IMPACT OF COVID-19 ON HEALTH WORKERS MAY DERAIL THE FIGHT
Samuel MuniuArticle Type:
Article Number: 4
Inadequate personal protective equipment and lack of support lead health care workers to strike amid the spread of the coronavirus
ABSTRACT The health workers' strike witnessed in some countries in the middle of a pandemic strongly emphasizes the need to strengthen the health workforce pillar of the healthcare system. In almost all of these strikes, inadequate personal protective equipment was the key issue. Governments need to ensure that frontline workers are protected if countries are to win the war against COVID-19.
The increasing number of countries grappling with health workers’ strikes while fighting the coronavirus disease 2019 (COVID-19) pandemic is a growing concern. Health workers play a critical role in the healthcare sector, and the World Health Organization (WHO) acknowledges them as one of the six core components of the healthcare system. They are at the core of the health system, enabling the system to achieve its goals. Health care workers provide services in health facilities, and during the COVID-19 period, have been on the frontline fighting the pandemic. There is every reason, therefore, for governments to motivate them and safeguard their welfare.
Countries grappling with health workers’ strikes
Health care workers’ strikes and protests have occurred in both developed and developing countries. According to France 24, France is one of the developed countries where health care workers, particularly doctors and nurses, took to the streets of Paris and other cities on 15 October 2020 to protest the working conditions in health facilities. Specifically, they required the government to hire more staff to help combat the surging COVID-19 cases, improve working conditions, and provide better pay.
In the United States, health care workers in Pennsylvania, Washington DC, New York, and California went on strike. For instance, 700 nurses from St. Mary Medical Center in Langhorne, Pennsylvania, went on strike on 17 November 2020 to protest against the lack of personal protective equipment (PPE), low pay, and understaffing that resulted in them working extended hours caring for COVID-19 patients.
In Zimbabwe, health care workers held a strike in June 2020. Their reason for striking was the insufficient provision of PPE and low salaries. The strike affected health service provision and hospitals turned away non-emergency cases.
Since early December, health care workers in Kenya have been on a nationwide strike and crippled public health services. They are demanding better working conditions, the provision of adequate PPEs, comprehensive medical cover, and the appointment of more medical personnel. Due to the increased risk of contracting COVID-19, they are also demanding an increase in their risk allowances. The country has already lost at least 14 doctors to COVID-19, and their demands for the provision of protective gear should be taken seriously.
In India, health care workers participated in a two-day strike in August 2020 to demand better pay and adequate PPE. At the time the government was struggling to contain the spread of the coronavirus, which had overstretched its healthcare system. The country had already over two million coronavirus cases and had lost at least 100 health workers to COVID-19. The government had not provided insurance cover for health workers, justifying their concern.
Doctors in Nigeria have gone on strike more than once in 2020. On 20 May, the doctors went on strike to protest police harassment during the government instituted lockdown, from which they were exempted. They embarked on a nationwide strike on 7 September 2020 to demand an adequate supply of PPE and better pay and benefits. This impacted on the provision of health services at public health facilities amid the spread of the coronavirus .
Three common factors driving industrial action by health care workers
Health care workers’ protests and strikes were common before COVID-19 and were mostly payment related. Striking health workers in the six countries had three common demands during the pandemic: better pay, improved working conditions, and adequate provision of PPE. The demand for adequate protection has been a recurring issue which governments need to prioritize since they are so dependent on the health workforce to fight COVID-19.
Expecting health care workers to perform their duties in the absence of adequate protection can be equated to sending soldiers to the battlefront without military gear. It is therefore vital for governments to equip and protect their frontline soldiers against COVID-19. As countries plan to roll out the COVID-19 vaccine, health care workers should be among the first to be vaccinated as their work puts them at higher risk of infection.
The need to motivate health care workers
Countries should learn from Ghana’s approach during the pandemic. The government of Ghana provided free transport to health workers during the lockdown as well as an insurance package and a daily allowance for contact tracers. The government also exempted all health care workers from paying taxes in April, May, and June 2020 and increased their basic pay by 50 percent for three months. These efforts aimed to boost the morale of the frontline soldiers who risk their lives to help contain the pandemic.
Since health workers are the healthcare system gatekeepers, keeping them motivated is one way of strengthening the entire system. The motivation and performance of health workers is closely linked to their job satisfaction. Improving the health care workers’ working environment, as well as providing them with adequate PPE, fair compensation, prompt payment, and specifically in the current COVID-19 context, the necessary support systems in the form of counseling, adequate time off where possible, and where time off is not possible, adequate overtime compensation, would be some of the ways of keeping them motivated. In addition, ensuring the career development of health workers and recognizing their work could boost their morale. Health worker retention also has the economic benefit of reducing the cost of recruiting and orienting new workers. Therefore, governments should be proactive in motivating health care workers rather than reacting to their plight when they are on strike.
The health workers’ strike witnessed in some countries should be a wake-up call for a need to strengthen the healthcare system’s workforce. Unless the health workers are adequately motivated and facilitated to perform their work, achieving health for all will remain a tall order.