Patients grapple with sexual harassment in hospitals over ignorance, unethical practices

  Patients grapple with sexual harassment in hospitals over ignorance, unethical practices

Writing about the low level of awareness of the rights of patients and how this puts females at risk of sexual harassment

Lola froze with shock on the examination bed in the consultation room when a male doctor who was examining her said, “See what you have done to me; you have made me ‘hard.’”

Not convinced that his 28-year-old patient heard him and unbothered about his action, the doctor pulled one of her hands towards his groin in a bid to make her touch his penis. Confused and wishing what was happening right before her eyes was not real, she swallowed saliva forming in her mouth as her heart raced.

Unable to bear the harassment and in a bid to avoid what looked could turn out to be rape, Lola jumped up and ran to the reception of the medical facility located in the Iyana Ipaja area of Lagos State.

In the waiting area crowded with medical workers and patients, she was unable to utter a word. As she tried to put herself together, she could feel the fear coursing through her body.

While on a bus on her way home that day, the tears she tried hard to hold back began to pour. She could only feel helpless, having trusted the medical workers at the facility she had been using for the past two years.

She wondered why things suddenly went wrong and why the male doctor who had treated her for the same ailment for two years suddenly wanted to make her his sexual prey.

She had assumed she was in safe hands especially because her father’s friend, who is a medical doctor, had referred them (she and her father) to the facility and the doctor had managed her case so well that she became comfortable with his services until 2021.

“It felt like a scene from a movie,” she revealed

Narrating her ordeal to our correspondent, Lola said, “In May 2021, the issue (ailment) I was treating recurred. This time, I went with a male friend to see the doctor. The doctor was jovial with us, asking if we were dating and getting married soon.

“I told him that my male friend and I were dating and that was why I was running the tests and we all laughed. Later, he asked me to come back for another test to be sure I could proceed with the new medications he prescribed.

“Usually, if he wanted to run any test on me where he would have to examine my breasts, his nurse was usually there, but on that particular day, he gave some excuses as to why she was not available.

“I remember seeing his wife in the next room and that gave me the confidence that I was not alone. Besides it wasn’t the first time.”

However, Lola said what started as a medical examination gradually turned into a pervert’s attempt to satisfy his sexual urge.

“We began the usual procedure and he asked me to take off my top to examine my breasts. This time while he did it, I noticed he started touching my breast in some sort of sexual way, next thing he bent down and put my breast in his mouth.

“I was too shocked at first then I gathered myself and pushed him off me from the bed. He still came close again, insisting that he was not done checking me.

“I was in confusion as to what he wanted to check, and the next thing I knew was him forcefully taking my hand and putting it on his hardened penis and saying, ‘See what you have done to me; you have made me ‘hard’.’” I was shocked and honestly confused even more.

“I pushed him away, got up, and was about to leave when he unashamedly held me back in the examination room and asked him what I wanted him to do since he had an erection. I pushed him again and rushed to the reception. I was shaking so much that I had no other option but to sit at his reception for some time before I left,” she added.

She said it took a few months to find the courage to disclose what she described as a nightmare to her boyfriend, who later confronted the male doctor.

“My boyfriend asked him direct questions – whether he did it but he was just talking off-point. He didn’t deny it nor accept it,” she said.

Lola, now 30, told Sunday PUNCH that the incident had remained indelible in her memory. She told our correspondent that she could not report him at the time because she didn’t have enough evidence against him.

“A few days ago, I saw him on the road, this was after three years, and shame enveloped me. He will meet his match one day,” she said with a tone of defeat.

Male dominated medical profession

There are more male doctors than female doctors in Nigeria, according to Statista, an online platform that specialises in data gathering and visualisation, which also said that out of the about 25,000 doctors in Nigeria in 2019, 65 percent of them were men.

With the dearth of female doctors and the ever-increasing exodus of health workers leaving for greener pastures, the reality could be grimmer as a female patient is more likely to be attended to by a male doctor than his female counterpart.

This, experts, said could give room to sexual harassment.

According to the American Academy of Orthopaedic Surgeons, sexual harassment is the exploitation of the physician-patient relationship in a sexual way. It is also the use of the physician’s power and dominance to satisfy his or her sexual desires at the expense of the patient.

The shortage of medical professionals in Nigeria leaves many patients with little or no alternative to medical care.

Checks by Saturday PUNCH further showed that there is a lack of understanding of what sexual harassment means, leaving many patients unaware as to what passes as sexual harassment.

Also, many women who know they have been sexually harassed by male health professionals tend to leave judgment in the hands of fate as they understand the labyrinth of Nigeria’s legal system.

The AAOS explained that sexual harassment in the medical line takes several forms –  verbal or physical behaviours of a sexual nature including conversation, gestures, and inappropriate touching.

It said sexual misconduct could be categorised into two: sexual impropriety – behaviours, gestures, or expressions that are sexually suggestive, seductive, or disrespectful of a patient’s privacy or sexually demeaning to a patient and sexual violation – and physical sexual contact between a physician and a patient, whether or not it was consensual and, or initiated by the patient.

This, the American Academy of Orthopaedic Surgeons, said would include any kind of sexual intercourse genital contact or masturbation, and touching of any sexualised body parts for purposes other than appropriate medical examination or treatment.

Sexual misconduct against patients, especially women, by male doctors, is considered a bane in the medical profession and does not align with the Hippocratic Oath sworn by medical doctors.

A part of the oath reads, “I will respect the autonomy and dignity of my patient… I will practice my profession with conscience and dignity in accordance with good medical practice.”

According to the AAOS, most sexual misconducts perpetrated by medical professionals are by men, and most victims are women.

A Spanish anti-sexual violence organisation, Rape, Abuse and Incest National Network, on its website, stated that some actions could be considered inappropriate and a sign of sexual exploitation by a medical examiner.

This, it said, included examining private parts without gloves, refusing to tell patients what they are doing or why they are doing it, declining to have another person in the room with patients, insisting that patients undress parts of their body not examined, and asking questions about patients’ sexual activity that make them uncomfortable.

Harassed by family doctor

Like Lola, 20-year-old Fortune said she was sexually harassed twice by a medical practitioner she trusted.

The 20-year-old, who said recounting her experience was like reopening a healing wound, spoke to our correspondent in low whispers as though to reduce the trauma that weighed her down.

As she spoke to our correspondent, she paused at intervals to catch her breath.

“The first time was in July 2023. I had fibroadenoma and needed to remove it urgently. The hospital was owned by a family friend and my sister also worked there.

“On the day of the surgery, of course, I had to remove everything I was wearing so I asked my sister, who worked there, to stay with me while I removed all my clothes but he sent her out to get something.

“After I was given some injection and lay down there barely conscious, I just saw him bring his mouth to my breast. At that moment I couldn’t feel anything.

“I knew something wrong was happening but I just couldn’t say anything. After the surgery, I left the hospital the next day without saying anything to anybody.

“Later in September, I was rushed to the same hospital to have an urgent appendicitis surgery and because it was urgent, I didn’t have a say. My parents just took me there,” she said.

“Around 8 pm when the other doctor who was supposed to assist with the operation went to change and the nurses were busy preparing the things for the surgery. The same doctor asked me to undress and sent my sister, who was with me, to bring something; I signalled at her not to go but she didn’t understand and, again, since he was her boss, she obeyed him.

“Even after the nurse gave me an anaesthetic, I was not asleep, I was aware of my environment, and then I noticed he kissed my breast again. This time, I flinched but the effect of the drug was already kicking in, so I was weak.

“I was there for a week, and multiple times he came to my bed and said he wanted to kiss his wife, referring to me, on the mouth but I always told him respectfully not to do that because I was not his wife. I always flinched and tried keeping away from him so he wouldn’t come near me. I was helpless,” she added.

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She said that even after she summoned the courage to report the incident to her mother, she (her mother) apologised on the doctor’s behalf.

“She told me not to be angry and that I wouldn’t go back there, but I expected her to do something more. I expected her to confront him. I wanted her to do more but she didn’t,” Fortune said.

Doctor said I acted like a child – 22-year-old victim

Before taking part in the National Youth Service Corps in 2019, Chidinma, 22, decided to have a routine health checkup at the Federal Medical Centre, Umuahia.

She said her problem started when one of the male doctors who attended to her advised her to undergo an X-ray outside the facility because the X-ray machine at the hospital was broken and then requested her phone number for follow-up.

“I like the red dress you wore to the hospital today. It brought out your shape,” his first text message to her read.

She said in subsequent messages, he tried to sexualise the conversation.

“I rebuffed him countless times but he didn’t stop. After the check-up at the FMC, he asked me to come to his privately owned clinic to run some more tests to rule out everything. I was puzzled because I knew I was fine but I still heeded because he was the doctor,” Chidinma said.

She added, “He told me to lock the door behind me on the day I went for the check-up, but I refused. He got up to do it and I threatened to scream if he locked it. That gave him some sense.

“But as soon as I sat down, he began asking some inappropriate questions. He asked me when last I had intercourse, who my first sexual partner was, and my favourite positions, but I tried to evade the questions politely while asking him what tests I needed to do.

“Later he brought out his phone saying he wanted to show me something about the test that I needed to run, but to my shock, it was a porn site. When I saw it, I threw the phone back at him and shouted at him but he told me that I was acting like a child.

“He said he wanted me to watch pornography so that I would be in the mood. Later, he stood up and started begging me that he was having an erection and that he needed me to help him with it.

“I became angry and stood up to leave. He held me back and was begging, but I warned him that I would raise the alarm if he refused to let me leave. That was when he let me leave. That was a married man with four children, as he told me earlier.

Doctors caught in the act

Some Nigerian male doctors have been accused of committing the crime outside the country. In 2016, a panel set up by the College of Physicians and Surgeons of Newfoundland and Labrador in St. Johns, Canada, found a Nigerian health worker, Dr Adekunle Williams-Owolabi, guilty of making sexual passes at a patient.

He was banned from medical practice for six months after making sexual comments to patients at his clinic in Labrador West.

In a report on the incident, a teacher, Arlene Johnson, who visited Owolabi’s clinic, was said to have testified that the doctor made some sexual comments during a pelvic examination.

Johnson was reported to have said that after a test, he (Owolabi) hugged her and whispered in her ear, “You have a beautiful clit, does your husband tell you that?”

In 2023, another Nigerian doctor in the United Kingdom, Ewere Onyekpe, was suspended for having sexual intercourse with a patient.

The UK’s medical regulatory body, the Medical Practitioners Tribunal of the General Medical Council, imposed a sanction of six months on his practising licence after he was found guilty by a tribunal that investigated the matter.

In February of 2022 also, a Canada-based Nigerian doctor, Efe Ovueni, was suspended by the College of Physicians and Surgeons of Alberta after hugging a medical officer and blowing her a kiss without her consent.

Speaking on the condition of anonymity, a medical laboratory scientist in a teaching hospital in Enugu told our correspondent that it was not uncommon for some male medical experts to take advantage of their female patients.

“It is very common. A lot of medical personnel do that especially if they want to do a vaginal examination of the woman, they would then start stimulating the woman. Unfortunately, some women fall for it and right there in the examining room they have intercourse,” the medical worker said.

Medical examination without chaperone unethical

He further explained some male doctors take advantage of the fact that some female patients were not aware that they could request a chaperone before undergoing a medical examination.

A chaperone is a person who accompanies or looks after another person.

“Once the doctor has a smart lawyer he can always escape because he would deny it. They would tell the female patient to prove how he harassed her. She would be left struggling for words except the doctor had previously been accused of harassment. If a patient cannot establish a case of harassment, the matter will be closed.

“The conversation should be about how we handle such cases. Should we start having cameras in the consulting rooms? If they have cameras who should be responsible for the images so we don’t breach the confidentiality of the patient?

“The patient should be able to ask that the camera be put on or not when inside the consulting room. It is a kind of complex situation; it is not a simple issue,” the medical laboratory scientist added.

A former president of the Medical Women Association in Nigeria, Lagos chapter, Dr Dumebi Owa, said it was unethical for a male doctor to examine a female patient without a chaperone.

“If as a male doctor you do not know you are supposed to treat a female patient with a chaperone, something is wrong with that doctor. If you are a male doctor treating a female where you have to do an extensive examination and you don’t have a chaperone or relative of that patient then you are in trouble because it is your word against the patient’s word if it ever comes to that,” Owa said.

A consultant gynaecologist and former general secretary of the Nigerian Medical Association, Dr Phillip Ekpe, emphasised the importance of chaperones when treating patients irrespective of sex.

“The main thing is having a third party all the time. For instance, if I want to examine a patient’s breasts or private parts, my nurses are always around.”

The President of the Healthcare Providers Association of Nigeria, Dr Austin Aipoh, explained that having third parties present while examining female patients not only prevents claims of inappropriate behaviour but also protects the reputation of the male doctor.

“Chaperones do not only protect the patient, they also protect the doctor as well because harassment could be either way. Also, for people to not tell lies that they were being harassed.”

Patients should know their rights

Speaking further, Owa said the level of enlightenment among patients about their rights is low, adding that patients must know their rights and not “just leave everything at the mercy of the doctor”.

“For a person to know their rights as a patient, they must be aware of the patient charter where the rights of a patient are stated. Despite this being plastered around hospitals, some barely glance at it or take it seriously.

“If you know that your body is your own and sacred to you, and you do not want anybody to touch it, they should not without your permission. When you tell a doctor you don’t want to be treated by them anymore, that is it. Your wish has to be obeyed.”

No sanction without evidence

Meanwhile, Ekpe said victims needed more than word-of-mouth accusations for action to be taken.

“Sexual harassment is not acceptable in any way so if a patient takes that accusation to the medical regulatory body, the Medical and Dental Council of Nigeria, the body will have to investigate the allegation and from there the appropriate sanctions will be given.

“The institution where the act occurred would also conduct its investigation and can also suspend, sack or warn the doctor depending on the extent of the act because it is not good at all for a doctor to have a relationship with the patient,” he added.

The MDCN is the regulatory body overseeing the practice of medicine and dentistry in Nigeria.

MDCN reacts

Responding to an enquiry by our correspondent on the matter, the secretary of MDCN’s investigation panel, Dr Enejo Abdu said, “The investigation panel is the statutory body with the mandate of investigating any allegations of misconduct in professional respect against registered medical practitioners or dental surgeons. The panel does not deal with allegations of crime.”

Abdu added that all doctors were expected, by the Code of Medical Ethics in Nigeria to, among other things, maintain appropriate and decorous relationships with patients, including ensuring that patients of the opposite sex were examined in the presence of a chaperone of the same sex.

On reporting cases of allegations of misconduct, he said, “Patients are encouraged to report allegations of misconduct in professional respect against registered practitioners to the MDCN in the form of affidavits deposed to before a commissioner of oaths or a notary.

“The affidavit should be sent to: the Registrar, Medical and Dental Council of Nigeria plot 1102 Cadastral Zone B11 Kaura District Abuja. Scanned copies should be sent to [email protected], [email protected] and [email protected].”

The president of the Nigerian Medical Association, Dr Uche Ojimah, had yet to respond to calls, texts, and WhatsApp messages sent to him by our correspondent.