Doctors speak out on latest developments

The Zimbabwe hospital doctors are deeply saddened by the continued misrepresentation of facts by some elements in regard to the on-going industrial action by doctors at all levels nationwide. This has inadvertently prolonged the industrial action which is now marking day 34 today.

As a result of numerous requests, we shall present this press statement in the form of answers to questions that are frequently being asked by interested stakeholders about the industrial action so far.

Question 1: Who exactly is on industrial action, is it the junior doctors alone?

Answer: No, the junior doctors are the ones who embarked initially on the industrial action but over the past 3 weeks doctors from all levels nationwide have since joined. This comprises doctors at district and provincial hospitals, middle level doctors and senior doctors at government central hospitals.

Question 2: Has the government answered all the doctors' grievances in full except only two?

Answer: BOLD NO, the government came to negotiate and gave their positions which we asked them to refine and reconsider. We are therefore awaiting the official feedback in respect to that. The following paragraphs will explain why.

Question 3: What are the pending doctor's grievances and what was the government's response to each?

Answer: The most important grievances by doctors and the government's responses are as follows 1. The employer must provide basic medications and sundries to all government hospitals as this has been having an extensive negative impact on the welfare patients.

The working environment has become increasingly hazardous to work in due to the absence of vital personal protective equipment and thus making it increasingly difficult for doctors to continue improvising.

In the spirit of negotiation and long term planning, the doctors are requesting for evaluable timelines and targets for the provision of subsequent batches of medication so that a sense of security is given to the medical field at large. This is merely in the form of a written document from our employer. Government responded that it had secured 2.2 million worth of drugs at Nat pharm and is in the process of distributing them.

The government is however reluctant to provide the long time line and targets as a sign of long term commitment to the promise.

Doctors have asked for this provision for the past four weeks to no avail. This has been the deadlock in the negotiation of this grievance.

2. The employer agreed through signed legally binding agreements in March 2018 to pay the doctors in USD. Doctors are therefore asking the employer to honour the agreement.

The need comes as a result of the harsh economic situation which has seen the rtgs salaries being devalued by nearly 4 times on the market whether officially or unofficially.

The employer also agreed that the on call allowance of doctors should be 10 USD/hour in a deal dating back to 2014. The doctors are asking the employer to honour the agreement and review the on call allowance to that figure. Government has responded that it cannot pay workers in USD despite those foresaid agreements. Government went further to indicate to its employees that even if they wanted an RTGS review, the government is not in a position to offer that.

The government also indicated that it is not in a position to review the on call allowance and will only consider it in the following few months. All this is despite the prevailing harsh economic situation. The doctors agreed that the government may not be in a position to provide for the grievance in full as this may be too much to ask but implored the government to bring an offer to the table that showed genuine concern on their part to address the plight of its workers. The government's response has been that there is no offer at all, the doctors must go back to work and the government will organise something in the future whilst they are at work.

3. Due to the persistent need for doctors to attend to emergency services. Government and doctors have been working on long term plans to ensure that doctors are assisted in securing cars in order to assist them to attend to emergency services. Government offered to provide all health care workers with 6 million rtgs for loans which will be coupled with a duty free scheme for the beneficiaries only. The loan amount would be 10 000 rtgs per beneficiary.

The challenge is the loan scheme will be available to less than 200 doctors nationwide as it caters for all other health workers as well. Doctors explained the amount offered was no longer competitive to the current market prices and also that it was not sufficient for all the doctors in need. As an alternative the doctors asked for a duty free scheme alone which will be available to all doctors. Government's response has been that it cannot give a duty free scheme which is available to all doctors and preferred to stick to the said arrangement of loan plus duty free to beneficiaries only.

4 The current doctor to patient ratio in our nation is way below par. The number of trained specialist is till incomparable to regional targets. Doctors indicated to the employer to provide GMO and training posts for doctors so that this situation can be addressed. As a nation, we can't continue with a situation whereby most doctors continue going outside due to the unavailability of government posts.

The government indicated that they had provided 402 posts across all health care workers. No specificity to which of those posts belonged to doctors and no mention of specialist training posts. We beseeched our employer to be more serious with this issue and provide the important information which is so much required.

The employer has so far not been in a position to do that 5 In the recent turn of events, government has indicated that it wants to employ incoming junior doctors under the ministry of higher and tertiary education. This decision was made unilaterally without consultation of the doctors who then felt it was a move to supress the junior doctors rights. The doctors have since indicated that such a move is regrettable and unacceptable. The government offered to give dialogue a chance on this particular aspect. This was welcome and we still await further communication.

Question 4: The strike has been deemed illegal by the labour court why didn't the doctors get back to work?

As doctors, we believe in dialogue. The employer in the form of the health services board led by Mrs Kaseke has been running a parallel agenda to the negotiations. Whilst pretending to be showing effort to address the grievances, in the background they were employing all other uncalled for methods meant to arm twist rather than to discuss. The challenge is the doctors are being asked to go into an environment which they perceive as being potentially dangerous to their wellbeing and without tangible attempts to address their welfare.

Secondly the methods by the HSB have made the work environment scarier than inviting and there is no longer any sense of security for doctors to go back to work. We note with concern the increasing move by the same board in that direction which has led to senior doctors downing tools yesterday. Whether the HSB has an agenda to make sure there are no negotiations and that the nation's health care system is destroyed to the maximum is also something that boggles the mind. We are also in the view that the same board has been lying to our Honourable Acting president and feeding him with the wrong facts. We have often desired to meet with the respectable office to iron out the facts but perhaps the said board has ensured that door remains shut. Unfortunately we have to keep relying on the same board to hope that perhaps at some point the truth shall be relayed upwards.

Question 5: Have doctors ever met with the vice president of the nation and explained to him their position?

Answer: No, that door has been shut by those who have taken centre stage in misrepresenting facts to the Honourable office. Question 6: Are there any security threats to doctors? Answers: The threats have been piling by day.

Recently we heard about the deployment of the joint operation task force to handle the situation as it is. Why the task force has been deployed to handle a labour dispute that can be resolved by a simple 1 day discussion and signing of agreements is shocking. Additionally, many other threats have been given to doctors individually and to the leadership. This we perceive as a disproportionate and uncalled for response to the real matter at hand. As already highlighted, the situation is getting increasingly difficult for the doctors to go to work in such a threatening environment.

We still call for a simple dialogue to resolve the impasse and come up with solutions that are favourable to both parties. Question 7: Are the doctors political? Answer: No, All of the above grievances above are driven from a point of need. There is nothing political about asking your employer to improve the conditions of service and your welfare.

All other proclaimed theories remain theories which will forever be unproven. At the same time, we cannot withhold any person or organisation from commenting about the on-going impasse in their own capacity as it is a public matter. The comments however remain comments and do not speak of any other underground connections whatsoever. The matters raised are genuine concerns and at all costs we as doctors have opened our hands to our respectable leaders to hear our cry. Question 8: What do doctors think must happen for the impasse to end? Answer: The employer must find common ground with the doctors and come to the negotiation table with an offer which has all the omitted vital information and also provide something to cushion doctors in this current economic environment. There is nothing that is beyond negotiation and we want to believe the impasse can end with these few measures any day for the sake of our patients at large. Further discussions to correct any other problems can be done after the situation has normalised.