Permanent Emergency
Medical Care Comes Second as Nurses Strike

April 1st, 2009
by Jay Chub


Director Lastenia Cruz in front of an empty hospital hallway.

Director Lastenia Cruz in front of an empty hospital hallway.

Roatan residents seeking medical treatment during the nurses’ strike at Roatan’s public hospital were turned away by a simple yellow and green union flag hanging on the hospital’s entrance. After the fourth strike in just six months, everybody knows what the flag means: yet again, the nurses are on strike.

The national strike began on February 27, and at Roatan Hospital involved over 140 staff: 43 auxiliary nurses, and cooks, guards, statisticians, receptionists, pharmacists and laundry workers. To at least offer emergency services, the Roatan Hospital director Lastenia Cruz ran a skeleton staff of 14 licensed nurses supporting the hospital’s 12 doctors, who did not join the strike.

“We are canceling about 10 planned surgeries daily”, said Cruz. “We do two or three urgent surgeries daily. There are no outpatient consultations, and people who were treated before the strike can’t return for their checkups.”

The aim of the strike was to secure better work conditions, more medicines, and better pay. “It’s their [hospital worker’s] right to strike. They have the right to be paid and even fed while they strike. If they blocked me from entering the Hospital I would have to respect that,” said Cruz who has become accustomed to running the hospital under strike conditions. “We operate in almost a permanent state of strike.” According to Cruz, Roatan hospital came to a halt in September, October and November of 2008. “We’re on an island, so people are affected heavily when the hospital is hit by a strike”, says Director Cruz. “It’s not like the mainland where people have lots of clinics.”

Dr Oscar Avila Cruz of Roatan Hospital stands in a deserted corridor with eyes blackened by obvious fatigue. The corridor joins the emergency and maternity wards and “is normally packed with patients”, says Dr Cruz. “Some days you can barely pass by.” But today just two patients sit on long, well-worn benches that could easily hold 20 or more.

As Dr Cruz leaves the hospital after a long shift to pick up his daughter from school, two patients call from behind curtains and he stops to treat them. He doesn’t know much about the strike, and seems too busy or exhausted to care. “I’m not that interested, I don’t know what they’re fighting for. I just hope it’s resolved soon”, he says.

Dr Cruz says that many patients who would otherwise be treated as outpatients come to the emergency ward during a strike. “I’m obligated by oath to attend to anyone who comes, whether there’s blood or not. I’m seeing patients with colds and coughs mixed in with potentially fatal wounds and conditions.”

Carla Gusman, 29, works as an auxiliary nurse, trained for maternity and emergency care. Ms Gusman is one of the nurses working in the emergency ward during the strike. “We keep working, because the others don’t have the training and knowledge”, she says. Ms Gusman sees big rises in the maternity and emergency sections during strikes. “Our patient load goes up something like 70%”. But Gusman supports the cause of her fellow workers. “We have the rights to do this, but we need to reclaim them. I work harder to support striking nurses. I don’t mind. I’m used to it”. Instead Ms Gusman’s greatest fear of strikes is that she may end up in one. “Gracias Dios I’m working instead of waiting, and I’m never bored”.

Argentina Alvarado spends her days waiting at the hospital during the strike. Ms Alvarado works as a receptionist at the hospital and agrees about the boredom. “It’s boring to be here, but it’s a just cause because without these new conditions we can’t survive”. Her friend Orchid Connor is an auxiliary nurse who trained two and a half years for her profession. “I would rather work and use my skills, but we need to strike. I even come here on days off to support the strike”.

When Trochez began work at the Roatan Hospital 15 years ago when he says his salary was just 425 Lps. a month. He now leads the fight to raise salaries of Roatan Hospital staff to 15,000 Lps. For three years Trochez has served as president of Chapter 49 of Sitramedys, the national Honduran medical workers union. Trochez is a man clearly in charge. He takes in the width of the room in a few large and easy strides, crossing to chat with one or another striking worker. The real negotiation happens in Tegucigalpa, where meetings with the President’s office and union executives resolve each strike – eventually.

So the scene at Roatan hospital is one of inaction. Trochez sums up the day’s plans: “We have meetings, sit down and do nothing until we get what we want.” When asked whether it’s fair that striking workers are paid full wages and meal benefits, Trochez’s answer is clear: “Yes. It’s the only way. It’s not our problem, it’s the state’s problem.”

In a country struggling to meet basic medical needs, a culture of negotiation through confrontation is the standard. Pressure has taken priority over planning as striking gets results for more than just workers’ salaries. “If we’re waiting on an order of medicine to arrive we might strike to get it here faster. If a doctor is moved away without a replacement we’ll strike. Unfortunately strikes are the only thing the government takes seriously”, says Trochez.

Trochez confirmed that although the strike runs for 24 hours a day on the mainland, in Roatan the strike has a ‘working hours’ focus. “We don’t like to be on strike, we know that it’s the poorest people who suffer most because they can’t afford private medical care,” said Trochez.

In eight Honduran departments 68 hospitals were on strike in March. While the government may reach a compromise a chance of the protests taking place again is likely. Trochez says that the strikes are all for the same reason: to pressure the government to follow through on commitments made during previous negotiations.” [/private]

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