Liberia: Doctors Warn of High Death Rate Should Health Workers Strike Continue; Condemns Replacement of Striking Workers

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The LMDA acts as the national representative body for the medical profession as well as promote health care delivery in Liberia.

MONROVIA – The Liberia Medical and Dental Association (LMDA) has expressed concerns that if nothing is done to quickly resolve the standoff between the government and striking health workers, the country’s health sector would soon collapse and there would be a mounting death toll at hospitals and health centers.

The LMDA also condemned the government’s action to replace the striking health workers with new recruits, noting that such would only compound the existing problem.

The LMDA acts as the national representative body for the medical profession as well as promote health care delivery in Liberia.

The Ministry of Information, Culture and Tourism in a press statement over the weekend disclosed that “The Ministry of Health has been instructed to solicit applications from qualified health workers of various grades, including nurses, nurse aides, midwives, laboratory technicians, etc. in order to fill the temporary vacancies that have resulted from the strike action. These applications must be submitted immediately to county health centers, the Ministry of Health, and the JFK, for screening by the MOH.”

The government’s press statement added: “The leadership continues to demand unionization for health workers, in addition to an immediate implementation of standardized pay-grade and increment in salaries for more than 9,000 health workers at an estimated cost of US$15 million per annum. The leadership is also demanding payment for more than 11,000 health workers who are not directly involved with COVID19 response, potentially a payment of US$8 million as “hazard pay” in addition to their regular monthly salary payment through the Ministry of Finance and Development Planning.” 

The government, during a meeting chaired by President George Manneh Weah on September 8, 2020, informed the leadership of the workers that unionizing civil servants, including health workers, would be a violation of chapter 1 Section 1.5 of the Decent Work Act, and the Civil Servant Standing Order which together exclude Government employees from unionizing. On the demands for immediate salary increment and hazard payment, the government assured the health workers of its demonstrated commitment to gradually increase the salaries of health workers, especially workers who are currently earning far below their standardized pay grade; and potential payment of a onetime hazard payment to health workers who are directly involved with the COVID-19 response.

“Given that other members of the team are absent due to the ongoing go-slow action, it is just the matter of time before the entire healthcare delivery system crumbles and death toll among patients increases exponentially.”

Liberia Medical and Dental Association

Addressing the media on Monday, the LMDA’s president, Dr. Emmanuel K. Ekyinabah, said the demands of the National Health Workers Union of Liberia (NAHWUL) are legitimate and there is the need for negotiation between the union and the government for an amicable solution and way forward.

“In the midst of negotiations, LMDA strongly cautions all parties to refrain from making any inflammatory statement and advises against the government’s decision to replace health workers who have legitimate concerns. This decision is unacceptable by doctors across the country,” the LMDA stated.

According to the LMDA, it has always championed the improvement of the healthcare delivery system through constant advocacy and negotiation with the government through Ministry of Health.

The LMDA noted that some of these advocacies have yielded fruitful results and while others are yet to be addressed by the government.  

The LMDA observed that the medical field requires team work and the absence of any player from doctors to cleaners, could cause a break in the system and result into adverse patient outcome.

“Given that other members of the team are absent due to the ongoing go-slow action, it is just the matter of time before the entire healthcare delivery system crumbles and death toll among patients increases exponentially,” the LMDA warned.

They also iterated that the medical team cannot work effectively when basic materials are lacking and the environment is unsafe.

“The government of Liberia should continue to endeavor in strengthening this fragile health system by providing all necessary support to build a resilient healthcare system. Knowing that we as Liberians including government officials and ordinary citizens are the direct beneficiaries of the healthcare system we build, we must prioritize improving the healthcare delivery system even in the midst of harsh economic situations,” the LMDA further stated.

LMDA is calling on NAHWUL and GOL to continue the negotiations so as to avert the go-slow action and have health workers returned to duties immediately.

Relative to the demands enlisted in NAHWUL press statement, LMDA is proposing the following actions: 

Union Certificate: Considering the legal implications of this demand as indicated by GOL through the Ministry of Labor, Ministry of Justice and Civil Service Agency, LMDA encourages the leadership of NAHWUL to seek legal recourse in this matter. We encourage them to suspend this demand as a prerequisite for health workers returning to work as legal proceedings take time to be resolved.

Reclassification of Health Workers According to Qualification and Payment of Salaries as per Professional Status:  LMDA acknowledges that disparity in salaries of similarly qualified employees results in demotivation in the workplace. We encourage the GOL to reclassify the health workers and upgrade their salaries at the level of others with similar qualification.

Redeployment: LMDA hereby reminds NAHWUL that the authority to employ, assign, promote, transfer, or pension employees lies solely with the Ministry of Health using rules and regulations governing civil servants. However, LMDA encourages MOH through the Human Resource to adhere to standard best practice, and publish policy documents regarding transfer of employees so as to alleviate fears of witch-hunt in the workplace. 

Replacement of Pensioners: We encourage the GOL to replace pensioners promptly so as to maintain adequate workforce to cater to the increasing loads of patients at public health facilities. The pensioning of health workers without timely replacement creates gaps in the workforce which results in potential adverse patients’ outcome.

COVID-19 Victims Benefit: LMDA extends gratitude to the GOL and its partners for allocating some benefits to the families of health workers who lost their lives to COVID-19. We however encourage the GOL through MOH to establish a support mechanism in the form of medical and/or psychosocial support for survivors who may experience medical complications resulting from COVID-19.

Salary Increment: LMDA acknowledges that health workers in general receive low salaries considering the huge risk and demanding nature of the work they do.

In as much as health workers commit to their duties not mainly because of the salaries they make, it is clear that their wellbeing and satisfaction is cardinal in providing quality and professional services to their patients.  We therefore encourage the GOL to commit to a progressive salary increment of minimum percentage each budget year until the target is achieved.

Hazard Benefits: LMDA welcomes the news of GOL allocating 2M US dollars to pay hazard benefits to health workers. We however encourage the government to explore other avenues such as tax waiver/break to health workers for specified periods in the absence of cash payment since funding is limited. 

In the midst of these difficult times, LMDA again admonishes both parties to resort to continuous negotiations as all efforts are geared towards calling off the go-slow action and returning health workers to duties. LMDA strongly frowns on any act to replace health workers who are on go-slow, as these actions will only undermine all ongoing negotiations and create another set of misunderstanding. 

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