8 January 2013

Mozambique: Strikers and Government Diverge On Impact of Strike

Maputo — The Mozambican Medical Association (AMM) and the Health Ministry have given wildly divergent accounts of the number of doctors who joined the doctors’ strike called by the AMM on Monday.

While the AMM claims that 80 per cent of the doctors in the national health service joined the strike, Health Minister Alexandre Manguele told a Monday night press conference that the majority of doctors turned up for work.

The major exception, he said, was the case of apprentice doctors undertaking postgraduate work at Maputo Central Hospital as a key part of their training. They had joined the strike, and Manguele urged them to rethink their position.

“We urge the doctors doing postgraduate work to resume rapidly their training, because the country needs specialist doctors”, the Minister appealed.

He recognised that the absence of any health professionals from their place of work has a negative impact “because we are a country with a shortage of human resources. So all doctors and nurses, all health professionals, are always necessary. The absence of health professionals, in this case doctors, always brings added difficulties – because even when all of us are at work, there are difficulties”.

The AMM is demanding a substantial wage increase for doctors, and the government says it is working to see how much money is available to improve the wages, not only of doctors, but also of nurses, teachers and other professionals in the public service.

“It is not up to me to say when this wage rise will occur”, Manguele told the reporters, “but I see that this work is being done and progress is being made”. He called for trust between the doctors and the government and said he was sure that their ages would soon be increased.

He added that the Ministry has been working to improve the living conditions of health professionals, citing as an example the restoration of a monthly food allowance of 1,800 meticais (about 61 US dollars) that had been withdrawn some years ago.

Manguele stressed that all specialist doctors working outside Maputo receive an extra 1,500 US dollars a month in addition to their normal wage, plus 500 dollars a month for housing.

The AMM had announced that it would only allow emergency services to operate – but Manguele insisted that all hospital services opened on Monday throughout the country. This was even true in the HCM, despite the absence of the trainee doctors. Doctors from the Maputo Military Hospital went t the HCM to help fill the gap caused by the absence of the trainees.

AMM chairperson, Jorge Arroz, cited by the independent newsheet “Mediafax”, claimed that 80 per cent of doctors had joined the strike, but gave no details. A report in the online version of the free paper “A Verdade” claimed that “over 90 per cent” of the doctors had joined the strike.

The “A Verdade” numbers, however, are that 1,200 doctors are members of the AMM, 987 signed a letter approving the strike, and 908 did not turn up for work on Monday. 908 is 76 per cent of 1,200.

Arroz said there had been no resumption of negotiations during the day. “As far as I know, there’s been no contact”, he said. “In the morning I personally tried to phone the Minister, but either there were problems in the phone network, of he had his phone switched off”.

Health Ministry spokesperson Martinho Djedje confirmed that the Ministry had not contacted the AMM, since it had been the AMM, and not the Ministry, that had broken off dialogue between the two institutions.

“Right from the start the Ministry has said that it is, and always will be, open to dialogue”, he said. “We said the matter was being dealt with and we were discussing normally. The government is finding a solution to the problem. There have been government meetings seeking solutions, and so we see no reason for this position taken by some doctors”.

Manguele said the government is willing to continue its dialogue with the doctors, but regretted that it is difficult “to negotiate with a group that lays down deadlines for results”.

Reports from across the country indicate that the strike is having a limited impact. The Maputo City Health Director, Pascoa Wate, told AIM that despite the absence of some of the doctors all the four hospitals and 29 health centres in the city opened on time and attended to patients (this does not include the HCM which, as a central hospital, is not subordinate to the City Directorate).

Wate admitted there were cases where, instead of three doctors being on duty, only one turned up. But even so services were still offered to patients, but had to be reorganised to take account of the number of staff present.

Not all the absences are due to the strike. Traditionally, January is the main holiday month in Mozambique, and several of the doctors are on leave.

The Bagamoyo and 1st June health centres each only have one doctor – and they are both on leave. Other health workers have been mobilized for those health centres – but this has nothing to do with the strike.

Serious problems were reported in Matola, the industrial city adjoining Maputo. Thus only two doctors reported for work at Machava General Hospital, where 168 people are currently hospitalised, and only attended to urgent cases. There are normally ten doctors at this hospital, each dealing with around 15 cases a day.

One worker in this hospital, cited in Tuesday’s issue of the Maputo daily “Noticias”, said “We have tuberculosis patients with appointments scheduled for today and nobody is attending to them”.

In the southern province of Inhambane, six out of the 37 doctors stationed there joined the strike, and in the neighbouring province of Gaza, doctors were absent from work in Bilene, Chokwe and Mandlakaze districtis. The Gaza provincial hospital, in the city of Xai-Xai, was reported to be working normally.

The director of the largest health unit in the centre of the country, Beira Central Hospital (HCB), Cesar Macome, told Radio Mozambique that “the hospital is calm, and operating normally”.

In the northern province of Nampula, the local health authorities said that less than ten of the 129 doctors who work in the province had not shown up at their health units. All ten strikers work in the Nampula Central Hospital and the Marrere General Hospital on the outskirts of Nampula City.

There are doctors working in all 21 Nampula districts, and Nampula provincial health director, Mahomed Mobaracaly, cited in Tuesday’s issue of the Maputo daily “Noticias”, said they had all gone to work.

As for the ten doctors in Nampula city who joined the strike, they will be marked absent and will this lose a day’s wages.

In the central province of Manica, eight of the 40 doctors working there did not report for work on Monday – three of them in he provincial capital, Chimoio, two in Barue district, two in Sussundenga and one in Machaze.

However, more than 60 per cent of the doctors in Manica are foreigners, and they are not on strike.

In the northernmost provinces of Cabo Delgado and Niassa, the local health services said that no doctors had joined the strike.

There were some reports of attempts to coerce striking doctors back to work. Thus “A Verdade” claimed that in Moamba district, 60 kilometres north of Maputo, the district administrator sent police to round up doctors from their homes and bring them to work. They obeyed, but once in the health units refused to do anything.

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