Govt orders striking medics back to work

Patients continue to be turned away from government hospitals across the country thanks to the ongoing health workers’ strike, leaving many with a range of medical conditions—some critical—in a spot of bother.

This even after—or because—the government menacingly waved the threat of dismissal for medical workers that have chosen to down their tools.

“Government is calling upon allied professional health workers, nurses and midwives to return to work on Monday...Failure to do so, all these workers will be considered as having abandoned duty and resigned accordingly,” Mr Wilson Muruli Mukasa, the Public Service minister—told a media briefing on Friday.

“If you find that the pay is not good enough for you and you decide to give up, that is your own individual decision. And when you have done so, then government takes the necessary measures to replace you,” he added while instructing chief administrative officers and hospital directors to declare which positions are vacant after carrying out an audit.

Strike biting

As Mr Mukasa issued the threat on Friday, patients like Ms Agnes Namuddu were bearing the brunt of the industrial action.

“I came from Bukomansimbi to seek antenatal service, and my daughter is also sick,” Ms Namuddu told Sunday Monitor at one of Masaka Hospital’s green spaces.

The hospital’s director, Dr Nathan Onyachi, told us that the industrial action particularly knocked the outpatients department sideways.

Mr Mukasa said on Friday that the ongoing industrial action contravenes Section 8 subsection 3a and b of the Public Service Negotiating, Consultation and Disputes Settlement Machinery Act of 2008. 

He added—sternly—that any commencement of industrial action should follow a 90 days’ notice after exhaustion of all avenues of reconciliation, arbitration or dispute settlement with the government .

“The government and the health workers through their union leaders have been engaged in various consultative meetings, which have included the President, Cabinet and the line ministries where the aggrieved parties have been assured of an increment in the 2022/2023 financial year,” he said, attempting to offer an olive branch.

The Public Service minister said public servants should rest assured that salary enhancements will be executed in a phased manner.

“If we are to enhance the entire service, we will need Shs1.5 trillion to enhance everybody…which at the moment we don’t have,” he confessed.

Ms Catherine Bitarakwate, the Permanent Secretary in the Ministry of Public Service, said Shs495b has been ring-fenced in the 2022/2023 National Budget to enhance salaries for scientists. She added that enhancement of salaries “is not a figment of imagination.”

Health workers, however, remain sceptical. We spoke to one patient admitted at Mulago hospital who told us he was discharged on Friday and advised to return in the second week of June when a reflection of the salary enhancement shows itself true. This, perhaps, explains why Ms Betty Amongi, the Gender, the Labour and Social Development minister, was quick to take on a reconciliatory tone.

She said: “I was in Mulago and I found nurses who have voluntarily decided to continue to work, but their colleagues who are striking are forcing them to abandon the work; yet under the law industrial action should take into consideration essential services. There were very many people stranded with babies.”

We spoke to one such person. A mother who only identified herself as Betty almost lost her eight month daughter to severe malaria at Bugiri Hospital.

“For the last three days I spent in hospital, no health worker came to attend to my child. Her health was deteriorating. I discharged myself and went back because that was the only option I had. Fortunately, my sister intervened and took us to Mulago,” she said.

Mixed picture at Mulago

Dr Rosemary Byanyima, the acting executive director of Mulago hospital, said they were bracing themselves for an influx of patients from elsewhere.

“My observation has been that whenever there are such strikes, many of the lower level hospitals close and we tend to get the higher influx at the centre, which stretches us,” she said, adding, “We are not sending away patients. All our referrals are critical. We have had a meeting with our staff, especially the nurses and management to remain coordinated so that we can attend to those emergencies.”

Dr Byanyima revealed that—as tends to be the case—the hospital’s outpatient department had “few” numbers despite being fully operational.

“We do not want to lose any life. We had a meeting with our nurses. Of course they are aggrieved and annoyed with the statement from the prime minister, but I was telling them that government can only give what it can. The prime minister spoke what government can do,” Dr Byanyima said.

When Sunday Monitor visited Mulago on May 26, some important units such as the orthopaedic and haematology laboratory were under lock and key. 

The receptionist at the orthopaedic unit—which handles people with broken bones said the surgeons cannot optimally work without other cadres like the orthopaedic technicians, nurses and radiographers.

Some nurses could also be seen moving around the facility, forcing their colleagues to down their tools.

“Don’t sabotage our strike,” one of the nurses was overheard shouting at her colleague who was working at the facility.

Patients were turned away at the hospital’s laboratory. The place is usually a beehive of activity with people who need blood transfusion and malaria diagnosis crowding it. There was an air of resignation amongst the 50-odd patients that hoped against hope for medical attention. Mr Paul Mugalu, a resident of Bombo who had brought his son to the hospital’s sickle cell unit, said he didn’t know what to do because there was no doctor.

“I have been waiting, but there is no doctor. There is nowhere I can go. I will wait. Maybe they will change their mind and handle us,” he said.

At the children’s unit, hundreds of parents were seen sitting around desperate to be handled. The few nurses and medical workers who were discharging their duties did so whilst not wearing scrubs.

At the causality unit, a medical worker who spoke on condition of anonymity said the nurses who were working were majorly students. Medical interns also came in quite handy at Masaka hospital.

“We have a good number of intern nurses and these have been well distributed in various departments to try and bridge gaps caused by the striking nurses,” Dr Onyacho revealed, adding, “We have been advising some patients that if they can pay for their treatment bills, they are better off seeking services at the private wing of the hospital.

Business as usual?

Elsewhere, Dr Margret Nannozi—the Mpigi District Health Officer—told Sunday Monitor that the strike has not been felt in the District. She confirmed that all allied health workers are working normally.

“We just heard about the strike through the media. Even the first one organised by allied health workers’ leaders did not affect us here. All our staff are on duty except those on official leave,” she said.

In both Gomba and Butambala, nurses and midwives were also operating normally at facilities such as Gombe General Hospital and Maddu Health Centre IV.

Meanwhile, Mr Paddy Mwesigye, the assistant Kabale District Health Officer in-charge of maternal and child health, said that a skeleton staff has been persuaded to remain working at the emergency and maternity wards to ensure that there is no crisis.

“We have been able to convince the nurses at health centre threes and health centre fours to remain on duty to create a skeleton staff that can attend to patients in critical condition and they accepted. I don’t know what will happen tomorrow,” Mr Mwesigye said.

Compiled by Jane Nafula, Tonny Abet, Brian Adams Kesiime, Malik Fahad Jjingo & Sylivia Katushabe