Public support wanes for striking doctors in South Africa

Doctors in South Africa who have been striking since the end of May have again rejected the government’s latest offer, intended to redress a range of issues, including poor pay and conditions and inadequate facilities.

The strike—which the government says is illegal, as doctors are regarded as “emergency workers”—has closed public hospitals in several provinces in South Africa with the poorest and sickest patients. These include KwaZulu-Natal and Mpumalanga, which have higher than average rates of HIV infection, tuberculosis, and other diseases. Interrupting treatment for HIV and tuberculosis can cause resistance to treatment, leading to new problems.

Entire provinces, such as the Free State, have run out of antiretrovirals and several other drugs. In and around Johannesburg hospitals and clinics report they have run out of formula milk used by HIV positive mothers to avoid transmitting the virus through breast milk, because the company supplying the formula has not been paid. Broken equipment in many hospitals remains unrepaired, electricity and water supplies are regularly interrupted, and buildings are dilapidated.

Doctors began striking after promises by the government two years ago to restructure employment conditions failed to materialise. These would have seen salaries rise by between 30% and 50%. The most recent pay offer from the government (rejected by the doctors) claims to meet these figures in a large part. But a complex system of differing emoluments has scuppered the latest offer, as doctors say that their basic needs have still not been met.

For the past month South Africans have been seeing on television screens white coated doctors toyi-toying (a chanting dance associated with protesting) outside medical facilities.

Hundreds of doctors have been dismissed in the course of the strike in different provinces. Some have since been reinstated, and some remain technically dismissed. However, the doctors now face an inquiry into their behaviour by the Health Professions Council of South Africa, the country’s regulatory body for health professionals, which could result in their being unable to practise in the country.

The public’s support for the strike is waning. The South African Medical Association, the trade union federation Cosatu (the Congress of South African Trade Unions), and the health minister, Aaron Motsoaledi, have been begging doctors to return to work. In some areas doctors have returned, but many remain on strike.

Dr Motsoaledi, addressing parliament on his department’s budget vote, acknowledged the poor state of hospitals and the inept management and corruption throughout the system and that doctors’ salaries were too low. These were among the major issues that helped topple former president Thabo Mbeki last year, along with his very unpopular policies on HIV and AIDS. Five million people in South Africa are currently infected with HIV.

The global recession hitting South Africa, lower tax revenues, and pressing demands from other sectors, such as education, are making it more difficult for the government to meet doctors’ demands for better pay.