Doctors' strike: A balancing act of ethics and rights

ON March 1 this year, junior doctors downed their tools in protest over deteriorating working conditions, on-call allowances, a facility to import vehicles duty-free and poor remuneration. Senior doctors also joined in, along with specialist health personnel.

The month long industrial action crippled health services at many public hospitals, bringing health services to the ground.

Patients, as always, bore the brunt of the strike, with many failing to access the option of private care. The usual tag-of-war in negotiations yielded nothing. The doctors were adamant and insisted that they wanted what was due to them and in line with what their colleagues in the region were getting.

But government dithered and threatened to take action (a common feature).

Nine months later, there is another strike, with the doctors raising the same issues with the government. The strike, has crippled service delivery and thousands of patients have been left stranded, again.

This has been worsened by the current challenges in the pharmaceutical industry, which has been battling with shortages of foreign currency. Most pharmacies are still charging in United States dollars, which the majority has no access to.

The doctors' rights as workers and the patients' plight has remained a sticky issue, which now need balancing.

Rights dimension…

The representative body for the doctors, the Zimbabwe Hospital Doctors Association, said they had downed their tools because of the "severe incapacitation and inability to withstand the current disabling working environment". They stated that shortages of drugs and sundries in public hospitals made it near impossible for them to dispense their duties accordingly.

On remuneration, the doctors said according to the collective bargaining agreement of March this year, their salaries and allowances were pegged in United States dollars. They claimed that the employer had breached it countless times.

"The ministry did not heed our call to rectify these, but has gone on to unilaterally decide to pay us in RTGS. This is a clear violation of the agreement," they said in a statement.

The doctors have also dismissed the announcement by the Health minister Obadiah Moyo that they earned US$1 800.

"This is not true because we do not earn United States dollars, and the association is yet to see a junior doctor who earns $1 800," the ZHDA said.
The doctors claimed they took home an average package way less than the stated figure.

"The bulk of it being the on-call allowance of around $1 000, which the doctor is paid at an hourly rate for working nonstop during the late hours of the night.
Another key issue was the availing of posts to junior doctors on contract as one is not able go into private practice soon after graduation, but requires a mandatory one year in full-time government employment.

The vehicle loan remains another of the doctors' sticking issues and they accuse the government of not committing in writing, and on a legally binding forum, to provide this scheme to all medical practitioners. The doctors, who have since been suspended pending hearings, said the suspension was 'brutal and would not bear any fruit towards resolving the impasse.

Ethical dilemma…

The healthcare crisis in the country has reached an unprecedented level. With the suspension of over 500 doctors, it has gone worse as patients are being turned away due to absence of doctors. Middle and senior doctors in nine provinces have also withdrawn their services and will only resume work when suspended members are reinstated and meaningful negotiations resume.

At Parirenyatwa Group of Hospitals, Harare and Chitungwiza hospitals, operations have virtually ground to a halt. Desperate patients are not getting medical care and with barely 10% on medical insurance, many will go home to die.

Unable to cope with the situation, hospital authorities have been discharging patients they deem stable and only attending to the very critical cases. Sorry sights at many hospitals bear testimony to just how bad the industrial action has impacted on service provision.

"The Health Services Board is playing politics with the lives of our fellow countrymen, throwing a legal charade whilst failing to address the issues affecting our health sector," said the doctors.

Meanwhile, on Christmas Eve, Moyo said government had made efforts to address the grievances to save lives.

"Loss of lives and pain suffered by parents and their loved ones could have been avoided if doctors were negotiating while at work," he said.
The health minister said the labour court had ruled in accordance with the law.

"However, I want it noted that I have continuously encouraged doctors to come back to work because efforts have been made by my ministry and government to address most of the issues," he said.