Healthcare professionals as witnesses : what the data reveals about historical and contemporary ways of attesting to crisis and catastrophe : knowledge synthesis report
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Background
Accounts by healthcare professionals (HCPs) often have a major impact on how an event
such as an industrial disaster, a natural disaster or a war is perceived and understood. Medical
workers are regularly called upon to provide testimony to the media, in legal proceedings or
to public inquiries. These varied contexts make different demands upon those witnessing and
shape how their accounts are delivered and, to an extent, received. The narratives HCPs
provide are often based on their personal observations but sometimes they also act as crucial
relays for testimony by others, sharing stories they have heard from those in their care. In
times of conflict, deliberate targeting of HCPs as a war crime can therefore potentially be
understood to form an assault on powerful sources of current and future testimony.
Witnessing by HCPs is therefore a topic of immense contemporary relevance. It is, however,
not straightforward and resists generalization.
Objectives
In this knowledge synthesis project, we considered what roles testimonies by HCPs have
played or continue to play in evolving narratives linked to four specific case studies: the
Holocaust, the Union Carbide Gas Leak Disaster in Bhopal (1984), the 2010 Haiti earthquake
and the climate crisis. Through analysing data linked to the case studies, we sought to address
to what extent existing research examined the important function testimonies by medical
practitioners have played in enhancing knowledge and understanding of such catastrophes.
Results
Based on our research we concluded that the existing scholarly literature that offers direct
critical engagement with testimony by HCPs in relation to three of our four case studies was
minimal. The outlier was the Holocaust where there is a steadily growing corpus of work
directly addressing the form and nature of witness accounts by medical practitioners.
However, witness accounts by HCPs have clearly been important for shaping popular
understanding of the Union Carbide Gas Leak Disaster in Bhopal, the 2010 Haiti earthquake
and the climate crisis. Some scholarship has addressed key issues of witnessing on these case
studies, but usually only indirectly. Further studies can build on this body of work to examine HCPs’ accounts, considering their content, level of effectiveness, reception and issues of
potential exclusionary practices.
Key messages
• Governments and NGOs need to engage in educational initiatives and develop supportive
communication practices to ensure medical testimony is diverse and representative
• Governments and NGOs that disseminate testimony by HCPs need to incorporate
targeted strategies that address social barriers to bearing witness and promote inclusivity
• Evaluation studies are required to address whether some healthcare stakeholders in
countries in the Global South are being discouraged from sharing testimony because they
are required to conform to hegemonic conceptions of what constitutes witnessing and its
appropriate form that are alien and alienating to them
• Testimony by HCPs is often crucial to understanding health emergencies and disasters
but should not be approached uncritically and policy related to the dissemination of
witness accounts should take this into account
• Holocaust education has been fundamental to medical education in aspects such as
medical ethics. Such pedagogical initiatives should be extended to considering the form
and effectiveness of testimony by healthcare worker-survivors in other situations
Methodology
Texts were initially identified by keyword searches, then following up the references in a
piece and a cited reference searches for pieces that we agreed to be key texts. This was
further supplemented by identifying key case studies within those texts that would help us to
focus on questions of witnessing. Texts were selected to represent the spread of arguments
and interpretations made by different scholars working in these areas.
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