Op-Ed Contributor: Art and Hypocrisy in the Gulf

LONDON — On May 11, the Lebanese artist Walid Raad was turned away at the airport when he tried to enter the United Arab Emirates, where the government is making a big investment in art with the Saadiyat Island project. The project, in the capital, Abu Dhabi, will include branches of the Louvre and the Guggenheim as well as a campus of New York University.

Mr. Raad, who teaches at Cooper Union in New York, says he heard an Emirates immigration officer say that he was being turned away for security reasons.

The previous week, the Mumbai-based artist Ashok Sukumaran was denied a visa to enter the United Arab Emirates for undefined “security reasons.”

Others recently denied entry to the country on the vague pretext of security reasons include Andrew Ross, a New York University professor who has been fiercely critical of labor abuses on Saadiyat Island, and the journalist Sean O’Driscoll, who last year co-wrote a New York Times article on harsh labor conditions at the Abu Dhabi campus.

The exploitative labor system in the United Arab Emirates binds migrant workers to employers, who confiscate their passports as a matter of course, which makes it nearly impossible for the workers to escape abuse. Exorbitant recruitment fees and the prohibition of trade unions add to the toxic mix.

In 2010, the developers of Saadiyat Island promised special labor protections for the workers, but that has failed to stop all the abuses. The Times article last year found that workers had been beaten by police officers and arbitrarily deported when they went on strike to protest low pay. In February, Human Rights Watch documented serious shortcomings in the enforcement of the labor codes.

Mr. Raad and Mr. Sukumaran are both members of the Gulf Labor Coalition, which has been calling for a boycott of the Guggenheim Abu Dhabi. The refusal to admit these artists, along with others pursuing creative and intellectual work, suggests that the United Arab Emirates and its development partners are unwilling to tolerate criticism and open debate.

In January 2014, as I left the country after doing research for our latest report on the treatment of the workers, the immigration authorities told me I was permanently blacklisted and could never return. They refused to give a reason.

On May 1, the Guggenheim described its Abu Dhabi project as “an opportunity for a dynamic cultural exchange and to chart a more inclusive and expansive view of art history.” John Sexton, who plans to retire as president of N.Y.U. next year, said something similar in 2007, when he described N.Y.U. and Abu Dhabi as “a good fit” and said that they shared “a belief that the evolving global dynamic will bring about the emergence of a set of world centers of intellectual, cultural and educational strength.” The Louvre Abu Dhabi’s website says it will be a place of “discovery, exchange and education” and describes it as “a product of the 18th century Enlightenment in Europe.”

These are laudable sentiments, but in practice they amount to empty words.

Banning artists and writers is nowhere close to the most repressive actions of the government.

Domestic critics have been at risk of disappearance, torture and imprisonment. The human rights lawyer Mohamed al-Roken is just one of scores of Emiratis serving long-term prison sentences after unfair trials. Last November, Osama al-Najer was sentenced to three years in prison on charges that included “communicating with external organizations to provide misleading information.” Mr. Najer had been quoted in a Human Rights Watch news release on the alleged torture of political detainees.

The government has continued to use a repressive 2012 cybercrime law to prosecute critics. In 2013, it even sentenced an American to 12 months in prison under the law, for his participation in a video parodying Dubai youth culture.

In 2014, a court convicted two Emiratis, Khalifa Rabia and Othman al-Shehhi, of criticizing state security on Twitter, sentenced them to five years in prison and fined them over $98,000. The television channel 24.ae subsequently referred to Mr. Rabia’s use of hashtags like #UAE_freemen as evidence of his subversion.

A 2014 counterterrorism law allows the courts to convict peaceful government critics as terrorists and sentence them to death. The crackdown has been so far-reaching that there are no longer any lawyers in the country actively defending dissidents.

In this context of repression, it’s clear that whatever the Louvre, the Guggenheim and New York University might say, the reality is that they provide a sheen of high-end respectability to an autocratic state.

Although N.Y.U., to its credit, recently announced it would compensate construction workers on its Abu Dhabi site who were excluded from its code of labor protection, none of the institutions have spoken out against the overall migrant labor system or the arbitrary deportations of hundreds of Saadiyat Island workers. Likewise, the institutions’ response as Abu Dhabi has turned away artists and intellectuals has been anemic at best.

N.Y.U. expressed support for “the free movement of people and ideas” after Mr. Ross was denied entry but then punted on the specifics, saying it could not “know all the thinking that goes into any immigration authority’s decisions.” The Guggenheim offered a similarly feckless response after Mr. Raad was denied entry, saying that immigration issues were “outside our sphere of influence.”

These institutions, and some art critics as well, have touted their move to Abu Dhabi as a turning point in cultural history. But right now, in a climate of increasing repression, it seems that art and culture are being put into the service of money and power, an unquestioning surrender to authority that contradicts these liberal institutions’ very ideals.

SEVERAL emergency-room nurses were crying in frustration after their shift ended at a large metropolitan hospital when Molly, who was new to the hospital, walked in. The nurses were scared because their department was so understaffed that they believed their patients — and their nursing licenses — were in danger, and because they knew that when tensions ran high and nurses were spread thin, patients could snap and turn violent.

The nurses were regularly assigned seven to nine patients at a time, when the safe maximum is generally considered four (and just two for patients bound for the intensive-care unit). Molly — whom I followed for a year for a book about nursing, on the condition that I use a pseudonym for her — was assigned 20 patients with non-life-threatening conditions.

“The nurse-patient ratio is insane, the hallways are full of patients, most patients aren’t seen by the attending until they’re ready to leave, and the policies are really unsafe,” Molly told the group.

That’s just how the hospital does things, one nurse said, resigned.

Unfortunately, that’s how many hospitals operate. Inadequate staffing is a nationwide problem, and with the exception of California, not a single state sets a minimum standard for hospital-wide nurse-to-patient ratios.

Dozens of studies have found that the more patients assigned to a nurse, the higher the patients’ risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight.

In pediatrics, adding even one extra surgical patient to a nurse’s ratio increases a child’s likelihood of readmission to the hospital by nearly 50 percent. The Center for Health Outcomes and Policy Research found that if every hospital improved its nurses’ working conditions to the levels of the top quarter of hospitals, more than 40,000 lives would be saved nationwide every year.

Nurses are well aware of the problem. In a survey of nurses in Massachusetts released this month, 25 percent said that understaffing was directly responsible for patient deaths, 50 percent blamed understaffing for harm or injury to patients and 85 percent said that patient care is suffering because of the high numbers of patients assigned to each nurse. (The Massachusetts Nurses Association, a labor union, sponsored the study; it was conducted by an independent research firm and the majority of respondents were not members of the association.)

And yet too often, nurses are punished for speaking out. According to the New York State Nurses Association, this month Jack D. Weiler Hospital of the Albert Einstein College of Medicine in New York threatened nurses with arrest, and even escorted seven nurses out of the building, because, during a breakfast to celebrate National Nurses Week, the nurses discussed staffing shortages. (A spokesman for the hospital disputed this characterization of the events.)

It’s not unusual for hospitals to intimidate nurses who speak up about understaffing, said Deborah Burger, co-president of National Nurses United, a union. “It happens all the time, and nurses are harassed into taking what they know are not safe assignments,” she said. “The pressure has gotten even greater to keep your mouth shut. Nurses have gotten blackballed for speaking up.”

The landscape hasn’t always been so alarming. But as the push for hospital profits has increased, important matters like personnel count, most notably nurses, have suffered. “The biggest change in the last five to 10 years is the unrelenting emphasis on boosting their profit margins at the expense of patient safety,” said David Schildmeier, a spokesman for the Massachusetts Nurses Association. “Absolutely every decision is made on the basis of cost savings.”

Experts said that many hospital administrators assume the studies don’t apply to them and fault individuals, not the system, for negative outcomes. “They mistakenly believe their staffing is adequate,” said Judy Smetzer, the vice president of the Institute for Safe Medication Practices, a consumer group. “It’s a vicious cycle. When they’re understaffed, nurses are required to cut corners to get the work done the best they can. Then when there’s a bad outcome, hospitals fire the nurse for cutting corners.”

Nursing advocates continue to push for change. In April, National Nurses United filed a grievance against the James A. Haley Veterans’ Hospital in Tampa, which it said is 100 registered nurses short of the minimum staffing levels mandated by the Department of Veterans Affairs (the hospital said it intends to hire more nurses, but disputes the union’s reading of the mandate).

Nurses are the key to improving American health care; research has proved repeatedly that nurse staffing is directly tied to patient outcomes. Nurses are unsung and underestimated heroes who are needlessly overstretched and overdue for the kind of recognition befitting champions. For their sake and ours, we must insist that hospitals treat them right. ☐