Tanzania Daily News (Dar es Salaam)

31 January 2012

Tanzania: Doctors Strike Illegal - Tucta

THE Trade Union Congress of Tanzania (TUCTA) has declared the strike by doctors illegal. However, most of them heeded the order by the Prime Minister, Mr Mizengo Pinda, to return to work by Monday or risk being sacked.

Most of the doctors countrywide reported to work on Monday although some staged a go-slow as they didn't attend to patients.

The TUCTA Secretary General, Mr Nicholaus Mgaya, told the 'Daily News' on Monday that the doctors' refusal to meet the Prime Minister to discuss their claims was a breach of the Public Negotiating Machinery Act of 2003 which insists that two conflicting sides should sit, discuss and amicably reconcile.

Mr Mgaya said that the Union felt sorry for whatever action would be taken against them and that it was not in the position to intervene in the whole saga at least for the time being. "I met them during one of their meetings and advised them to meet the Prime Minister but they vehemently opposed the idea. "I am not sure what the motive behind their action was since it is through negotiations that the dispute can only be solved," he noted.

Mr Mgaya said initially, interns were supposed to understand that the law prohibits special groups like doctors and nurses, aviation staff and fire brigade from going on strike due to their sensitive nature of their professions. Instead, he explained, such groups were required first to channel their grievances through the Essential Services Committee, which could then refer their case to the Commission for Mediation and Arbitration (CMA) for further determination.

"But these people not only refused to meet their employer but chose to follow their own path. For me this is serious lack of responsibility and I think it is because they are still young and immature," stated TUCTA SG. According to Mr Mgaya, failure to meet the Prime Minister last Sunday, the doctors have automatically withdrawn from the negotiation table and had no other option but to obey their employer's order and return to work or get sacked. Apart from isolated cases of go slow in some hospitals, services at key medical departments at three Dar es Salaam municipal hospitals were offered to the patients.

A survey by the'Daily News' in Temeke, Amana and Mwananyamala hospitals showed doctors attended patients in the maternal clinic, operating theatre, paediatric unit, wards and the out-patients Department (OPD). However, some of the intern doctors in these hospitals have carried on with the strike where some did not attend at work while others have reported and disappeared after they signed the attendance book.

The situation at Temeke hospital was fine since most of the interns were providing services to patients without any signs of a go slow. According to the Temeke Medical Officer-in-charge, Dr Amani Malima, only five interns had not reported for work while the remaining 25 were working since morning. He said the only problem the hospital was facing was the lack of services for patients who needed referral to the Muhimbili National Hospital (MNH).

He said the number of patients who were visiting Temeke hospital had increased since last week where they have been attending up to 2,000 patients daily from normal figure of 1,000 to 1,500 patients in a day. According to the Amana Medical Officer-in-Charge, Dr Meshack Shimwela, all the 90 doctors in his hospital have signed including the 44 interns but the interns were not working. He said the OPD was not operating due to the unsettled situation where the available doctors had to attend only the patients with serious cases.

"The intern doctors have signed but are not seen working...The OPD is still closed due to the situation persisting where the only doctors available are attending patients with serious cases," he noted. At Mwananyamala hospital only 30 interns out of 58 reported had signed while an evaluation indicated that only 21 were working. 'Daily News' saw some of the doctors holding private discussions out of the hospital in a nearby pub and after some minutes they went back to the hospital.

On the other hand, the Dar es Salaam Regional Commissioner, Mr Saidi Meck Sadiki, carried out an inspection at all the public hospitals to oversee the situation where he applauded the Temeke hospital for maintaining the medical services to a satisfactory level. He added that the regional authorities would announce next step after completion of on going verification exercise. The situation at MNH was not good as nurses too joined doctors in a go slow.

The 'Daily News' survey found out that most of the doctors arrived at the hospital, signed the attendance register and disappeared. Nurses were also seen under tree sheds talking leisurely while patients needed care in the wards. "Our presence in the wards without doctors is simply meaningless, we have also decided to rest waiting for the doctors to return," said the Chairman of the Tanzania Nurses Association (MNH Branch), Mr Paul Magesa. Mr Magesa said that they had decided to have one nurse present in every ward and some 1,020 others had laid down tools.

This comes a day after Mr Pinda issued ultimatum to striking doctors to resume duty by yesterday (Monday) or consider themselves sacked. "Doctors have reported for work this morning, signed and disappeared. This is a challenge we are facing now," said the MNH Senior Public Relations Officer, Mr Aminiel Elgaisha. Mr Elgaisha noted that the number of outpatients arriving at the hospital has also gone down tremendously as many of those admitted were seeking services elsewhere, making the busy MNH look underutilized.

The 'Daily News' witnessed most of the beds in the wards empty while the hospital's emergency unit remained idle with few patients who were brought in critical conditions being sent away. "Go and look for a private hospital. We cannot receive patients and admit them as there are no doctors to take care of them," said a nurse at the emergency unit while sending away a patient in an ambulance that came all the way from Tumbi Hospital, Coast Region.

Ms Emma Mapunda, a woman who came to the hospital with his mother in a private car was disappointed after she was told that her mother could not be received there. "I am confused and do not know what to do, my mother is in critical condition, she needs immediate care but I cannot get service here," she said. Ms Mapunda further noted that the standoff between doctors and the government was at the expense of people's lives.

"The government should do something. The Prime Minister said they would bring doctors to take over, where are they?," asked a man who identified himself as, Said Kungwi. Reports from Dodoma, Mbeya, Rukwa, Kigoma, Iringa and Morogoro regions showed that most of the doctors reported to work and attended to patients. Some doctors at the Morogoro regional hospital did not attend to patients. Instead, they locked themselves in their offices after signing the attendance register.

Medical services at Dodoma Referral Hospital returned to normal. Patients at the hospital told the 'Daily News' that services had improved since yesterday morning. 'Most of the doctors are on duty and working as normal. I hope that the week-long strike by the health professionals is coming to an end," Ms Mary Wandipa said during an interview.

Dodoma Regional Medical Officer (RMO), Dr Godfrey Mtei, said all workers at the hospitals had resumed work and that the number of patients had increased significantly. "Some patients with minor problems had opted to stay at home but since this morning they have been turning up in large numbers, thanks to the statement by the PM which encouraged them to come for treatment," Dr Mtei said during an interview with the'Daily News.'

The RMO said all 422 staff at the hospital had resumed work since yesterday morning save for those undergoing further studies and those on leave. "We also have 35 intern doctors at the hospital and they are all at work except two who have family problems," Dr Mtei said. A quick survey found out that patients in the OPD and other departments were receiving treatment as usual. However, Dr Yahya Magaso maintained that only emergency medical services were offered to needy patients.

"We cannot offer some services due to lack of equipment, at present only patients with emergency needs are being served," Dr Magaso said. According to him, doctors at the regional hospital are willing to offer services to patients but they are being held back by poor working conditions.

For his part, the Chairman of the Interim Committee of the Doctors Association, Stephen Ulimboka, was still adamant that they will continue with their standoff until their demands are addressed. Dr Ulimboka however noted that they were ready to sit with the government and discuss the issues on the table. "What happened before was a communication breakdown. He (Mr Pinda) wanted to meet us on Sunday and we were not ready on that day. That's why we asked for Monday," he said.

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