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South Africa: Health workers' strike
295
the British pipeline even before the Supreme Court decision. Until now, British lawyers have concentrated on rare conditions such as Buerger’s disease, because of the more direct causal relation. Now the lawyers plan to tackle mainstream lung cancer, bronchitis, and passive smoking cases.
There was more bad news on the passive smoking front this month. A report from the Royal College of Physicians estimated that smoking by pregnant women caused 4000 miscarriages of healthy fetuses each year, and that a further 17 000 children under 5 were admitted to hospital because of smoke from their parents or carers. Reviewing 400 research papers, the working party estimated that children whose parents or carers smoke inhale the equivalent of up to 150 cigarettes a year. Stand by for the first infant lawsuit against a smoking parent. Malcolm Dean
Round the World South Africa: Health workers’ strike Mounting violence now characterises the eight-week-old national hospital workers’ strike. Thus far the strike, which is increasingly moving into the political arena, has claimed the lives of three people and cost more than 8000 striking workers their jobs. The organisers of the strike, the National Education, Health, and Allied Workers Union (Nehawu), are demanding that general hospital workers-many of whom are on salaries of R400 per month and still classified as temporary workers despite more than 15 years’ service-be paid a minimum living wage ofR1300 per month. On July 24, nine protesters were arrested for occupying the superintendent’s office at the Baragwanath Hospital in Johannesburg. The group vowed not to leave until their be that dismissed workers reinstated demand is met the Transvaal, Cape, and Free unconditionally by State Provincial Administrations. Showing solidarity for the strikers, the Soweto Civic Association threatened to "take over the running of Baragwanath Hospital if the Transvaal Provincial Administration (TPA) did not address the demand" this week. The Congress of South African Trade Unions (Cosatu), of which Nehawu is an affiliate, also resolved to include demands for the resolution of the strike as part of its political mass-action platform this week. In the townships, the hospital staff-strikers or non-strikers-have had their homes petrol-bombed or been threatened with such action, increasingly so in the past two to three weeks. According to Philip Dexter, general secretary of Nehawu, the three lives claimed were of union members, contrary to reports that only non-strikers’ homes have been attacked. In many centres, nurses have been singled out for assault because strikers feel "betrayed" by the lack of support from nurses. But many nurses say that, even with more than ten years’ service, they too are earning meagre salaries, some as little as R600 per month. Nehawu has, however, consistently denied intimidation claims, but assaults on nurses have turned the profession firmly against the stoppage, even though the amendment of the nursing act permits them to strike. Only at the Ga-Rankuwa Hospital in the Transvaal have health professionals gone on strike, and for only one day. This week the Coordinating Committee of the Medical Faculty Deans, representing seven medical schools, called on the authorities to settle the strike urgently.
Chief of medicine at Baragwanath Dr Ken Huddle says, "We appreciate that the strikers have legitimate concerns; also that the other side (administrative officials) have an overly rigid approach". If the strike does not end soon, says Huddle, the hospitals will not be able to cope with the backlog. Hospitals countrywide are largely empty. Ironically, for hospitals such as Baragwanath, said to be one of the world’s busiest hospitals, fewer patients mean better treatment, according to doctors there. Members of the South African Defence force are being used both to control strikers and to help with hospital laundry. Beathur Baker
Serbia:
Disintegration
of health-care system
The health-care system is on the verge of total collapse. Between 3 and 3-5% of Serbia’s gross national product goes to provide health care, largely free at the point of delivery, for its 10 5 million people. A health contribution from salaries goes into a national health fund. The money is then distributed to Serbia’s hospitals and primary-health-care system. Standards have until recently been on a par with those in most of southern Europe. However, spiralling costs, especially in hospitals, have prompted much needed but unsuccessful reforms. Over the past year these have included the introduction of co-payments by patients and legalisation of private medicine. Now hyperinflation, unemployment, and widespread economic recession have emptied the health fund and the whole system in grinding to a halt. The war and the ethnic clashes in the region over the past year have contributed to the collapse. The effect is seen clearly in Belgrade’s 2000-bed University clinical centre, which has a staff of 7500 and acts as a tertiary referral centre for the republic. Supplies of most items are running out. The number of diagnostic laboratory procedures that can be done has halved in the past 2 months. The centre has run out of even glucose dipsticks. Items such as syringes, needles, disposable gloves, X-ray fihns, and some antibiotics that used to be imported from Croatia and Slovenia are now in very short supply. There are no local producers for most of these goods. Many disposable items such as urinary catheters are now sterilised and reused. The hospital cannot pay its bills and has been warned that telephone lines and water supplies may be cut off. Patients now rely on their families for most of their food, which is difficult for refugees, who make up over 10% of all admissions. In addition hyperinflation at over 75% per month means that hospital staff are unable to survive on their salaries. Although medical supplies are officially excluded from the international economic blockade of Serbia and Montenegro introduced on May 30, the extra paperwork required can cause delays. For example, around 50% of the country’s insulin comes from Denmark. For each order the supplier has to obtain an export licence from the Danish Government, which in turn has to get clearance from the UN to ensure that no materials are transported in violation of the UN Security Council resolution. The supply and distribution of insulin within the country is also irregular because many road links have been cut, and local companies are not ready to risk distributing insulin that nobody can pay for. Even in Belgrade insulin may at times be obtained only from private pharmacies. "In the past month there has been a 30% increase in cases of ketoacidosis. Most come from outside Belgrade", says Prof Predrag Diordjevic, chief of the
the British pipeline even before the Supreme Court decision. Until now, British lawyers have concentrated on rare conditions such as Buerger’s disease, because of the more direct causal relation. Now the lawyers plan to tackle mainstream lung cancer, bronchitis, and passive smoking cases.
There was more bad news on the passive smoking front this month. A report from the Royal College of Physicians estimated that smoking by pregnant women caused 4000 miscarriages of healthy fetuses each year, and that a further 17 000 children under 5 were admitted to hospital because of smoke from their parents or carers. Reviewing 400 research papers, the working party estimated that children whose parents or carers smoke inhale the equivalent of up to 150 cigarettes a year. Stand by for the first infant lawsuit against a smoking parent. Malcolm Dean
Round the World South Africa: Health workers’ strike Mounting violence now characterises the eight-week-old national hospital workers’ strike. Thus far the strike, which is increasingly moving into the political arena, has claimed the lives of three people and cost more than 8000 striking workers their jobs. The organisers of the strike, the National Education, Health, and Allied Workers Union (Nehawu), are demanding that general hospital workers-many of whom are on salaries of R400 per month and still classified as temporary workers despite more than 15 years’ service-be paid a minimum living wage ofR1300 per month. On July 24, nine protesters were arrested for occupying the superintendent’s office at the Baragwanath Hospital in Johannesburg. The group vowed not to leave until their be that dismissed workers reinstated demand is met the Transvaal, Cape, and Free unconditionally by State Provincial Administrations. Showing solidarity for the strikers, the Soweto Civic Association threatened to "take over the running of Baragwanath Hospital if the Transvaal Provincial Administration (TPA) did not address the demand" this week. The Congress of South African Trade Unions (Cosatu), of which Nehawu is an affiliate, also resolved to include demands for the resolution of the strike as part of its political mass-action platform this week. In the townships, the hospital staff-strikers or non-strikers-have had their homes petrol-bombed or been threatened with such action, increasingly so in the past two to three weeks. According to Philip Dexter, general secretary of Nehawu, the three lives claimed were of union members, contrary to reports that only non-strikers’ homes have been attacked. In many centres, nurses have been singled out for assault because strikers feel "betrayed" by the lack of support from nurses. But many nurses say that, even with more than ten years’ service, they too are earning meagre salaries, some as little as R600 per month. Nehawu has, however, consistently denied intimidation claims, but assaults on nurses have turned the profession firmly against the stoppage, even though the amendment of the nursing act permits them to strike. Only at the Ga-Rankuwa Hospital in the Transvaal have health professionals gone on strike, and for only one day. This week the Coordinating Committee of the Medical Faculty Deans, representing seven medical schools, called on the authorities to settle the strike urgently.
Chief of medicine at Baragwanath Dr Ken Huddle says, "We appreciate that the strikers have legitimate concerns; also that the other side (administrative officials) have an overly rigid approach". If the strike does not end soon, says Huddle, the hospitals will not be able to cope with the backlog. Hospitals countrywide are largely empty. Ironically, for hospitals such as Baragwanath, said to be one of the world’s busiest hospitals, fewer patients mean better treatment, according to doctors there. Members of the South African Defence force are being used both to control strikers and to help with hospital laundry. Beathur Baker
Serbia:
Disintegration
of health-care system
The health-care system is on the verge of total collapse. Between 3 and 3-5% of Serbia’s gross national product goes to provide health care, largely free at the point of delivery, for its 10 5 million people. A health contribution from salaries goes into a national health fund. The money is then distributed to Serbia’s hospitals and primary-health-care system. Standards have until recently been on a par with those in most of southern Europe. However, spiralling costs, especially in hospitals, have prompted much needed but unsuccessful reforms. Over the past year these have included the introduction of co-payments by patients and legalisation of private medicine. Now hyperinflation, unemployment, and widespread economic recession have emptied the health fund and the whole system in grinding to a halt. The war and the ethnic clashes in the region over the past year have contributed to the collapse. The effect is seen clearly in Belgrade’s 2000-bed University clinical centre, which has a staff of 7500 and acts as a tertiary referral centre for the republic. Supplies of most items are running out. The number of diagnostic laboratory procedures that can be done has halved in the past 2 months. The centre has run out of even glucose dipsticks. Items such as syringes, needles, disposable gloves, X-ray fihns, and some antibiotics that used to be imported from Croatia and Slovenia are now in very short supply. There are no local producers for most of these goods. Many disposable items such as urinary catheters are now sterilised and reused. The hospital cannot pay its bills and has been warned that telephone lines and water supplies may be cut off. Patients now rely on their families for most of their food, which is difficult for refugees, who make up over 10% of all admissions. In addition hyperinflation at over 75% per month means that hospital staff are unable to survive on their salaries. Although medical supplies are officially excluded from the international economic blockade of Serbia and Montenegro introduced on May 30, the extra paperwork required can cause delays. For example, around 50% of the country’s insulin comes from Denmark. For each order the supplier has to obtain an export licence from the Danish Government, which in turn has to get clearance from the UN to ensure that no materials are transported in violation of the UN Security Council resolution. The supply and distribution of insulin within the country is also irregular because many road links have been cut, and local companies are not ready to risk distributing insulin that nobody can pay for. Even in Belgrade insulin may at times be obtained only from private pharmacies. "In the past month there has been a 30% increase in cases of ketoacidosis. Most come from outside Belgrade", says Prof Predrag Diordjevic, chief of the