Wednesday, 15 February 2012
Joint Committee on Foreign Affairs and Trade DebatePage of 5
Chairman: We will begin the next part of the meeting, our discussion on Bahrain. I welcome the following witnesses from the Royal College of Surgeons in Ireland, RCSI, to the meeting. We have Professor Cathal Kelly, chief executive and registrar, Professor Hannah McGee, dean of the faculty of medicine and health sciences, and Mr. Michael McGrail, director of corporate strategy. I thank them sincerely for agreeing to attend today’s meeting. The committee has been already in contact with them regarding the detention and ill-treatment of Irish-trained medics in Bahrain in 2011. It is an appropriate time to attend given that the anniversary was yesterday. As they are aware, there has been some criticism of the RCSI’s response to the issue. I am however aware that the Department of Foreign Affairs and Trade acknowledges that the RCSI has at all times sought to influence in a positive way by encouraging the Bahraini authorities to embark on a process of reconciliation and pointing out the damage caused by the current actions to Bahrain’s international reputation. I invite Professor Kelly to update the committee on the Bahraini issue and in general on the activities of the RCSI in assisting with the training of foreign medical personnel overseas, which is a highly worthwhile activity through the college which makes a significant contribution to the quality of life of millions of people around the world. The college is to be commended on that.
Before I invite Professor Kelly to make his contribution I advise the witnesses that they are protected by absolute privilege in respect of the evidence they give to this committee. If they are directed by the committee to cease giving evidence in regard to a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should neither criticise nor make charges against a Member of either House of the Oireachtas, a person outside the House, nor an official by name, or in such a way as to make him or her identifiable.
Professor Cathal Kelly: I thank the Chairman and Members of the Oireachtas for inviting me and my colleagues to today’s committee proceedings. We very much welcome the opportunity to state our position and responses to unfolding events over the past year. The continuously evolving situation in Bahrain has been a uniquely challenging one for RCSI. We have never been in this situation, nor do we think have other third level institutions in Ireland, where we have been present in a very volatile and sensitive international environment, with direct responsibility for more than 1,000 students and staff. We have endeavoured to do the right thing, focusing on our core educational mission and we continue to do so.
RCSI is an independent, not-for-profit, health sciences institution. Our primary purpose is the education and training of health care professionals and health sciences research. RCSI is Ireland’s truly international centre of higher education. Only 30% of the student population in Dublin is Irish. We are an international organisation; our campus in Dublin has more than 3,800 students and 860 full-time staff. Currently, there are 14,000 RCSI graduates working as medical doctors or in allied disciplines all over the world.
The RCSI is the largest international surgical trainer in the sub-Saharan countries of Ethiopia, Kenya, Malawi, Mozambique, Lesotho, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe. The RCSI runs training programmes throughout the Middle East, with a training campus in Dubai and a university in Bahrain, and we also run undergraduate and postgraduate programmes in the Far East, most notably in Malaysia. The RCSI is a not-for-profit institution, and it is largely self-funding. Any financial surpluses generated from our activities are reinvested in our research and academic programmes.
The RCSI is a significant contributor to the Irish economy. Approximately 8% of our income comes from the Exchequer and the balance is raised from our delivery of undergraduate, postgraduate and continuous professional development education in Ireland and abroad. In Ireland, 70% of our students are non-Irish, amounting to more than 2,000 students. In addition to many non-economic benefits, these students bring jobs and spend in the local economy. Estimates show that each foreign student spends an average of €15,000 per annum.
In Bahrain, students in our campus are drawn from 17 countries around the world. There are currently 1,021 students enrolled in medicine, nursing, and Master’s programmes. There are more than 120 academic and administrative staff in Bahrain, who are likewise drawn from all over the globe.
The RCSI has had a relationship with Bahrain for more than 30 years. The college agreed to establish a medical university of Bahrain in 2003. The first students were admitted in 2004 and we graduated our first medical and nursing students in 2010. Today, the college has more than 1,000 students and 120 full-time staff.
The opening of our university buildings in February 2009 by the then President, Ms Mary McAleese, marked the culmination of the RCSI’s €70 million investment in Bahrain. This is a substantial investment in line with requirements to fund a well-resourced medical school. The university was funded entirely by RCSI resources and is performing in line with our expectations both from educational and financial perspectives.
Many of us know Bahrain well and have great regard for the people and progress that has been made in the country since its independence in the 1970s, with significant investment in infrastructure, education and health care.
The United Nations human development index, HDI, is a broad definition of well-being. It provides a composite measure of three basic dimensions of human development: health, education and income. Bahrain’s HDI rating is 0.806, which ranks it 42nd of 187 countries with comparable data. The average HDI of Arab states is 0.641, placing Bahrain above the regional average. Bahrain, like Ireland, is in the top quartile of countries with the highest HDI.
Although a small country, Bahrain is a profoundly complex one. It is located in a region of enormous geopolitical upheaval; it is possibly the most westernised of all the Gulf states and, critically and unfortunately, almost all differences within the society now crystallise around the sectarian Shia-Sunni divide.
The ongoing events that began in February 2011 are a tragedy for Bahrain. It has been deeply distressing to watch events unfold over the past 12 months. It is critical that the RCSI, as an organisation, help build bridges rather than contribute to greater fracturing. It does this by being non-partisan, non-aligned and restrained in public commentary. Otherwise, it would become part of the problem rather than the solution.
At the RCSI, we are very clear that we are a health sciences institution. Our focus is on medical and health professions, education at all levels, including undergraduate, postgraduate and continuous professional development. Our primary responsibility is to contribute by providing a high-quality education based on internationally recognised ethical principles in medical and health science education in a safe and supportive environment. It is a case of allowing students to reach their potential and maximise their opportunities, irrespective of their background.
With this in mind, when the internal and security situation escalated following protests in February 2011, senior staff in Dublin immediately travelled to Bahrain to monitor and ensure the safety of our students and staff and, if possible, to enable them to continue their education. In the early stages, we closely monitored events, focusing on communications with students, their parents and staff. When the situation further escalated in March, we temporarily suspended teaching. Staff continued to attend the university ensuring it remained a focus for our students. We made contact with all parents, as well as students, keeping them informed of developments, as necessary. We developed an evacuation plan, and when the situation deteriorated we evacuated students and staff who wished to leave. A core group of staff from the RCSI remained in Bahrain to maintain the university and to set up and staff a temporary accident and emergency unit for the local population in Muharraq. We were heartened that all of our students, including many international students, returned when we reopened the campus.
We developed contingency plans, including evacuation to Ireland, to ensure that, irrespective of political unrest, our final medical year students would graduate on time. A delay in graduation for this class would mean a full year of lost employment at a pivotal time in their careers. In June, 53 medical doctors and 70 nurses graduated as originally scheduled. We have been criticised for holding this graduation. In our view, it was important that the graduation take place as a tribute to the commitment and courage of the young people. Many of these students are the first members of their families to attend a university and obtain a degree. The students who graduated come from all ethnic, religious and cultural backgrounds.
As the new academic year started in September 2011, the focus of the RCSI university in Bahrain was contingency planning in the context of volatility and considering the role of the university as being part of the solution rather than the problem. To this end, staff-student working groups, from all communities and political viewpoints, are examining how to live with difference and to remove division and tension from university life and health care provision.
We in the RCSI are in a very different position from advocacy groups, national governments such as those in the United Kingdom and United States, and international organisations such as the European Union and United Nations. We have a unique balance of responsibilities and opportunities. We judged that we could be true to our responsibilities and more effective in advocating for the health care professionals through private advocacy in Bahrain. Our approach has been guided by what we have judged to be most effective in Bahrain. In support of this approach, we have chosen to minimise public statements in Ireland.
We greatly respect the work of various advocacy groups and they do their work in a manner consistent with their role and their opportunities. We have met these groups and anyone who wished to discuss our stance. We have both listened and explained our position.
The Irish Government, as the Tánaiste indicated in a reply to a parliamentary question, has publically stated our national view, as have the European Union and the UK and US Governments. Throughout the period in question, we have stayed in close contact with the Department of Foreign Affairs, which has worked through our embassy in Riyadh. We have repeatedly met senior government officials in Bahrain, outlining our concerns and position. We took the view that a positive influence would be more effectively exerted through dialogue rather than through public advocacy. That said, we unequivocally stated our position in a letter to The Irish Times in June 2011.
Medical practice is a privilege that carries rights and responsibilities. Doctors have a responsibility to treat all patients, irrespective of their background, to the highest possible standard, under all circumstances.
Hospitals must be politically neutral. Society has a responsibility to allow doctors and nurses to treat all patients in need. The protection and care of people wounded in conflict is a basic right guaranteed by the Geneva Convention. Punishing doctors or nurses for treating patients, irrespective of their backgrounds, is completely unacceptable. The World Medical Association’s International Code of Medical Ethics and its Medical Ethics Manual define the duties of physicians as including the administration of emergency care and adhering to principles of non-discrimination. Governments should not infringe upon the duties of medical professionals and should not target or punish those who seek to uphold these internationally recognised principles.
We believe the future for Bahrain has to be one of dialogue and reconciliation. Our own national story tells us that the problem will not be resolved quickly. We will continue to contribute through education and to advocate for just outcomes. In October 2011, we further reiterated this view, stating that while we were not prepared to pre-judge on the guilt or innocence of any of the medical personnel facing charges arising from the Bahraini protests, we were unequivocal on the need for due process, transparent judicial procedures and the presumption of innocence until one is proven guilty.
Against this tense and volatile background, we believe it was a wise act by His Majesty the King of Bahrain to establish an international commission of inquiry, the Bahrain Independent Commission of Inquiry, BICI. The five members of the commission were international experts on human rights. The chair was Professor Cherif Bassiouni and its members were Judge Philippe Kirsch from Canada, Professor Sir Nigel Rodley from the UK, Dr. Mahnoush Arsanjani from Iran and Dr. Badria Al Awadhi from Kuwait. The commission had the same privileges and immunities as United Nations experts on mission. It started its work in July and presented its report in November. It received more than 8,000 complaints and statements of various human rights abuses relevant to its mandate. In a comprehensive 500 page report, it published the results of its investigation of the events occurring in Bahrain in February, March and thereafter. The report made a series of recommendations.
During the period of the commission’s work, it took steps to address existing issues of human rights violations. This was accomplished by communicating with Government of Bahrain officials where there were immediate interventions. Subsequently, more than 300 detainees were released and special medical attention was provided to injured persons. Hundreds of dismissed public and private sector employees and suspended students were reinstated.
The commission indicated that there was no doubt that what occurred in February and March and subsequent related events were the result of an escalating process and that the Government of Bahrain and the opposition have their share of responsibility in letting events unfold as they did.
It was suggested in one Irish commentary that the commission referred to the Royal College of Surgeons in Ireland, RCSI, in its report. The Bahrain Independent Commission of Inquiry, BICI, does not mention the RCSI. It discusses events at the University of Bahrain and Bahrain Polytechnic, neither of which is connected with the RCSI. The BICI was saddened to see violence break out among students in places of learning. In sharp contrast, there was no violence at the RCSI’s campus and no students were expelled or suspended for political activities.
In response to the report, his majesty King Hamad accepted that the commission identified serious shortcomings on the part of some organs of the Government, particularly in failing to prevent instances of excessive force and the mistreatment of persons placed under arrest. The King has undertaken to implement the commission’s recommendations.
The RCSI unequivocally welcomes the BICI report, which is comprehensive, wide-ranging and unflinching in its findings and conclusions. We are deeply concerned at the findings, including those of human rights abuse and intimidation. We welcome the decision of his majesty King Hamad to pursue those who abused their authority in this way and the decision to move all trials to civil courts. In particular, we welcome the decision to set aside confessions obtained under duress.
Following the publication of the report and with an understanding that these outstanding legal cases were a block to meaningful dialogue and the rebuilding of society, the RCSI formally wrote to his majesty in December asking him to drop all outstanding legal charges against those who were charged, including medical personnel.
The college has also written to Professor Bassiouni, chair of the commission, pointing out that the medical profession in Bahrain has become deeply polarised to the extent that public trust in the profession is now seriously compromised. To rebuild trust, several actions need to be taken. The outstanding charges against the medics need to be dropped. These charges are a major obstacle to progressing any reform initiative and only serve to fuel hostility and division. In addition, a health sector forum should be created to bring the different positions and opposing groups together towards a common project of building reconciliation and mutual understanding among health care professionals in Bahrain. The RCSI has offered to assist in every way.
The situation in Bahrain remains challenging. Our hope is that, in this week one year after the start of these events, people will reflect on what has been achieved in Bahrain and what is at risk if the process of dialogue and reconciliation does not continue.
As Irish companies and universities increase their activities abroad, which we all must do in the national interest, we will find ourselves working in countries with different political systems and cultures than our own. To work in those countries, we must find a way to be true to ourselves and our core missions while being respectful of their cultural, judicial and political norms. The RCSI welcomes the work led by Chancellor Dr. Maurice Manning of the National University of Ireland in developing a charter for universities working overseas. While the RCSI has been traditionally acknowledged as the lead in attracting international third level students to Ireland and bringing Irish education to international settings, this is now an important aspect of many higher education institutions’ work and a key part of Ireland’s development as a knowledge economy. Thus, we all need to consider how to respond to the inevitable challenges illustrated by the Bahraini unrest of the past year. As we sit here today, RCSI people are listening and working in Africa, the Middle East, the Far East and Ireland. I want them to know that I greatly respect the work they do. They are a credit to Irish education and are great ambassadors for our country.
To Bahrain, I say that we at the RCSI are with you and we will continue to contribute by providing high quality medical and nursing education in a non-sectarian environment. It is our belief that we can contribute to the future of Bahrain through education. The priority for the RCSI is ensuring quality health care through the provision of high quality education. Our approach in this unprecedented year in Bahrain has been to focus on our health care education mission and to ensure that events did not compromise a safe, non-sectarian, respectful educational environment for our students and staff.
Chairman: I thank Professor Kelly. His statement was clear and comprehensive and provided a good update on the RCSI’s activities in Bahrain. The words “dialogue” and “reconciliation” were very much in evidence. They seem to be the way forward.
Deputy Pádraig Mac Lochlainn: I thank Professor Kelly and his colleagues for attending. As we speak, protestors are on the streets of Bahrain. Sadly, the disturbances continue. The protestors’ objective is not to overthrow the ruling regime, but to establish a democratic constitutional monarchy and the recognition of human rights. The BICI report goes a long way towards achieving the second objective.
The events of last year were deeply disturbing. I wish to read into the record the harrowing testimony of Dr. Ali Al Ekri, a senior consultant pediatric orthopaedic surgeon. He completed his postgraduate training in Dublin and served in a Dublin hospital and has been working at Salmaniya Medical Complex for the past 20 years. He was arrested. His curriculum vitae shows him to be a man of outstanding credentials. He is the founder of the Cerebral Palsy Friendship Society in Bahrain, an honourable member of the Royal Charity Organization, a volunteer and a member of the Al Karama centre and the Bahrain Human Rights Society. The list goes on and on. This is his testimony. With the Chairman’s permission, I will read as much of it as I can. Dr. Al Ekri states:
It is absolutely disgusting that this should happen to a man of such eminence who is performing his medical duties and honouring his Hippocratic oath. This is just one of 47 doctors. A total of 1,000 people were arrested. Front Line Defenders, Médecins san Frontières, Human Rights Watch, Physicians for Human Rights and the Royal College of Surgeons of England condemned it, but the RCSI did not.
While I welcome the statement today and the tone and way in which it was delivered, the recent period has, sadly, damaged the international reputation of the RCSI. Two of the world’s most widely read medical journals, The Lancet and the British Medical Journal, have condemned the RCSI for not speaking out, with the British Medical Journal accusing the RCSI of complicity with the regime. These are very serious allegations and they do not come from a political or human rights group but from the college’s medical colleagues. In Ireland, a number of medical professionals ranging from doctors to professors spoke out against the RCSI for not condemning, in view of its very influential position in Bahrain, the horrendous abuse of human rights that was inflicted on doctors doing their job in a hospital.
Why did the RCSI not condemn this when so many others from the medical profession internationally did, including international representative organisations such as the UN? What efforts did the RCSI make to secure their release or at least to protect their rights on being made aware of their arrest? Does the RCSI acknowledge that the medical professionals in Ireland who have spoken out about this have the right to do so and that they are entitled to challenge it, if they wish? Apparently there are allegations that some of the staff based in Bahrain would have been active in criticising the regime. Were any staff let go from their positions in Bahrain following the uprising a year ago? What is the RCSI response to allegations that staff were let go in order to silence them?
Senator Jim Walsh: The reason the RCSI representatives are here is that there was a general feeling within the committee that they could have done more and been much stronger in their condemnation of what is happening. The submission from Professor Kelly today was comprehensive and came across as open and honest, with a great deal of clarity. I am inclined to accept that the approach the RCSI took was probably the correct one, in that quiet diplomacy can sometimes be more effective. As Professor Kelly said, there are many advocacy groups there who could condemn it. However, he was also clear in condemning the breaches of human rights, which is very important. I understand why he wishes to ensure that the RCSI is in a position to continue its role and the contribution it is making to people’s welfare. Obviously, the witnesses are medical practitioners and students from the college are probably doing far more good than we could effectively do in taking a different line.
I am conscious of what Deputy Mac Lochlainn said in this regard. I have a lingering doubt. The RCSI has a medical university in Bahrain which has many students. To what extent does that inhibit the RCSI? That did not come through in the submission; other reasons were given. Second, has there been any interference with the operation of the university there? To take nothing from the appalling abuse of human rights, I note that a number of the medical staff were involved in political activities and 47 were arrested. Does the witness know or can he comment on the extent to which it was people who were in the opposition, which of course would be a breach of their rights and of their right to seek a more democratic society there, or if it was just a global matter of them treating people who were opposed to the regime who happened to be injured in the ongoing conflict there?
Deputy Maureen O’Sullivan: I agree with the witness on the issue of dialogue and keeping the channels for dialogue open. I do not know if the witness heard the reference to a meeting earlier this week with Archbishop Odama from northern Uganda and how, in a 20 year war, groups coming together and keeping dialogue going were able to bring about peace. I am in agreement with the witness on that issue.
He mentioned private advocacy. Where was that directed? It is obvious the Bahraini authorities did not have respect for the neutrality of hospitals that he mentions in his document. They did not respect the right of doctors to treat all patients, regardless of their origin. What has been happening with the commission’s recommendations? Has the witness seen practical implementation of what it suggested? With regard to his letter to the BICI, what exactly did he ask for and is progress being made on that? Why put so much money into Bahrain? Why was that country chosen instead of another? That is unrelated to the other discussion but I am curious.
Deputy Bernard J. Durkan: This issue has a particular relationship with the subject we discussed in the earlier part of the meeting. I am not so certain that there is not a role for advocacy in such cases. It might be difficult for institutions that have an investment in a location outside this jurisdiction but it is always important to ensure that where there are clear and unequivocal abuses of human rights there is a reaction to it and that the rest of the world community is made aware of what is happening. It is always easy for people to remain silent, although I do not suggest that the witness remained silent. It is more difficult to tackle the issues as they present themselves.
Over the years I and other members of this committee have met people who have been subjected to torture and abuse. They are not necessarily from Bahrain but from various other locations. Even though one expects to be shocked, the actual shock is far greater than the expectation. In those circumstances we all must realise that we have a role to play, be it as parliamentarians, people living in a democracy or just simply as members of the global community. It is ongoing and difficult. It is very difficult to tackle a subject of this nature in various locations and often at the same time. However, we all know there is no excuse for blatant abuses of people’s human rights. There is no point in wringing one’s hands and trying not to confront the issue. We are as well off to be open about it. Abuse is abuse and we must be unequivocal about it at all levels in society, and wherever we have a responsibility, regardless of its shape or form, we must convey our opposition and disgust to the widest possible audience on every occasion. Otherwise, it appears as if we give our imprimatur to wrongdoing and that should not be the case.
Deputy Eric Byrne: I welcome the debate which is important and has been going on in subliminal form for quite a while. Now it is being addressed in its totality. It is fascinating but also fascinatingly complex and it is easy for us to get emotional about the behaviour of other societies that do not act in the sophisticated way of the West. Having heard Front Line Defenders and the phenomenal work it is doing in defending human rights, it is difficult for politicians to realise the accepted norm may not apply whereby medical hospitals are sanctuaries for the sick and wounded. It is culturally, religiously and politically alien to us to imagine people being arrested for treating victims of riot situations.
The counterpart is the other developments in the country. The RCSI has been to the fore in opening universities in far-off lands with different cultures and religious beliefs. We cannot escape the undercurrent of conflicts throughout the Arab world with the conflict between Shia and Sunni Muslims. There is an undercurrent in Bahrain. I will not be dogmatic in condemning the university because I do not know what it did until its representatives answer Deputy Mac Lochlainn’s question. I welcome a university moving into the Arab countries. Our universities and third level institutions are extending the hand of friendship across the globe in attracting and wishing to create relationships with China, whose future premier will be here this week. I have met the wonderful people of Oman, who are coming in greater numbers, and I have met Saudi students in UCD. I am very aware of the fact that the Omani Minister for education will be here next week.
How do politicians in Ireland influence Bahrain? We do so through our Department of Foreign Affairs and Trade, using contacts such as the universities. We must recognise the undercurrent between the Sunni and Shia Muslims. Conflict resolution is an area we specialise in and perhaps Irish Aid or the Department of Foreign Affairs and Trade can engage in this. People from the Turkish Workers’ Party and people with diverse political, religious and cultural conflicts have come here and perhaps we can help.
We should do all we can to lessen the conflict between hardliners within the present Government in Bahrain and support the King. I am impressed by the King’s rapid response in creating this international body and very quickly acting upon its report. If we have any influence, it should be used to assist the King in resolving the tensions. It is easy to fall into the role of condemning the activities when we are so far away from the scene. We have two important roles to play; one of which is to act as defenders of human rights, the other is in moving into more culturally and religiously diverse areas of the world. I welcome that the National University of Ireland is developing a charter for universities working overseas, of which I was not aware.
Senator David Norris: I welcome Professors Kelly and McGee and Mr. McGrail. I compliment Professor Kelly on a fluent presentation. I was involved in third level education for a number of years and I know the unusual position of the RCSI, on which it is to be congratulated, in maintaining its complete independence from the Government using an efficient business model. I note that Mr. McGrail is the director of corporate strategy, which suggests a certain business element and there was reference to substantial investment. There is a business aspect to this and I make the point neutrally.
The concerns of the Joint Committee on Foreign Affairs and Trade are matters of foreign policy. We have a human rights sub-committee, on which some of us sit, and immediately prior to the attendance of the RCSI, Mary Lawlor and her colleague represented the Frontline Defenders. We are interested in a number of the cases, including one from Bahrain, Mr. Abdulhadi Al-Khawaja, withwhich I was not familiar previously He has visited Ireland on a number of occasions and has been involved in the human rights resource centre headed by our former President, Mary Robinson. The Bahrain Independent Commission of Inquiry report concluded that, having been received by a forensic medical experts and interviewed for the report, Mr. Abdulhadi Al-Khawaja had been tortured. The word “torture” is not used in the RCSI presentation. This is a question of language and the closest the RCSI presentation comes to it is “In particular, we welcome the decision to set aside confessions obtained under duress” aka torture.
The approach of the RCSI is somewhat different to other groups and it believes constructive engagement has more possibilities than confrontation. I am not altogether sure and I tend to be a confrontational type. The difficulty is that a deferential attitude can sometimes compound the situation and I am worried that this might be the case, particularly when the RCSI is shy of using the word “torture”. That is exactly what it is. The RCSI speaks of its mission, which is fine and noble and about the spreading of medical education and ensuring quality health care. No one can disagree with that but some of the people who were snatched, imprisoned and tortured for providing medical assistance without taking sides, were graduates of the RCSI. Is that the case? The RCSI says it has minimised public statements in Ireland and that positive influence is exercised more through dialogue. The RCSI referred to its duties to its students and if these people are graduates surely there is also a responsibility to graduates. Professor Eoin O’Brien took a strong stand on this. I am prepared to be corrected on this. The RCSI refers to the responsibility to operate in circumstances where it shows respect. It was stated, “To work in these countries we must find a way to be true to ourselves, our core mission and be respectful to the cultural, judicial and political norms of the countries in which we work.”. This must be extraordinarily difficult in some circumstances, particularly where the cultural, judicial and political norms of these countries violate what most people in the west see as fundamental and basic human rights, including the right to be free from torture and certain attitudes with regard to gender and equality. How can this be accomplished? This will be the most difficult aspect and I ask the witnesses to comment on it.
If the witnesses do not mind I will read their reply in the transcript of the committee proceedings because I thought Private Members’ business in the Seanad was beginning at 5 p.m. but it began at 4 p.m. and I must leave to take part in the debate. I ask the witnesses to excuse me for any apparent rudeness. I apologise.
Senator Lorraine Higgins: I welcome Professor Hannah McGee, Professor Cathal Kelly and Mr. Michael McGrail and thank them for coming before the committee. I thank Professor Kelly for his very detailed submission. I condemn in the strongest possible terms what has happened in Bahrain, in particular to the students of the RCSI. It is clear that significant efforts have been made by the former Minister of State at the Department of Foreign Affairs and Trade, Deputy Jan O’Sullivan, the ambassador to Saudi Arabia, the EU Foreign Affairs Council and the EU to highlight this issue and seek redress for the breaches of the basic human rights of the individuals involved. While we await the outcome of the hearings on 19 March, has the RCSI considered what steps it will take following any adverse findings that might arise against the detainees? A very dangerous, unsafe and unjust legal precedent will be established if the original findings are upheld.
Senator Averil Power: I welcome Professor Kelly, Professor McGee and Mr. McGrail. I am sorry I could not be here for the initial presentation and the discussion with Front Line but I had other commitments. I am glad the committee is still in session because I was anxious to attend this meeting. Because we have discussed this issue previously Professor Kelly knows I was in Bahrain as part of an Irish delegation last summer with representatives from Front Line, the former Minister, Mr. David Andrews, Ms Marian Harkin and others. We met medics who had been detained and subjected to torture and we listened to their first-hand stories. We also met the families of people still in prison. I have been following events constantly on Twitter and on the Internet since. I am growing more concerned by the day, particularly as it is now the one year anniversary of the violent crackdown on legitimate protest and matters have not really moved on. As pointed out in the presentation, the Bassiouni report was published last November and no real move has been made to address the genuine concerns of the people of Bahrain.
I appreciate where the college is coming from and how initially it was caught up in all of this without any planning when events erupted. I am growing more concerned about the role of the college since then. I understand that initially the college was concerned about protecting the education of its students and ensuring it could keep its doors open, as was stated in the written presentation provided to the committee.
When I was in Bahrain with the group not only did we meet former staff of the college who had been arrested but we met current students who were able to point to the fact that sectarianism is creeping into education. We asked the Minister with responsibility for health about the fact that in the previous year everybody who had finished their academic training was given a placement in a public hospital to get medical experience, but the students told us this no longer happens. The Minister gave us a very weak response about a sudden capacity issue which had not previously existed. This capacity issue seems to break down on ethnic sectarian grounds as far as I can see so I am concerned about the current students of the RCSI and its responsibility to them. I appreciate the college had to make decisions very quickly at the beginning but this has been going on for a year and it is starting to creep into other levels of Bahraini society. I can see things only getting worse which is upsetting.
I agree with much of the substance of the witnesses’ presentation, that while there have been ongoing violations of political rights in Bahrain it has been a good and peaceful society. When I was there I was struck by the respect for women and how well-educated women there are. The most articulate of the doctors we met were female and this is very positive in the Middle East. However things are falling apart in Bahrain. Every night I read about teargas being used against people and innocent human rights defenders being arrested. Two days ago a lady with the Twitter name @angryarabia, was arrested when taking part in a peaceful process. She is a very brave young lady whom I met when I was there.
Has the college re-evaluated its position in light of ongoing events? The presentation document states that the college wants to be non-partisan and non-aligned. I agree with committee members that when it comes to torture there is nothing to be neutral about; one cannot be neutral in this context. The college runs the risk of alienating the vast majority of Bahraini people. The college might state that it is not taking sides but being seen to not take sides and to not speak louder is taken as acquiescing to what the Government is doing. The college needs to be conscious of this in the long term because if significant changes occur in Bahrain, and it might well come to this, the college will find itself on the wrong side of the majority of public opinion in the country. This should be taken into account.
I thank the Chairman for being very gracious and allowing me to make such a substantive contribution. The Oireachtas Joint Committee on Education and Skills is very strict on speaking time and I get only two minutes to speak. I thank the Chairman for his indulgence because I feel very strongly about this issue.
Senator Mark Daly: Thank you, Chairman. I congratulate my colleague on her trip there and the efforts she has made to highlight this issue. I suspect she is far more informed about it than most people in the room or in the building.
I want to return to a point raised by Deputy Mac Lochlainn. He listed a range of organisations which condemned what was happening in Bahrain, including the Royal College of Surgeons of England, but the RCSI did not. This is reprehensible. Let us not kid ourselves, this boils down to money. The RCSI has an institution in Bahrain which generates money and it is trying to protect its interests. A neutral observer on the outside would believe the delegation did not use the word “torture” in its presentation because it did not want to pay the consequences in Bahrain, but it is torture. Do the delegates believe people are being tortured in Bahrain? Will they issue a statement to the effect that the Royal College of Surgeons in Ireland condemns torture? The people whom the Royal College of Surgeons in Ireland educated are being tortured. It is not aloof or just educating people. Its former students are being taken away and treated in the way outlined by Deputy Pádraig Mac Lochlainn, yet its response has been nothing short of pathetic. In the years after this issue has been resolved and when the majority is in power, the lack of a response from the Royal College of Surgeons in Ireland will and should be noted. Evil prospers when good men stay silent. It is easier to stay silent than to stand up to the king and say torture is wrong. The people in question should act in accordance with the Hippocratic oath in that they are supposed to help all those who present at hospitals, irrespective of how they were injured or who injured them. They deserve to be treated. If a former student of the Royal College of Surgeons in Ireland or any medical professional in Bahrain is taken away to be tortured - people have been killed after being tortured - and the college stays silent, it is shocking. One year on, the response of the Royal College of Surgeons in Ireland to the committee - it does not even include the word “torture” - is appalling. Do the delegates believe people are being tortured in Bahrain and will the Royal College of Surgeons in Ireland issue a statement condemning torture?
Chairman: The Royal College of Surgeons in Ireland responded, as was noted at the meeting. However, we had not received the letter by the time of our meeting two weeks later. It was in my pigeon hole and another week passed. It was circulated to members after I had received it. It is unfair to claim, therefore, that Professor Kelly avoided the committee, especially given the delegation’s attendance today. All members have a high level of genuine interest in the situation in Bahrain. The delegates are here and we should listen to their reply.
Chairman: Senator Daly, please. I am in possession. The response was a holding letter, but a comprehensive reply was in my pigeon hole two weeks later. The professor was away. That representatives of the Royal College of Surgeons in Ireland are attending today indicates that they will answer questions.
Professor Cathal Kelly: I thank the Chairman for his fair-minded response. This type of discussion and engagement is much appreciated and the comments are reflective of and grasp the complexity of the situation. This is not simple soundbite territory; rather it is a complex issue that will have long-term and important implications in Bahrain. My colleagues and I have tried to note the various comments made and I will try to answer them. Forgive me if I miss some of them, as many were made. Members can revert to me if I do so.
My fellow countyman Deputy Pádraig Mac Lochlainn’s comments tapped into something mentioned by Deputy Byrne in this and a previous module, namely, the need for robust and irrefutable evidence. Our line in the sand was the report of the Bahrain Independent Commission of Inquiry. I recommend that those who are genuinely interested in the situation in Bahrain and the issues concerned should read the report, as it provides a superb chronology of events there. It was a country in which civil society was on the verge of a complete meltdown and it is undoubtedly the case that the government overreacted. The international commission - the bona fides of its members were beyond reproof - lay the blame on both sides. The Bahraini Government was to blame, but the opposition did not engage constructively with it. I was there at the time and could see what was happening. Everything else stemmed from this, although I am not justifying it.
The Bahrain Independent Commission of Inquiry report is superb and transparent. The commission had full access and was unequivocal in its description of abuse, torture and so on. We have read, studied, welcomed and fully accepted its report. We are delighted that the Government of Bahrain has also accepted it and undertaken to identify and punish those responsible. It has accepted that organs of government did not behave well or overreacted - call it what one will. They abused prisoners and engaged in illegal activities. The government has also undertaken to compensate the victims of the abuse. This is only right and proper and no one would advocate otherwise.
We are clear in our views, processes and standpoint. There have been multiple commentaries in many journals and the like in Ireland. As our document states, we want to balance our responsibilities to our organisation, staff and students with our responsibility to do the right thing based on robust evidence. On the basis of the report of the Bahrain Independent Commission of Inquiry, we have written to the king to ask him to drop the charges, given that many of them may be based on forced evidence. The current legal position is an impediment to meaningful dialogue in seeking a resolution. From events in our own country we know that going over what happened in the past time and again will get us nowhere. We need to look to the future and get dialogue going. We have worked closely with the Department of Foreign Affairs and Trade and the embassy in Riyadh and engaged with the relevant Ministers. We have met senior officials in Bahrain at many levels of government. We have been unequivocal in our approach and the evidence we have presented to them. I hope I have addressed some of Deputy Mac Lochlainn’s comments.
Deputy Pádraig Mac Lochlainn: My third question was on whether the Royal College of Surgeons in Ireland acknowledged the right of medical professionals in Ireland to speak out and criticise, which I presume it does. My fourth question was related to the allegation that staff were being silenced and let go.
Professor Cathal Kelly: We acknowledge and welcome comments from anyone, medical or otherwise, and support the right of people in Ireland to express their opinions, which they do freely. Regarding the allegation that staff were being let go to silence them or that they were being told to stay silent, that is not the case. In any university there is a turnover of staff in the normal sequence of events, particularly one that has been open since 2003. In the age of ICT and Twitter, it is impossible to keep anyone silent, but that is neither here nor there.
We have worked hard with staff and students to build unity in our university. In the University of Bahrain there was violence and rioting, with people running through the campus with swords, sticks and other implements. People were injured and a lot happened. We avoided all of that on our campus. We have spent a great deal of time in providing post-traumatic stress counselling for our staff and students. We have also built dialogue groups. Among our staff and students there is every shade of opinion, including Sunni and Shi’ite. Even using these terms is too simplistic, as there is a range of opinions among them. Some are at the extreme, while others are more moderate and so on. Even though I have visited Bahrain many times during the years, it is only in the past year that the complexity of its society has struck me. It is almost a mosaic of views and as an outsider, it is difficult to capture and understanding it fully. I hope I have answered all of the Deputy’s questions.
I thank Senator Jim Walsh for his comments. He asked whether there was any interference in the operation of the university. Apart from the general breakdown in society, the answer is “No”. Owing to the inability of people to move around as a result of the civil unrest, we closed the university twice and evacuated it once. We then got things back running again. There has been no other interference in the running of the university which continues to run well.
As to whether people were arrested for engaging in political activity or providing medical treatment, that is a complex issue. There was tremendous confusion at the time. I do not wish to be seen as an apologist for the government, the opposition or anyone else, as I am trying to steer a middle course and be fair to all sides, but Medecins san Frontières and the Bassiouni report identified the need for a hospital to be seen as a neutral space and that was lost in Bahrain. It is difficult for professionals to exercise their professional roles and at the same time have a political role. One can argue the merits of this all day, but it led to a very confused picture.
The document I use as the robust truth is the Bassiouni report which is very comprehensive. I have spent a great deal of time in Bahrain and meet people of all opinions. One hears stories and views that are diametrically opposed from professionals and non-professionals. It is very difficult to decipher the truth of what is going on when one is there. Undoubtedly, however, evidence has emerged in the Bassiouni report that is robust and acceptable. We have taken action based on it and been very clear in our opinions and support for this.
In response to Deputy O’Sullivan, our private advocacy was at every level of government to which we had access. Ours is not a political or advocacy organisation. We do not have investigative or legal expertise. We were not at that point in a position to judge the merits of the many opinions expressed, but we continuously emphasised the need for due process, fair judicial procedures and the need to allow medics to treat patients, irrespective of their background. In some ways, the real losers are Bahraini patients. Unfortunately, there has been tremendous polarisation of Bahraini society, particularly in the medical profession, along religious lines. There are patients in Bahrain who are afraid to go to health care facilities and deal with doctors based on their perception of their background and views. Ultimately, the medical profession’s responsibility must be to patients and what is better for them. That is why we say we have the Bassiouni report and the truth or the closest we will get to it. The charges must be dropped; we must move into dialogue and rebuild the health profession in order that trust in it can be rebuilt for the people of Bahrain. That is what it is all about.
The Deputy asked why we picked Bahrain. The Royal College of Surgeons in Ireland has been dealing with Bahrain in terms of the provision of postgraduate courses for over 30 years. We have a very warm relationship with its people who stand out for their hospitality and warmth and there is great joy in dealing with them. We have a very warm and respectful relationship with all the people in Bahrain, which is probably why we are there.
I hope I am dealing with all the comments made. I agree with everything Deputy Bernard Durkan said. We have taken many of our lessons from successful Irish NGOs which operate in difficult situations. Their view is that one must first concentrate on one’s core mission and make sure one delivers on it, bear witness and speak as is necessary. When we had clear and unequivocal evidence of what was happening, based on this international report, we were unequivocal in our response and we have continued to be unequivocal that it is unacceptable to do what was done and that there must be redress. That is what I said in response to Deputy Pádraig Mac Lochlainn.
I thank Deputy Byrne for his comments. During the previous presentation by Front Line Defenders and in his comments on this one, he captured the complexity of the issue. We have had a very mature discussion which touches on the complexity and the challenges that Irish people will face everywhere abroad. The Deputy has recognised the multiplicity of roles we have as human beings, advocates and in executing our mission, whatever it might be, in the various jurisdictions in which we work. Like him, I believe the work the NUI is doing in creating a charter to guide universities in their activities abroad will be extremely helpful. We welcome this and look forward to working with the NUI in generating it. It is a challenge everybody in the west faces as we seek to increase our engagement. The Government’s international policy is to be welcomed. It is at the heart of the knowledge economy we wish to build, but we need guidance and help in how we go about it.
Senator David Norris talked about the business aspect which links in to what was said by Senator Mark Daly. They have asked if this is all driven by business. It is not. We are very up-front that we have an investment in Bahrain. However, the truth is that if we did not have an investment in Bahrain but had 1,000 students there, as we have, and 120 staff, we would have a duty of care to those students. Through education my colleagues and I will help to create for them the future they deserve. Surely our country can see and understand that the greatest contribution we can make in Bahrain is not by lecturing people but by educating them and building human capital. I am among a group of people who agree with this.
Mr. Michael McGrail: We have invested $70 million in Bahrain from our own resources, for which we are answerable. However, our total investments in Bahrain come to far less than 20% of the total assets of Royal College of Surgeons in Ireland. This is not about a commercial or business investment.
Professor Hannah McGee: With regard to the students and to respond to Senator Mark Daly’s point, we have no difficulty with using the word “torture”. We absolutely accept the commission’s report that torture took place. None of us has a difficulty in saying this. I am sorry people read so much into the omission of the word. They should give us some credit for the rest of the text in the document. There is no denying that we accept the commission’s report that torture took place in various situations.
Senator Mark Daly: Professor McGee is the first person to use the word “torture”. The words “illegal activity” and “forced evidence” have been used but not the word “torture”. My point was that torture was taking place. This is not an abstract; these are the delegates’ former students. An organisation, from a humanitarian point of view, should state: “These are our former students. We want them out of jail and the torture to stop.” If the Royal College of Surgeons in Ireland heard about this in the past year, did it do anything to try to get them out of jail on an individual basis? That is legitimate activity in most countries. Were there cases in which the families of former students came to the college to explain they could not go to the police and ask it to do something, given that Ireland is respected all over the world? That is my point. It is all well and good that the delegates accept the report, but they are very slow to use the word “torture” in their replies. Saying it is used in the report and saying they accept that it is used in the report is a little woolly, to be honest.
Senator Averil Power: On the issue of current students and those who have just finished their academic training, the students testified to me that there was discrimination. Do the delegates acknowledge that there is and, if so, what has the Royal College of Surgeons in Ireland done about it? Professor Kelly has said his key interest is his educational responsibility. Students have told me they are being discriminated against within the education system on the basis of their religious beliefs. Does he acknowledge that this is an issue? If it is, what is the college doing about it?
Deputy Pádraig Mac Lochlainn: There is nothing complex about torture. I accept we cannot enforce our cultural norms but the principles of human rights are global. The right to a fair trial and the right not to be subjected to torture are global and internationally accepted principles. There is no complexity on this point. With the knowledge the witnesses now have, would they have handled things differently? I do not wish to impugn the tremendous global reputation of the RCSI. Eminent organisations such as Front Line Defenders, Médicins Sans Frontières, winners of the Nobel prize for peace, Human Rights Watch, Physicians for Human Rights and the Royal College of Surgeons of England did not hesitate in their condemnation of what was apparent and clear torture, illegal and reprehensible actions that even the UN Secretary General and the EU High Commissioner for Foreign Affairs, Cathy Ashton, condemned. Do the witnesses not look back over the past year and acknowledge they were slow to condemnation? There are lessons to be learned for the RCSI and in the absence of their actions, it was left to doctors and professors to uphold the reputation of the Irish medical history of human rights defence around the world. Looking back, could they not have handled it better?
Professor Cathal Kelly: I will answer the current question and move on because I tend to forget the questions as they come in. We have learned a lot over the past year. When anyone stands back and examines the performance of the RCSI over the past year, we did remarkably well under difficult circumstances. Unlike the organisations mentioned, we are responsible for over 1,000 people in Bahrain. I am enormously proud of what my colleagues in the RCSI in Bahrain achieved. We can compare what happens in the RCSI in Bahrain with what happened in the University of Bahrain, where there was rioting and people running rampant through the campus with swords, sticks and clubs. There was a breakdown in civil society there but we managed to maintain a campus of harmony, where students were able to realise their full potential and achieve what they set out to achieve. I do not know of any other university in the world that had to close down twice and be evacuated once between February and June and still manage to graduate its cohort of doctors and nurses on schedule. That is a significant contribution to Ireland’s health care and education reputation abroad. With respect, it is a contribution to health care in Bahrain. We have been unequivocal at all times, saying that we want due process and that doctors should be allowed to treat patients without fear of recrimination of any type. We also said that doctors have responsibility to treat patients, irrespective of their background.
The Bahrain Independent Commission of Inquiry report is interesting in some of its evidence about what went on in the medical profession in Bahrain. That is another day’s work and needs to be evaluated in another forum. We behaved in a measured, fair-minded manner, steering a middle course, exercising our mission and responding robustly as the information arose. Once we had the Bahrain Independent Commission of Inquiry report, we had clear evidence of what went on and we unequivocally asked that all charges be dropped against all people, not just medical personnel. We furthermore asked to work with Professor Cherif Bassiouni, who is back in Bahrain, monitoring the implementation of his recommendations. Our people have performed very well under the circumstances.
Professor Cathal Kelly: We responded in writing to the criticism in The Lancet and the British Medical Journal. The article in The Lancet was written by an Irish doctor, whose views are clear. We have met him and articulated our views to him. We had no right of reply, we were not consulted for the article and we had no right to give evidence. In the fullness of time, when the journals look back at what happened and what we achieved, they will not be as strident in their views. We responded to the article in the British Medical Journal and articulated our views. Some agree with us and some do not but very few people have our level of responsibility in Bahrain. I do not know of any organisation that has met government officials in Bahrain as often as we have in the past year and clearly articulated views to them.
Deputy Pádraig Mac Lochlainn: Does Professor Kelly feel he was right not to condemn what happened over the past year? Professor Kelly has not used the word “condemn” in respect of the arrest without charge of 1,000 people and the torture of many of them, including two doctors who served in Professor Kelly’s organisation.
Professor Cathal Kelly: I have enormous regrets for the tragedy that has befallen Bahrain, which is a beautiful country with beautiful people that has made enormous progress over the years. It is in the first quartile of the human development index and what has befallen the country is a tragedy. We have a role to use our expertise in conflict resolution to engage with them constructively. I hope we do so and the RCSI will be to the forefront in it.
Based on what came out in the Bassiouni report, I wholeheartedly welcome and support it because I believe in the robust nature of the investigation and I fully endorse the recommendations. The report condemns torture of innocent people and outlines that this should be investigated with the perpetrators punished. I fully support that. The report indicates that the victims of this should be fully compensated, which I support. I hope I have been unequivocal in my statements. I thought I had been and I apologise if I have not been clear cut.
Professor Hannah McGee: No students have been discontinued from the college and we do not have any interference in student recruitment. Our medical student population is half Bahraini and half international. Some 17 countries are represented, including those in North America and Europe and neighbouring countries. All the 400 or so nursing students are Bahraini students funded by an agency of the Bahraini State and they are almost all from the Shia majority community. There has been no interference with our recruitment or with students. All the students who were with us before the trouble broke are continuing their studies our have graduated.
Senator Averil Power: I specifically mentioned the placement year. Is it true that previously final year students received a placement year in a hospital but that is not happening any more? The Minister of State confirmed that this was the case.
Professor Hannah McGee: Yes. Those who seek internships, like in Ireland, can do so locally, if they are Bahraini, or internationally, which some students do for their betterment. Many international students need to do a preregistration year in their own countries. We have had no graduates who said to us that they have not been able to do an intern year.
Professor Cathal Kelly: I welcome Senator Power’s commitment to Bahrain and I enjoyed talking to her about it. Things have changed significantly since she was there in August and much progress has been made. There is much progress to be made but in Ireland it took us 40 years to resolve our differences. I hope the Bahrainis make better progress and do so more quickly but there has been a significant chilling of the anger and aggression that existed during that visit in August.
Chairman: I thank the witnesses for being so up-front and honest. They have answered most of the questions from members. This was an interesting meeting and all members contributed. I thank the witnesses for attending this afternoon at the request of the committee. Their activities in Bahrain are to be commended in training foreign medical personnel overseas. To have this facility in Bahrain run by the RCSI, along with the contribution the college makes to medicine in Bahrain and around the world, is appreciated by all of us.
The committee would urge the RCSI to continue to use its considerable influence to protect basic human rights. That is vital and it outlined today its intention to continue doing that. The Irish-trained medics and students at a time of crisis in Bahrain should be let continue their work, even if the situation deteriorates, although we hope it will not. The political situation in Bahrain is complex and challenging and is changing rapidly. Perhaps if the witnesses come before us again in a few months again, things will have changed again, hopefully for the better.
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