Recently junior doctors in the UK have been in the news for taking industrial action in protest at their new contract. A similar situation is happening in Colombia. However it is harder to report on because of the imbalance of Colombian news media reports. (1-3)
Doctors in Colombia have gone on strike for a number of reasons. They are protesting against unfavorable labour conditions such as low wages, jobs without social security, and delays in payments of their salaries (sometimes for up to seven months). Frequent episodes of aggression against doctors and nurses are widespread across the country. (4) There is a lack of medicines and resources available which is hindering their ability to practice. Some doctors are opposed to reforms led by the health ministry while others favour a reform of the current healthcare system and repeal of Law 100. (Law 100 is the name of healthcare reform that happened in 1993). The public healthcare system is currently in a financial crisis in rural and urban healthcare centres, which is also made worse by widespread corruption.
As well as going on strike, during this past year there have also been reports of large numbers of doctors resigning from their posts across the country. (5)
What are they asking for?
Doctors are asking for better labour conditions, more transparency in the institutions operating under Law 100, access to medicines and materials to perform their job, and dignity at work. (6) There are different opinions among doctors about the current situation of the health care system. Some are asking for a reform of Law 100, but at the same time are opposed to changes in the health care system proposed by the health minister Alejandro Gaviria. (7)
Has it had any effect?
The massive resignation of doctors at Esimed Cali Norte IPS Saludcoop received attention by the news media at a national level (newspapers and television). (5) Other strikes and parades have also received a variable degree of attention by the news media. In terms of improving labour conditions there is still a long way to go.
Are there plans for any more strikes?
Yes, but these plans are mostly the product of sporadic initiatives instead of doctors unions. A page recently created on Facebook “Médicos con Dignidad” (Doctors with Dignity)—which has received a large amount of attention from doctors across the country—is calling for a national doctors strike on 17 March 2016.(8)
Have the doctors unionized?
Doctors trade unions are new in Colombia, the only exception is SCARE (the union of anesthesiologists) created several years ago. Approximately 18 doctor’s unions were created during the last year receiving legal approval and recognition by the national government. (2)
Colombia is the most dangerous country for trade unionists according to a report from the International Trade Union Confederation (ITUC) and there is no reason to think that unions of doctors in this country are free of any risk. Recently Dr María E. Guerrero (vice-president of SIMUC—Sindicato Médicos Unidos de Colombia) publicly exposed her concerns about the quality of medical care at the clinic Esimed Cali Norte. This was followed by threats of dismissal and reprisals (withholding her salary for four months). This was probably done to serve as a potential deterrent to unionists and whistleblowers. But Dr Guerrero went on hunger strike at the facilities of Esimed Cali Norte. The hunger strike ended on the 3 March 2016 after one week. (9)
Jorge Ramírez is a Colombian physician, PhD in Biomedical Sciences, currently working as a professor of pharmacology at Universidad Santiago de Cali, Colombia.
Competing interests: My conflict of interests are declared here.
References:
1. Doctors strike in Colombia? doc2doc forums.
2. “We have assumed the challenge to unionize” (…) doc2doc forums.
3. A summary of Law 100. doc2doc forums.
4. ¿Por qué agredimos a los médicos? El Espectador.
5. La sentida carta con la que 15 médicos retratan la crisis del sector salud. El Espectador.
6. Trade unions of general practitioners and specialists from Colombia: Open Letter.
7. Vuelve el “médico de cabecera”. El Espectador.
8. Médicos con Dignidad – Facebook.