Teaching hospital struggles to cope with health workers strike

An understaffed university teaching hospital is bearing the brunt of a health workers' strike as it tries to cope with an unprecedented caseload at the only functioning public health facility in the capital, Lusaka.

Unionised health workers and ministry of health medical staff embarked on a work stoppage earlier this month, demanding better pay and working conditions, as well as the payment of outstanding allowances. The strike has spread from Lusaka to the western province of Copperbelt.

The University Teaching Hospital is run by an independent board that regulates the employees' working standards and reviews their conditions of employment. Its staff are not involved in the strike action.

According to university hospital spokesperson Kennedy Makukula, "the situation is really bad for us, more so that we are currently very much understaffed as a hospital. It has put us under a lot of pressure and we are now attending to all Lusaka-based patients who can't afford to pay for the services at the private clinics."

The shortage of beds and huge caseload has seen women giving birth on the floor of the labour ward. "We are not putting anyone on observation just now unless it is a very complicated delivery case. We have to attend to over 50 cases of delivery in one day, which is not even good for our personal health," said one nurse, who declined to be identified. The hospital was also discharging women soon after they had given birth.

Many medical staff have been lured to the United Kingdom and other developed countries by better paid jobs and working conditions. The doctor-to-patient ratio in the UK is about one to 50 patients; Zambia's ratio is one doctor to 14,000 patients.

Dorica Mbewe, a Lusaka woman assisting a pregnant relative in the labour ward, said she had seen a number of women giving birth on their own. "Some of the women are going into labour while in the toilet and we have to ask for a wheelchair from the nurse to move them because the nurses are not enough to attend to everyone at the same time. One [woman] actually gave birth just next to my bed this morning," she said.

The circumstances under which some women were giving birth were a gross violation of human rights. "Letting women give birth on the floor is an abrogation of the right to life as enshrined in the Constitution - giving birth should be a joyful event for every woman, not the life-threatening exercise that it has now become," said Emily Sikazwe, executive director of Women For Change, a non-governmental organisation. "Government must seriously resolve this strike action before the situation gets any worse."

Ahead of the September 28 general election, health workers are demanding a 40 percent increment in housing allowances, back-dated to 2002, long-service bonuses and on-call allowances, some of which have been in arrears since 2003.

The average monthly salary for nursing staff in Zambia is about US$200, with an additional US$20 housing allowance. Rental for a three-bedroom house in Lusaka's medium-cost residential areas ranges from $180 to $300 a month, with many landlords demanding a deposit of between three and six months' rent.

The health ministry's director of technical services, Velepi Mtonga, said government had started resolving the workers' grievances. "Government is doing everything possible to ensure the situation is normalised. We have started depositing the money, but we first have to verify the names before the workers can finally be paid."