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 Saturday 04 September 2010
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SOUTH AFRICA: Survivor's guide for non-striking health workers

Photo: Anthony Kaminju/IRIN
The army has deployed staff to help out at some public hospitals
JOHANNESBURG, 2 September 2010 (PlusNews) - Public sector strikes in South Africa have become so common in recent years that people are asking if plans should not be put in place to prevent the disruption of HIV and tuberculosis [TB] treatment, and prepare health workers.

Striking public sector health workers launched industrial action on 18 August in a quest for better pay and benefits, and have barred patients and non-striking staff from entering many state hospitals and clinics. A handful of health workers have managed to continue providing essential services.

IRIN/PlusNews spoke to some of the non-striking health workers, who asked not to be named, about how to keep a hospital that treats patients with multidrug-resistant tuberculosis (MDR-TB) and HIV/AIDS running during a strike.

Here are some of their suggestions -

1. Been there, done that? Share. Staff who have not experienced strikes before, especially junior staff, might not know what to expect. Sharing lessons learned from previous strikes can help them overcome fear and stay focused.

One health worker who experienced a strike in 2007 said she was able to reassure junior staff that the current strike would not turn violent. "I have an inherent trust that the community wouldn't do anything [violent], and that helped," she said.

2. Identify core functions. Pharmacy, laundry, kitchen, removal of medical waste and corpses, and notifying the families, were prioritized by health workers in the hospital when the strike started.

"We had to make sure that we could still notify families, which meant getting at least two contact numbers. In my [rural] area this usually meant getting more than that, because inevitably at least one of the numbers you get won't work. In a lot of cases, this usually means getting the number of a neighbour or a community health worker."

3. Man the switchboard. Communication between staff, provincial health authorities and community members is vital. Reports of strike-related violence could scare many patients away, even from health facilities that were still functioning.

"You've got to have someone savvy; someone that isn't going to blurt something out that will compromise security."

4. Security is essential. Health workers said security services not only ensured safety and allayed fear, but security personnel also often helped out with non-medical duties.

"We gave patients in the wards our numbers and the security guards pulled the night shift; it was the only way to do it, or else we would have lost everyone to burnout. We had security guards sweeping and mopping floors, sitting with patients through the night."

5. Mark your keys. Everything from medication to nappies (diapers) is under lock and key at the hospitals, and health workers reported that in the absence of staff members who usually handled these keys, looking for the right ones could waste time.

"Medical managers have like ... [many] keys ... and you have to go through and try each of these keys just to get a nappy out."

6. Orientate your volunteers. Health Minister Aaron Motsoaledi has volunteered his spare time at strike-hit hospitals, as have hundreds of other South Africans. Volunteers could definitely reduce the workload of the few remaining skilled staff, but this was not always the case.

"Volunteers can mean that more of your time has to be spent monitoring them, so what they do must be ... something that they can do unsupervised. I could ask someone to organize a storeroom full of medicines ... but then it would take me twice as long to redo it correctly."

7. Ask striking workers who live on the property to leave for the duration of the strike. This can help the mental well-being of patients and those staff who are not striking.

8. Coordinate with emergency services. Health workers suggested that strike action be included in the emergency planning of hospitals and clinics - as floods and large-scale accidents are - and that coordination between health facilities and emergency services be improved.

"We had one drug delivery that was turned away because [emergency services] said they couldn't get through. We have no problem collecting supplies from [them] when the protestors aren't there."

9. Allocate duties at the outset. Many health workers said the division of labour eventually took shape, but duties should be assigned at the start. Because they had to rely on each other during the strike, their teams became stronger rather than falling apart.

"If you have staff you think might slack off, or are very junior and nervous, formal allocations initially are a good idea, both for team work and also for equity.

"Our male doctors didn't really do the dirty work, like laundry. I had a blackboard where I would write down what needed to get done ... [but] you can't plan for every day, because you never know who's going to be there; you're literally dealing with every day as it comes."

10. Hold daily meetings to stay in contact, and debrief. Health workers said they had informal staff meetings in the mornings and after lunch to discuss what needed to be done.

During the day they updated each other on the hospital's needs with text messages as they moved through the wards. At night, they often gathered at a co-worker's house to debrief, to laugh about what was funny, and sometimes to cry about what wasn't.


Theme(s): (PLUSNEWS) Care/Treatment - PlusNews, (PLUSNEWS) HIV/AIDS (PlusNews), (PLUSNEWS) PWAs/ASOs - PlusNews


[This report does not necessarily reflect the views of the United Nations]
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