Unacceptable working conditions, wages suffocated by galloping inflation and other structural problems. About 15 days after the start of an “unlimited strike”, the president of the union of health workers at the Hospital of the State University of Haiti (HUEH), Évelyne Frémont, believes that the hospital of the he State University of Haiti is not the priority of the authorities.
“If the Minister of Health was understanding, the director general took on a rather condescending air with the strikers. He made a whole presentation to prove to us that the problems mentioned are not real, ”denounces Évelyne Frémont. In the meantime, the workers, furious after the meeting with the health authorities, barricaded the rue Saint-Honoré. They proclaim loud and clear that the lifting of the strike now depends on the authorities.
On the list of demands, according to Évelyne Frémont, are 19 months of debit card, a salary adjustment and improved working conditions.
For her part, the executive director of the HUEH, Dr. Jessie Colimon Adrien, stresses that these claims go beyond the power of the hospital management. “From the start of the strike, I informed the highest authorities of the MSPP and we stayed in contact with a view to finding a solution,” said Dr. Jessie Colimon Adrien.
A source from the MSPP requesting anonymity adds, however, that health workers at HUEH must show understanding so as not to enter into an endless cycle of claims. “The Minister inherits some problems that he will not be able to solve overnight. The workers must agree on an acceptable minimum, engage in a process of dialogue with the MSPP, in order to gradually improve the situation”, reports this source from the MSPP.
In the process, at the start of the week, the staff of the Justinien university hospital serving the far north went on strike. “We try to do our best not to abandon hospitalized patients, but the hospital has been dysfunctional since Monday. If nothing is done, it will be total paralysis,” laments a resident at Justinien University Hospital.
Never mind, residents of the maternity ward at the Peace University Hospital are threatening to go on strike this week. Since the last residents’ strike launched on March 28, 2016, university hospitals have been virtually on autopilot. No thought has been given to finding a lasting solution to the recurring crisis in public hospitals in Haiti.
After approximately six months of strike, it is the president Jocelerme Privert himself who was obliged to take the reins of the negotiations. “While waiting for a final solution, President Jocelerme Privert decided firmly, our best offer is to double the compensation costs – 100% increase, we cannot go beyond because we live in a lean period. All of you, doctors on duty and administrative staff, must make your contribution to the reopening of the hospital so that Haitians can enjoy their right to health care. »
It took 183 days, or 2 months after the declarations of President Privert, for the reopening of public university hospitals. Since then, no lasting solution has been considered, not even the finalization of the reconstruction of the HUEH.
The late Maurice Mainville, executive director of the HUEH at the time, predicted the collapse of university hospitals within a decade if the state did not agree to engage in real reform.
For him, the strikes were the tip of the iceberg. “We risk the total closure of university hospitals. The cost of living is rising, there is a governance crisis, sometimes conflicts of interest that prevent HUEH from playing its role. All of this must be the subject of a sincere discussion in order to initiate real reforms, ”said Dr Maurice Mainville in an interview given to Le Nouvelliste in June 2020.
“A whole series of short-term adaptations to the current funding model are also needed. Make public hospitals competitive; strengthen the autonomy of hospitals; improve the performance and management of hospitals and prepare for the establishment of an information and internal financing system”, he had proposed in a reform document.
To achieve this, the former executive director of the HUEH had proposed a set of priority strategic axes, starting with a framework law. “We need a law on hospital reform in order to strengthen the autonomy granted to public university hospitals and certain public departmental hospitals. The main law will be that which confers on public university hospitals and certain departmental public hospitals a special status, that of public health establishments (EPS). These public health establishments would provide services such as care, prevention, education and vocational training, and scientific and medical research. It is important that laws on hospital reform be drawn up since, for a long time, the management of hospitals has remained unsatisfactory, stock shortages persist leading to work stoppages; This is evidenced by the situations experienced by many public hospitals and public university hospitals recently.
At the implementation phase, Dr. Mainville pointed to four prerequisites for beginning the reform:
“1) the management autonomy of hospitals with decision-making bodies including the various stakeholders and executing bodies as well as administrative, financial and professional control mechanisms;
2) the rationalization of human resource management with a specific status for civil servant health personnel as well as the aspects of encouraging the abandonment of anti-values;
3) the effective financing of the hospital system: an adequate budget, an effective disbursement of the voted State budgets, the organization of a solidarity fund, the development of health insurance and other mechanisms;
4) development of leadership at the MSPP level to steer hospital reform, particularly in terms of budget, institutional support, and performance requirements for each health care establishment.”
Also, he stressed, as long as public hospitals with a university vocation are not reformed, the Haitian health system will not be able to meet the needs of the population. Covid-19 has precipitated many short-term interventions.
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