Government has fired more than 250 nurses and midwives for going on strike. Health Minister Joseph Kasonde has informed Parliament in a ministerial statement that the dismissal of nurses and midwives is a lesson to other workers. He says normal operations has been restored at all affected hospitals in spite of the dismissal of some workers as new nurses were being recruited. (Source: The Post)
Those affected are from UTH, Kasama General Hospital, Livingstone General Hospital and Levy Mwanawasa. The nurses, who staged a 10-day strike are demanding 100 per cent salary increment, as opposed to the 4 per cent that was awarded by government. They also want equal work and equal pay, and extra patient allowance, K2,000 monthly housing allowance and K2,000 night duty allowance as well as harmonisation of salaries in comparison with other classes of health workers.
It is a rather interesting development because as we have previously discussed the country faces a gigantic shortage of medical staff. Although progress was made in 2012 to recruit more people, we are still 24,000 short of meeting WHO recommended human resource support. The problem is acute across all areas. There's a long way to go because this sector has been overlooked for so many years.
In terms of nurses alone, we have 0.7 nurses per 1000 population. With a shortage of around 8,000 staff across the country. We have 0.2 midwives per 1000 population. The shortage is estimated at around 3400. And of course the government is constructing 650 health centres around the country that require nurses. Zambia continues to struggle to keep good nurses because of the brain drain to other countries. Firing the nurses is clearly not going to help!
The problem is that these health strikes have become very frequent. And there's a real danger that we may return to the 2009 situation when hospitals shut admission wards and sent many patients home following a strike by nurses over an extended period. In many countries, certain essential staff (e.g. medical staff, police) are not allowed to go on strike because they are so integral to the welfare of the nation. Those who get those jobs go in knowing they can't strike in the event of a pay dispute. The level of pay is set via other nationally agreed criteria.
There were hints last week that this is what the President had in mind when he said:
"If you ask [Labour Minister Fackson Shamenda] nurses did not declare a dispute for them to go on strike but we understand they have children. Those nurses who are strking, they are human beings, they have relatives in hospitals and some of their relatives are dying with them going on strike; probably they would have helped someone who is dying. But I don't want to use this channel to tell you what government is thinking, I will leave it to the MPs to deal with them." (Source: The Post)
The last sentence implies that there may be a law that comes in to stop nurses, police officers and other sensitive "front line" staff from going on strike. I am broadly in support of such a law for this category of workers provided it comes with automatic membership in a single union that represents employees. What I do oppose is firing nurses when the country has a severe shortage.