HEALTH STRIKE IN THIRD WEEK: NEGOTIATIONS DEADLOCKED

With a strike by doctors and some other health workers now in its third week, negotiations between the Mozambican Health Ministry and the Medical Association (AMM), which called the strike, remain at a standstill.Each side accuses the other of responsibility for the impasse. A Monday press release from the Ministry said that it has always been open to dialogue with health professionals and their associations – but it has not found from the AMM the openness needed to solve the dispute. In the Ministry’s view the impasse is caused by the lack of respect shown by the AMM leadership for the government negotiating team, which is headed by the Permanent Secretary in the Health Ministry, Marcelino Luca, and includes national directors from the Ministries of Health, Finance, Justice and the Public Service.The AMM, however, claims that the government team is not empowered to take decisions. It has thus sent a letter to Prime Minister Alberto Vaquina requesting that the government replace members of its delegation with people who can take decisions. This looks like a veiled demand for the government to send Ministers or Deputy Ministers to negotiate with the AMM. Meanwhile, the strike is taking a heavy toll on the health service in Maputo – but seems to enjoy little support among health professionals elsewhere in the country.In the capital, out-patient appointments have been suspended because of the lack of doctors to deal with them. Other services in the main health units (Maputo Central Hospital and the Mavalane and Jose Macamo General Hospitals) are operating with the support of military doctors, volunteers from the Mozambique Red Cross, and students from the Health Science Institutes). Cited in Tuesday’s issue of the Maputo daily “Noticias”, the director of the Mavalane hospital, Ussene Isse, said that, due to the absence of striking doctors, the hospital can only provide basic services such as maternity and paediatric facilities and intensive care.“In recent days, we have seen the return to work of some nurses and other support staff, so the teams on the wards seem complete. But we can’t say the same about the doctors”, he said.The Jose Macamo hospital is semi-operational, thanks largely to the presence of the medical students. “Noticias” found that the emergency services at this hospital were now functioning “with some degree of normality”. At both hospitals, the morgues are now operational, which has allowed funerals to be held normally.In the northern province of Nampula two doctors at the health centre in Ribaue town have returned to work, after a two week absence. But there are still 21 doctors in the province on strike – 20 in the Nampula Central Hospital and one in the Angoche Rural Hospital.

In Gaza province, the situation remains unchanged. Two doctors and two nurses at the Chokwe Rural Hospital remain on strike, but the other health professionals at this hospital, which serves all the northern districts of Gaza, are continuing to work.The clinical director of this hospital, Manuel Cipriano, told “Noticias” reporters that the commitment of these workers, plus the contribution made by a military doctor and nurse provided by the Interior Ministry, has allowed the hospital to operate “in complete normality”.The Gaza Provincial Government issued a press release praising most health workers in the province for refusing to join the strike, and those who, after initially taking part in the strike, have subsequently returned to work, “thus showing that life is above any other interest’.In the central province of Manica too, the situation remains unchanged with only two of the 47 doctors in the province on strike – one in the provincial hospital in the city of Chimoio, and one in the Chitobe health centre in Machaze district.The Manica Provincial Health Director, Juvenaldo Amos, told reporters that the gap caused by the absence of these two doctors has been filled by resorting to foreign doctors, and students from the local health science institute.In the northern province of Cabo Delgado not a single health professional has gone on strike. The provincial health director, Saozinha Agostinho, said that in all 17 Cabo Delgado districts the health units are operating without any restrictions, and all the health workers have presented themselves for duty as normal.