The Association of United and Solidarity Health Professionals of Mozambique (APSUSM) – which represents nurses, servants, ambulance drivers and morgue workers – accuses managers of some hospital units of intimidating the health professionals who were involved in the last strike in the health sector, which was suspended approximately three weeks ago as a result of negotiations with the government to resolve the concerns in question. 

According to APSUSM spokesperson, Rosana Zunguze, despite the fact that a strike is a constitutional right, directors and managers of some health units point to those who joined the strike as defaults, therefore registering their absences. Because of these absences, the strikers’ salaries are being reduced.

In addition to the salary reduction, other hospital managers, showing arrogance and intimidation, are threatening to transfer the strikers to remote areas without any reason.

For APSUSM’s spokeswoman, these attitudes are not guidelines from the Ministry of Health (MISAU) but the will of some directors who, in order to flatter their superiors, believe that by sanctioning the professionals involved in the strike, they will be promoted.

 “They want to be seen by their superiors as do-gooders, even if they have to break the law and embarrass their colleagues. We are sometimes obliged to send documents justifying that the strike is a right, so there is no reason to penalize those who join it,” the spokeswoman said, adding that “the mother law itself makes room for strikers not to be seen as offenders. That’s why we don’t understand why they are complicating the lives of their colleagues, given that the strike is a right enshrined in the Constitution of the Republic.”

For Zunguze, the hospital managers’ behavior, is aimed at intimidating professionals so that they don’t join the strike next time.

The spokeswoman also revealed that APSUSM members have been receiving informal notices to go to the police station to make statements about their involvement in the strike, which consisted of paralyzing activities at health centers across the country.

“This is a way of intimidating colleagues. They received the message, but when they got to the police station, no-one turned up. The permanent officer ended up dismissing them, advising them to wait for a written summons from the police,” he said.

The spokeswoman regretted the fact that some of her colleagues were acting in this way, “since the fight for pay justice is aimed at benefiting everyone, improving working conditions for the profession, as well as patient care conditions.”

Government promises to review salaries from this September

In another development, with regard to the progress made in the negotiations, Zunguze said that with regard to salary justice, a simulation of possible salaries is underway, depending on the government’s financial availability.

 Although the proposal is not ideal, APSUSM welcomes it, bearing in mind that its aim is not to go on strike, but to reach a consensus on its concerns, a salary that dignifies health professionals.

“Actually, our aim is not to strike. We ended up creating, as a way of drawing the government’s attention, the minimum conditions for our work and the care of our patients,” she emphasized.

In this context, according to the APSUSM spokeswoman, the government has guaranteed that, starting this month, there will be a pay rise.

“We hope that this is no more than a promise to undermining the healthy course that the negotiations are taking,” she said.

With regard to working conditions, Zunguze guaranteed that some of the equipment has already started to be made available, and that in this first phase, priority will be given to reference hospitals, before moving down to health centers and health units in more remote areas.

By way of example, on the 5th of this month, the government, through the Ministry of Health, delivered various items of equipment to Maputo Central Hospital (HCM).

The equipment delivered – consisting of 8 operating tables, 5 cyhalytic lamps, 2 aspirators, 10 electrocoagulators, 5 anaesthesia machines, 15 multi-parameter monitors and 10 vital signs monitors – aims to guarantee the quality of the HCM’s operating theatres.

Maputo Central Hospital also received several surgical kits for amputation, caesarean section, herniorrhaphy, laparotomy and hysterectomy.

“As a government and as a sector, our expectation is that this hospital equipment will have a positive impact on hospital indicators, particularly in reducing hospital mortality,” said the Minister of Health, Armindo Tiago, when the equipment was handed over.

However, APSUSM says that there is still much to be done to improve working conditions, and it is crucial that the executive fully fulfils the commitments it has made.

The availability of medication, another problem that led the class to demand it, has been improving in the health units, according to the visits made by the Observatory for Health (OCS) to the main hospital units in the country’s capital, shortly after the suspension of the strike in that sector.

“Now we’re catering for the biggest hospitals, the main hospitals. After that, we’ll look at other units, the more remote ones. Patients are often transferred because of the lack of hospital conditions. So, this is the fight. We’re going to wait, because the government says it’s not possible to do everything at once,” said the spokeswoman.

In the meantime, if the government doesn’t fulfil the agreements made, APSUSM is threatening to resume the strike.

Users talk about improved service

This Monday, the Citizen’s Observatory for Health visited some hospital units and health centres in Maputo City to monitor the provision of health services following the resumption of activities.

Approximately three weeks ago, doctors and other health professionals put an end to the strike that shook the National Health System (SNS) for more than 45 days. The stoppage lasts until 5 November this year, and during this time the health professionals are trying to reach a consensus at the negotiating table with the government.

During the monitoring carried out by the Citizen’s Observatory for Health (OCS) at Chamanculo General Hospital and the Malhangalene and 1˚ de Maio health centres, patients were unanimous in saying that health services are much improved compared to the period of the strike, when care was practically non-existent.

“The service these days has been good, they’ve started to attend. During the severe period everything was very complicated, they wouldn’t let you go downstairs. The last time I was here, they told me to go home. Now everything is normal,” said Olícia Machava, one of the patients heard at Chamanculo General Hospital.

Olícia Machava

For her part, Leandra Cumbane, also interviewed in Chamanculo, said that she arrived at the post in the early hours of the morning and had already been assisted by 11am. For her, the service was good, without much cause for complaint.

“I managed to get almost all the pills here in the hospital pharmacy. I’m missing one, which I’ll buy outside. It’s a big improvement because there are times when you can’t get any of the medicines you’ve been prescribed inside the hospital,” said Leandra Cumbane.

Leandra Cumbane

Another patient interviewed at the Malhangalene health center is Dinis Chau, who, like the others interviewed, classifies post-strike care as much better.

“Now it’s much better than it was at the time of the strike, we’re being treated better than before. It was annoying because people didn’t have access to health services. I’ve only just arrived and my daughter is already inside being attended to. The medicines are available, whereas at the time of the strike it wasn’t easy to get them,” she emphasized.

Still at the Malhangalene health center, the OCS team spoke to Juvêncio Guambe, who said that “they are being flexible. There was a person in bad condition here, but he was attended to,” he said.

Juvêncio Guambe

“Everything is normal, for example, here in the adult ward, the service is fast. On the other side, in the children’s ward, they’re being a bit slow, but the service is normal compared to the time of the strike, it’s improved a lot,” concluded Lina Sigauque.

Lina Sigauque

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