health has got 9,000 employees. So, 40 is nothing compared to 9,000, when you think about it.

Hilleary: So, how do we understand this then? If you had to sum it up -

Al Ansari: I think health care was compromised. That’s what I would [say]. Health care was compromised by a group of extremists, and what they did – they were the cause of denying care to people who had come to Salmaniya [Hospital].

Hilleary: There was no case that you are aware of in which a doctor was afraid to give care to the protesters, for fear of the ramifications?

Al Ansari: No, protesters, whoever was there, was getting care. We do give care. But I’ll tell you an example. The expatriates that were handcuffed, that were brought in – one of them was severely bleeding from a cut. We had to take him to the resuscitation room.  A colleague of mine, he was there, he told the […] official surgeon who was dragging this patient – I cannot treat him like this. I need to take the handcuffs [off], to cut them off. He said ‘no.’  Treat him as such. He’s a criminal. How can a doctor label a patient as a criminal?

So, our doctor who was there, who was not pro-government or anti-government – who was just a physician doing his work – and insisted on cutting [the handcuffs], and because the patient was deteriorating, he did cut the handcuffs or whatever they were, the plastic things, and he did manage to suture the guy, the patient. Care was given, whether to the hostages or demonstrators when they came in with exposure to tear gas. I’m not saying that all of our doctors did not participate in the treatment, but some of them were not allowed to do their job properly because of the chaos.

What happened, simply, we created a disaster within a disaster. What happened in Bahrain, it was a disaster in one way or the other. But when those people, those doctors, who had nothing to do with whatever happened in disaster medicine, they came and they took over the emergency services. They created a disaster themselves there through interfering with the provision of proper care to everybody, not only to the protesters.

Hilleary: Knowingly or by virtue of the fact that they stepped out of their departments

Al Ansari: No, I don’t think that stepping out of their departments, - I think that there was much more than that. It happens during a disaster that we make a call that we need this and that, and other doctors might come in and we tell them ‘thank you, we don’t need your help; if we need you, we will call you.’ But that was not the case there. The case there was: we are the bosses, you stay aside. If we need you, we’ll get you in it. Just turn 180 degress.

Hilleary: Doctor Al Ansari, thank you so much for talking with us.

Al Ansari: Appreciate it. Thank you for having me..

__________

We have run several reports and interviews with Bahraini human rights activists who provided details on a variety of reported human rights abuses allegedly committed by the Bahraini government. In the interest of fairness and balance, we approached the government of Bahrain several times to get its perspective. We therefore welcomed the opportunity to sit down with Dr. Al Ansari to ask him some of the questions that had been raised.

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