We're in the midst of the second large scale Public Service strike that I can remember. Pundits say that it's the third since 1997. Things are really heating up down on the ground. I come to work, bypassing groups singing, “ my father was a garden boy, my mother was a kitchen girl, that's why I'm a socialist, I'm a socialist ...”.
The floors are dirty, a few days away from being filthy and the toilet paper is running out – fast. Dietitians say that the food stores are just enough to last over the weekend. Protesting groups are blocking patients from entering the hospital, and that's why I can write this note while sitting at work – the casualty is empty. We do see emergencies ... but don't spread the word. Protesting mobs may track us down calling us 'magundwaan' or 'rats'.
Back to 2007. It was my first year of working as an intern and the strike hit us something awful at Chris Hani Baragwanath hospital. Working in a setting with no porters, cleaners or nursing staff was frustrating. It took about fives times longer to get work done. So while there might have been a lower patient load, the work day was just as long and infinitely more frustrating. This highlights the absolute necessity of every 'link in the chain'. It pointed out the importance of the so-called-menial-worker. The work needed to go on ... and it did. The army came in and were more grand-looking than effective. When the strike finally abated, we knew that we would have to deal with a severe backlog ... and we did.
The 2009 Doctor's strike lacked the pizazz of strikes lead by more militant (and effective) unions. What we saw here were 'wealthier faces' of varying colours asking for better wages. The public were divided in opinion. So was I. We had a 'live-able' salary.
My opinion changed when I heard an ICU doctor state her case. It was a time when the strike was really gaining momentum. We were running 'essential services' alone. The question of a 'complete shut down' arose. We were debating closing ICU facilities – and perhaps letting the private sector absorb our current patients – at the state's expense.
This doctor had dedicated her life to public service. She could have been earning at least four times her salary in the private sector, but she believed in providing a service to the less fortunate. She was calling for an ICU shut-down. She said that she didn't need the extra money as hers was a supplementary income in the household. She wanted doctors to be paid more so that more doctors would remain in the public sector.
We are experiencing an exodus of skills to private hospitals and abroad. The result is a public service that is understaffed, under-skilled and collapsing. Young doctors are looking at their working hours, working conditions and salary and comparing it to their corporate counterparts. For many of these skilled professionals, the reward of being altruistic just doesn't cut it. Does the ends justify the means ? An ethical dilemma.
A huge ethical dilemma is what we are faced with. In this setting, it's definitely not fair to write deaths off as collateral damage. The results in a strike situation are more acute and evident. However, the results of nurses and specialists leaving the country en mass to seek better pay are far more chronic and debilitating – but the issue is not as sexy as a large-scale strike which grabs media attention.
So here we are , at the beginning of our third large-scale Public Service strike. Workers have expressed a commitment to engage in protracted strike action. Government is digging its heels deeper into the ground. Both sides are posturing – a familiar series of events. It all seems quite reactionary .
Policy analyst Ebrahim Khalil Hassen offers alternatives to the present methodology of negotiating .http://sacsis.org.za/site/article/535.1
In the meanwhile the poor guy who gets the bad end of it all is – the poor guy. Yet again the have-nots are at the mercy of the privileged (or somewhat privileged).
Regarding strike tactics – South Africa has a strong protest history which I believe to be a positive thing. Our apartheid legacy , though, leaves us with heavy-handed tactics like intimidating non-strikers, coercing people to join and turning violent on those seen as not completely sympathetic to the cause. Ideally and theoretically a more 'democratic' mode of engagement is needed. In reality – people are angry and on the brink of tipping over to the violent side.
The casualty staff on duty tonight are in support of the strike but have come to work – they are afraid.
Just a few minutes ago an elderly lady somehow made her way through the gates into casualty. She was short of breath. Even though we don't see adult medical patients in our casualty generally,we were ethically obliged to see her as it was an emergency. We did primary management, but she needed admission to a tertiary facility. The best that I could do was write a referral letter to our referral hospital, knowing that the gates of the Helen Joseph hospital were shut. Does the ends ever justify the means?