The National Health System (SNS) has recently been struggling with a number of problems, ranging from a lack of supplies for proper medical care and medication for users to problems associated with the payment of salaries to health professionals, in the context of the implementation of the Single Salary Table (TSU) in the public administration.

These and other problems forced health workers to stop working for a while, until an agreement was reached at the negotiating table with the government, through the Ministry of Health (MISAU).       

The last doctors’ strike, which the Mozambican Medial Association (AMM) called the “second phase of the third national doctors’ strike”, lasted around 40 days and involved, according to the association, more than 2,000 doctors.

At the time, the AMM gave the government 40 days to resolve all the doctors’ concerns. If the government didn’t come up with answers within this period, the AMM would resume the strike. The deadline expired on October 9, but the strike has not yet resumed and the Association’s leadership has backed down from a new confrontation with the government.

However, the resident doctors at Maputo Central Hospital (HCM), Mozambique’s largest health unit, in a letter to the hospital’s management, threatened last week to stop working overtime from November 1, as they have not been paid for nine months.

The issue of overtime is included in the doctors’ demands in the light of the negotiations with the government. However, it seems that there has still been no consensus on this issue, because even with the suspension of the general strike, the doctors in question have broken their silence and called meetings with hospital management to demand overtime pay.

Because the answers obtained in the attempt to negotiate were unsatisfactory, causing these health professionals physical and emotional exhaustion, the doctors decided to stop working after normal working hours.

In their letter to the HCM management, the resident doctors threaten to stop working due to physical and psychological exhaustion, including difficulties in travelling because they don’t receive the amounts in question.

“We have unanimously decided to stop working overtime and have declared ourselves unavailable outside normal working hours, on public holidays and at weekends. During this period, we will not be able to carry out patrol work, emergencies or other relevant activities”, reads the resident doctors’ letter.

The resident doctors also state that they have had several meetings with the hospital’s management to demand satisfaction over the non-payment of overtime. However, they have not received a satisfactory response and “unfortunately, we have reached a state of physical and psychological exhaustion and, at the moment, we are not in any condition to work overtime.”

“After the meeting on October 3, 2023, it was unanimously decided to declare the residents unavailable for activities outside normal working hours, on holidays and weekends as of on November 1 midnight”, the doctors stress.

Reacting to the letter, the director of the HCM, Mouzinho Saíde, said that “solutions are being sought to avoid a strike that could jeopardize the functioning of the hospital.”

Medical Association shows solidarity

Although the announcement of resident doctors is not part of the general plan for the doctors’ strike, the AMM, in the voice of Mustafá Agy, has expressed its solidarity with colleagues.

“The association is sympathetic, but it wasn’t up to it to call this strike. It’s the leaders at the Central Hospital who are pushing ahead with this measure. Since the government won’t pay overtime, the doctors have decided to stop working, leaving only normal working hours”, he said.

With regard to the national doctors’ strike, which was suspended on August 24th of this year and was due to end on October 2nd, the AMM representative, Mustafá Agy, said that the suspension had been extended to the end of this month.

“We decided to extend the time a little further. We weren’t very incisive in meeting the date that had been agreed as the deadline. The idea of extending the days is for the government to resolve some issues that are bothering this class”, he said.

According to Agy, in the first week of November, if the demands are not fully answered by the government, AMM will schedule a national meeting to decide on the next steps.

“It has to be said that the line of dialog has been opened and is happening, albeit very slowly. Things are moving at a chameleon’s pace. There are some impasses that so far are not being overcome. These include the doctors’ position on the salary scale, a situation that will never be resolved” he said.

Agy also revealed that some doctors have had their salaries cut since May of this year.

“Although it’s not that significant, we have a group of doctors who are still not on the normal payroll and have been receiving undue salaries”, said Agy, adding that, on the other hand, there are around eight doctors who simply don’t receive salaries because they are not on any payroll.

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