Most vulnerable pay during strike
But what Nightingale has come to symbolise – humane, professional nursing -- has died hundreds of times over in South Africa during the public sector workers’ strike.
Despite the weekend court interdict ordering essential services staff including nurses back to work and prohibiting strikers from intimidating non-strikers, few nurses turned up for work this week.
Women with birth complications, premature babies, sick children, accident victims and people dependent on antiretroviral medication have literally been caught in the crossfire between strikers and government. Some have died already, while others will still die as a result.
In most parts of the country, with the exception of the Western Cape, no contingency plans have been made by unions to allow some workers rendering essential services to stay at their posts.
Despite the intimidation and threats of violence, a number of nurses have braved the protests to serve patients, some by sleeping over in their hospitals or arriving at work really early in the morning to avoid protestors.
But many have been assaulted for their efforts, mostly by members of the National Health and Allied Workers Union (Nehawu), which organises workers such as cleaners and porters.
“We are scared to come to work and sometimes we can’t come inside because of the protestors. But people mustn’t think we are relaxing at home,” said a nurse in Pietermaritzburg’s Grey’s Hospital.
“I support the struggle for better wages, but we haven’t been given an option about the strike. Why couldn’t the strike leaders co-ordinate this so that some of us could stay inside and protect the patients while the others were protesting outside?”
At the same time, plenty of nurses are whole-heartedly behind the strike.
One nurse at a Gauteng picket line spelled this out very clearly when she said: “The time of Florence Nightingale is long over. We want money.”
By allowing its members to enforce the strike with violence at the expense of patients, the unions have lost much public sympathy.
By turning their backs on the most vulnerable – the sick who have no medical aids that allow them access to private hospitals – union leaders have shown that the narrow sectarian interests of union members are their over-riding concern.
Cosatu members are able to pay for private doctors in times like this. Unemployed people don’t have that choice.
Cosatu general secretary Zwelinzima Vavi has even blasted those volunteers who have stepped in to help feed and clean the stranded patients, describing them as “scabs” who are “frustrating and angering workers”.
In doing so, Vavi has made volunteers vulnerable to attack. Yet unlike scab labour, most of those who volunteering have no interest in taking the strikers’ jobs. They have been moved by the plight of patients left lying in their own urine, unfed and unmedicated.
Health Minister Dr Aaron Motsoaledi himself has been volunteering at badly hit hospitals.
“Even during times of war, hospitals are never tampered with,” said Motsoaledi.
“If you get into theatre where somebody is being operated upon and you toyi-toyi there; you disrupt – you are committing murder. I can’t describe it in any other terms. You are saying this innocent person who does not even know what’s going on, must actually die. It can never be allowed. We don’t know any part of the world where such a thing is practiced and we are not about to allow it here.”
Ronnie Kasrils, ANC struggle veteran and former intelligence minister, this week described the violence of the public sector strike as “unacceptable and scandalous” and called for “a proper culture of protest in this country”.
“We fought for workers’ rights but we must insist on the correct type of protest methods to be used,” Kasrils told a meeting this week.
However, Cosatu has blamed the government, saying that its failure to reach minimum service level agreements with trade unions has meant that there is no “clarity with an agreed number of workers to continue providing a service in case of essential services”.
Government’s clumsy attempt to pass off a 1.5% performance-related increase as a revised wage offer has incensed the union movement and been described as “brinkmanship” by the Treatment Action Campaign and Section27.
However, government spokesperson Themba Maseko said that “90 percent of workers will get this increase” as there are few performance level agreements.
While the issue of wages is the burning issue for now, if government does want to improve the public sector it should also look urgently at concluding performance agreements with its employees alongside wage agreements.
For many years, high absenteeism, low motivation and sometimes complete indifference to patients has become entrenched in our dysfunctional health service.
It is no accident that hospitals notorious for delivering poor services, including Natalspruit and Edendale, have been worst affected by the strike.
At many such institutions, the culture of caring is long dead. Desperate doctors tell stories of a nurse “mafia” that refuses to co-operate and spends more time eating than caring for patients.
This poor work ethic will not be addressed by higher wages and can only be overcome by a total overhaul of the management of health services that includes ensuring that all health workers are held accountable for the services they render.
Cosatu has decribed the performance-based approach as being a “unilateral system is not an objective tool” where “bonuses are allocated on favouritism, nepotism and blatant unfairness”.
But the current “promote one, promote all” approach means that there is no reward for those health workers who go the extra mile, despite trying working conditions and no punishment for those health workers who simply lack the humanity to be in a caring profession.
But any management overhaul has to be backed by adequate resources.
In his Budget speech earlier in the year, Finance Minister Pravin Gordhan said that “the wage bill in the public service) has almost doubled in five years”.
“Now that a major revision to public service remuneration is behind us, it will be necessary to moderate salary increases going forward,” said Gordhan, somewhat optimistically.
“This is required to ensure that funds are also available for growth in public service employment and so that spending on school books, hospital building and maintenance of infrastructure is not compromised.”
Given that the recession has knocked government’s tax revenue, if the strikers’ demands are met money will have to be cut elsewhere. The bloated expense accounts of top government officials would be a good place to start.
The TAC and Section27 ascribe the “anger of workers” to “the growing inequality in our country fed by the conspicuous consumption of those who occupy high governmental office”.
While the wholesale looting of the economy by what Jay Naidoo calls the “predatory elite” continues, many government leaders lack the moral standing to call on their employees to tighten their belts.
There are not likely to be many winners coming out of this strike. But the biggest losers are the poor and the powerless, who have mutely turned away from the hospital gates without a protest, used to being ignored and trampled on.