On the night of Nov 17, 2019, I was embedded within one of a few medical teams providing emergency care to injured protesters engaged in violent confrontation with police at the Hong Kong Polytechnic University. All emergency medical workers were wearing high-visibility vests with prominent Red Cross insignia, helmets with Red Cross markings, gas masks, and air-tight eye protection (the latter two measures against the large amounts of tear gas customarily encountered in these protests).

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Lum A Polytechnic University war zone: how Hong Kong radicals got boxed in by police after two days of ferocious clashes. Around 2030 h that evening, police issued an announcementthat at 2200 h the protest would be labelled a riot and that any person present within the university building complex after that time would be arrested for rioting (for which the punishment upon conviction is up to 10 years imprisonment). Furthermore, police later broadcast their intention to enter the university premises by force, using deadly means if necessary, and that all persons present (with the exception of credentialled journalists) would be subject to arrest. A designated route for exit was promulgated at about 2130 h.

There was discussion among the medical teams, and it was decided that those with hospital-based specialties (surgery, anaesthesia, operating department nursing) should depart to be stationed in casualty receiving hospitals, and that the other emergency medical providers, nurses, and paramedic first-aiders would remain on site.

2 Chan H Hong Kong police arrest 51 who ‘claimed to be medics or journalists’ near besieged PolyU campus. My team successfully departed the campus, changed into civilian clothing, and made their way to hospital. We subsequently learned that a group following us (comprising doctors, nurses and paramedics) had been arrested at the police cordon line after leaving the campus.

A photograph, widely circulated online, shows at least 16 individuals sitting on the ground with their hands bound behind their backs with zip-cords: they are wearing high-visibility vests with descriptions of Doctor, Nurse, and EMT (emergency medical technician). These people were all arrested for taking part in a riot.

Police subsequently assaulted the campus at about 0530 h. At least one doctor who was actively providing medical care to a casualty was arrested. The police did not enter far into the main body of the building, but rather withdrew after a brief assault, leaving some 500 protesters and injured inside, but surrounded.

3 Cheung E Hong Kong Hospital Authority denies leaking data to police after extradition bill protesters arrested in public hospitals. Injured protesters at the campus are reluctant to seek emergency care through the public hospital system for fear of identification and arrest (as has been documented after previous protests). Police indicated that ambulance crews could attend the site if requested by the university administration, but this was declined by protesters for fear of immediate arrest in the transferring ambulance (a common practice of law enforcement during these unrests).

As social media messages circulated about injured students unable to receive care, the public disquiet increased. In the early morning, I called the Red Cross and Médecins Sans Frontières (MSF) to seek their consideration of involvement.

2 Chan H Hong Kong police arrest 51 who ‘claimed to be medics or journalists’ near besieged PolyU campus. , 4 Reddit

Red Cross finally allowed to enter PolyU. From other sources, medics and nurses arrested yesterday were all charged for rioting and may end up with 10 year imprisonments. 5 Reddit

[Stand News] Doctors Without Borders have sent 4 crews into PolyU at 4:45pm. In the afternoon of the following day, television news reports showed a team from the Red Cross entering the university.The Red Cross had decided that the situation amounted to a humanitarian crisis and self-initiated an intervention. The team arrived at the cordon of protest zone but did not receive police approval to enter until more than 2 h later; furthermore, the police had set a time limit of 3 h for their mission ( appendix ), which was subsequently extended by Red Cross demand due to the number of people requiring treatment (Hong Kong Public Doctors Association President, personal communication). MSF initiated their own humanitarian intervention 2 days later, on Nov 19).

2 Chan H Hong Kong police arrest 51 who ‘claimed to be medics or journalists’ near besieged PolyU campus. When questioned about the arrest of medical aid workers at a press conference on the evening of Nov 18, 2019, police asserted that they had intelligence that rioters were masquerading as doctors (and first-aiders) and therefore these people had to be arrested so as to confirm their identity.This is doubtful since all doctors were in possession of their Medical Council of Hong Kong registration details and identity cards. At least five doctors are known to have been arrested and detained by police for more than 24 h. The police also misleadingly claimed they had invited the Red Cross intervention (Head of Operations of the Hong Kong Red Cross, personal communication).

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Hospitals swamped with injured from PolyU. A statement from the Hong Kong Hospital Authority on Nov 19, 2019 revealed that some 300 injured people from the Polytechnic University confrontation had been sent to 12 different hospitals, with injuries related to water cannon blast, tear gas, and rubber bullets.

The actions of the Hong Kong Police Force have fallen far below accepted international norms for the handling of volunteer emergency medical providers. The arrest of these personnel is almost unheard of in civilised countries and is incompatible with the compact of humanitarianism. Furthermore, the chilling effect can only serve to deter would-be volunteers from offering their services in the much-needed medical care of injured people in this ongoing uncivil war.

Copyright © 2019 Darren Mann

I declare no competing interests.

Supplementary Material Supplementary appendix

Article Info Publication History Identification DOI: https://doi.org/10.1016/S0140-6736(19)32909-5 Copyright © 2019 Elsevier Ltd. All rights reserved. ScienceDirect Access this article on ScienceDirect