WeeklySA_AdminPARLOUS: Unions raise common grievances that include bad working conditions, workload and compromised public healthcare delivery…
By Pavan Kulkarni and Len Maseko
Unions representing thousands of nurses in both South Africa are up in arms over poor salaries and unsatisfactory working conditions, demanding urgent redress to the deepening crisis in the countries’ health sector.
The two unions pressurising their governments in separate disputes to address long-standing grievances raised by the nurses in their countries are Democratic Nursing Organisation of SA (Denosa) and Zimbabwe Nursing Association (Zina).
This week, Denosa members in Gauteng marched from Pretoria to Johannesburg to present a memorandum of demands to the Premier of Gauteng Panyaza Lesufi and the MEC for Health over dire conditions at public healthcare institutions, such as understaffing and healthcare workers have to work in dilapidated buildings.
They demand urgent action to tackle serious staff shortages and poor working conditions in a profession already reeling from stagnant salaries, workload, shortages and professional exodus amid a deepening global crisis. The Gauteng health department is also under fire over underspending and unspent budgets, compounded by Denosa accusations that vacant nursing posts have remained unfilled for nearly a year.
In Zimbabwe, the local union – Zina – has raised alarm over conditions faced by nurses in that country who are “living in abject poverty” as a consequence of low salaries –and unable to send children to school, or afford food, or to even secure transport to work.
Enock Dongo, president of the Zimbabwe Nurses Association says their members’ income was “far below the poverty datum line, rendering our nurses incapable of sending their children to school, buying clothes, affording food, or even securing transport to work.
“Many are walking long distances to their workstations, while others are forced to live in overcrowded single-room accommodations with their families due to an inability to pay rent,” complained Dongo.
In South Africa, while Health Minister Aaron Motsoaledi moved last month to address the critical shortage of healthcare professionals in the public healthcare system by announcing the approval of 1 200 new positions for doctors and 200 nurses, these measures have been dismissed as inadequate by Denosa. Under the new budget presented by the Minister of Finance last month, a total R1.78 billion was allocated to fund the recruitment of healthcare workers.
Describing the shortage of nurses in South Africa as “nothing short of a devastating crisis”, Denosa expressed deep disappointment and outrage at the Motsoaledi’s announcement regarding the recruitment of just 200 nurses into the public healthcare system.
“In the face of a nationwide crisis of nurse shortages, this announcement is not only shockingly inadequate but downright insulting to the nursing fraternity. The Department of Health has not only failed to respond meaningfully to the dire shortage of nurses across the country, but it has also shown a disturbing lack of shame in publicly announcing the recruitment of a mere 200 nurses—as though it were a breakthrough.
“This token gesture, coming after repeated calls for urgent and large-scale investment into nursing human resources, is a slap in the face to the thousands of nurses who are already stretched beyond capacity. It is an affront to those working under impossible conditions, often without rest, proper compensation, or adequate support,” Denosa added in a statement.
Denosa said these shortages had had devastating impacts, leading to:
• Patient care being compromised, with fewer nurses caring for more patients, increasing the risk of complications and mortality.
• Long waiting times in clinics and hospitals, poorer health outcomes and deepening inequality.
• Overburdened nurses experiencing burn-out, with many leaving the profession or emigrating due to untenable working conditions, further compounding the problem.
In Zimbabwe, real wages have sharply declined since 2018, with Zimbabwe having embarked on a failed experiment with a new currency – initially pegged at 1:1 with the USD, but sharply lost its value, eating into incomes.
The monthly salary of nurses, which in 2018 was an equivalent of USD 840 (R15 410), has sunk to less than USD 400 (R7 338) – 240 (R4 402), of which is paid in USD and another USD 150 (R2 751) (equivalent in ZiG).
Up to USD 120 (R2 201) was being deducted from the salaries of nurses staying in government accommodation as monthly rent for basic rooms.
“Shockingly,” Dongo added, “these deductions are made from the US dollar component of their salaries, not the ZiG portion,” which the Reserve Bank devalued 43% last September only months after introducing it.
The public often blames health workers “for delays and inefficiencies, but how can you perform miracles without even basic resources,” questioned Dongo. “There is a severe lack of medical resources, equipment, and essential drugs.”
The need to constantly improvise with the limited available resources leads “to long queues, slow service delivery, and increased suffering of patients. This also results in heightened exposure” of the nurses “to infections and extreme fatigue”.
To escape such working and living conditions, nurses have been emigrating en masse, especially to the UK, where they are being absorbed into the National Health Service (NHS) under a bilateral agreement. This brain drain has caused chronic staff shortages in Zimbabwe’s hospitals.
This has in turn overburdened the remaining nurses, who, while struggling to make ends meet on poverty wages, work long and irregular hours, with a “nurse-to-patient ratio as high as 1:20 or even 1:30 in some wards. This is unmanageable and endangers both patient care and nurse wellbeing,” warned Dongo.
Instead of addressing the root cause of this brain drain, which is poverty wages, the government is reportedly withholding the academic credentials of 4 000 nurses who have completed their courses to prevent them from leaving Zimbabwe for better opportunities abroad.
“This is a blatant infringement on their right to choose their employer, and we demand immediate release of these documents to all eligible nurses,” Dongo protested.
Meanwhile the World Health Organisation has predicted a global shortage of 10 million nurses by 2030.
In a survey conducted among 64 nursing associations announced last month, findings painted a grim picture showing increased violence against health care workers, poor pay, and exhaustion driving many nurses to leave the profession altogether across the world.
This shock trend was revealed in a new report released this week by the International Council of Nurses (ICN), which has warned of a deepening crisis in the global nursing workforce. The ICN comprises over 130 national nurses’ associations (NNA) representing millions of nurses worldwide. It highlights enormous challenges faced by the nursing profession currently.
Nearly half of the world’s national nursing associations (48.4%) have signalled a significant increase in nurses’ migration or exodus from the profession since 2021, according to the report. This was the dire consequences of stagnant salaries, poor health system performance, and growing violence directed at nurses, along with a continually increasing workload.
Meanwhile, southern Africa health systems rest on the shoulders of an overwhelmed nursing workforce, who in addition to servicing high patient numbers in poorly equipped hospitals and clinics are sometimes forced to operate from churches, schools and other non-traditional settings where they cannot access the tools they need to effectively deliver care, according to Healthy Policy Watch. “They are often poorly paid, overworked, and prone to burnout and constrained by limited opportunities for professional growth, yet they continue to discharge their duties with commitment, delivering much-needed care and saving millions of lives,” the non-profit adds. – Weekly SA Mirror, People’s Despatch
