The Mozambique’s Medical Association (AMM) recently announced the resumption of the strike of doctors, suspended in December 2022 to make way for negotiations with the Government, through the Ministry of Health (MISAU). The strike, which consists in the paralysis of activities in all health units, will be in force from 10 July, and may be extended for 21 days, covering almost all services.
The announcement of the strike resumption comes days after the Citizens Observatory for Health (OCS) published a report regarding the possible silent strike in several hospitals, even after the Association of United and Supportive Health Professionals of Mozambique (APSUSM) had reached consensus with the MISAU. Read the full article through the following link: https://www.observatoriodesaude.org/en/illegal-charges-slowness-and-intimidation-highlight-possible-silent-strike/
Since the approval and implementation of the Single Wage Tariff (TSU) at the end of 2022 – associated with other factors such as low salaries, lack of work equipment and medicines for users – strikes in the health sector have been common, occurring intermittently.
Going back to the beginning of the battle for claims, the Medical Association, on 27 October 2022, thought it ideal to go on strike, since no consensus had been reached at the negotiating table with the government. Meanwhile, on 06 November, believing in the good faith of the Executive, the group decided to reschedule the start of the 3rd National Strike of the Medical Class for 05 December 2022, as a way of giving the Government time to find answers to the questions presented in the claims section.
As there was no satisfactory response, the 1st Phase of the 3rd National Strike of the Medical Class took place from 5 to 22 December. This strike, however, was suspended “with the aim of providing greater security and tranquility to the Mozambican people during the festive season, and to give the Government time to find ways of meeting the demands of the medical profession, in response to the appeal from the President of the Republic”. Already in February 2023, new agreements were established between the Government and the AMM.
More than four months later, the Medical Association says that only 10% of what was agreed has been implemented by the Government. The non-fulfilment of a significant part of the agreements, according to the class, demonstrates that the government is not interested in resolving the remaining concerns. This time, explains AMM, doctors are forced, once again, to go on strike as a way to pressure the authorities to provide fruitful and immediate answers.
“In this context, the situation remains stagnant, there has been no implementation of the significant part of the agreements, the dialogue has not produced tangible results and the remuneration situation of doctors tends to deteriorate, to such an extent that many doctors work without salaries, without extraordinary remuneration, without allowances (shift, location, diuturnity, research, availability, among others)”, reads a statement unveiled by the AMM.
According to the document, “To make this situation worse, in the months of May and June, there was a considerable salary reduction for many doctors, without justification and without prior explanation. This degrading situation led doctors to arrange a national meeting, which took place last 07 June, where the group decided to start the 2nd Phase of the 3rd National Strike, starting 10 July 2023 for 21 extendable days.”
“The strike will begin at 07:00 hours, covering all doctors in service in the Public Administration, throughout the national territory, assigned to public health units and institutions subordinated to the Ministry of Health (MISAU)”, the document adds.
At the level of the institutions under the Ministry of Health, the Provincial Health Services; Provincial Health Directorates; District Health, Women and Social Action Services; Municipal Health Councils; Research Institutions; Health Training Institutions; Medical Examination Centers; medicine and medical articles warehouses will be affected.
Minimum Services Will Be Provided
However, the medical profession guarantees that during the period when the strike is in force, the minimum services will be guaranteed. Adult and pediatric ERs and Resuscitation; Gynecology ERs and delivery rooms; Emergency operating rooms; and inpatient services (wards).
In what concerns the activities to be paralyzed during the strike, the highlight goes to external consultations, including those of special/personalized care; elective surgeries; auxiliary diagnostic exams of an elective nature.
“Also included in the list of activities covered are elective diagnostic medical procedures, including autopsies; all public health activities; teaching activities in all public sector health training institutions (training centers, institutes and universities); and tutoring/supervision of internships in health units”, the document says.
The Medical Association also guarantees that the minimum services should be ensured by doctors who, although they are associated and sympathetic to the demands of the class, for various reasons cannot participate in the strike, namely military doctors and foreign doctors.
“The general, clinical and service directors, if they wish, can provide minimum services”, it stresses.
According to the AMM, doctors covered by the strike should not go to work, while those scheduled to provide minimum services should go to their respective workplaces, at the times they are scheduled to in order to guarantee patient care.
“During this period, the AMM will announce activities of a social or claiming nature for the striking doctors. Any attempt to violate the exercise of the right to strike, including attempts or consummation of threats or coercion, will lead to the change of the guidelines outlined, with consequent total paralysis of all medical activities, including minimum services”, explains the class.
The AMM will resume its strike at a time when the Association of United and Supportive Health Professionals of Mozambique (APSUSM) has suspended its strike for 60 days to give the Government room to analyze and solve its claims.
Regarding the claims of AMM, as well as those of APSUSM, the Citizen Observatory for Health reiterates its position, stating that the strike of health professionals negatively affects the National Health System and the services provided to the users.
Moreover, the successive strikes reveal the continuous tug-of-war between the health professionals and the Government. On the one hand, it is clear that the Government lacks the mechanisms (or the will) to respond to the demands raised by health professionals. On the other hand, it is evident that the problems experienced by the National Health System, apart from being financial, reside in the lack of understanding between doctors and the Government.
Therefore, as a civil society entity in favor of the good functioning of the health sector, we call, once again, for the good sense of the Mozambican Executive, in order to solve the problems of both doctors and all health professionals, as a way of avoiding that users are sacrificed, since they are the most affected in these disputes.