Communiqué of the 9th Plenary Session of the West African Health Sector Unions Network (WAHSUN) held at the Health Services Workers’ Union Centre, Tema, Ghana, on September 21-22, 2012


Introduction
The West African Health Sector Unions Network held its 9th plenary session at the Health Services Workers’ Centre, Tema, Ghana, on September 21-22, 2012. In attendance were delegates from Health Services Workers’ Union of Ghana TUC, Ghana Registered Nurses’ Association, Medical and Health Workers’ Union of Nigeria, National Association of Nigeria Nurses and Midwives, Sierra Leone Health Services Workers Union, National Private Sector Health Workers’ Union of Liberia and officials of the Public Services International Regional Office for English Speaking (East & West) Africa. The Health Services Workers’ Union of Rwanda was represented in an observer status, while sister unions affiliated to the Ghana TUC as well as the national leadership of the Ghana TUC graced the opening session of the programme.

The meeting deliberated extensively on the state of the sub-region and the national situations in the different countries of WAHSUN member-unions. The delegates also held intensive discussions on deepening the commendable role of WAHSUN and its member-unions in the quest for better health services in the sub-continent.

In the course of its deliberations, the WAHSUN-in-session observed and resolved thus:

1.     The global economic crisis continues to subsist with dire consequences, particularly for the working people. This is reflected in rising unemployment and inflation rates. Unfortunately, governments have been attempting to find solutions with the same neoliberal tools that constitute the problem, which include; privatization, deregulation and cuts in social spending. WAHSUN-in-session calls for the reversal of this paradigm of development and the enthronement of a people-centred pathway to economic recovery which will include: more, and decent jobs; increased social spending and; participatory democracy from below;
2.     The present year is one where general elections will hold in Ghana and Sierra Leone, while gubernatorial elections will hold in Ondo state of Nigeria. This reflects the consolidation of democracy in the sub-region. WAHSUN-in-session welcomes this as a development from the era where military dictatorships held sway in West Africa. There is however the need to deepen democratic ethos in ways and manners that ensure the will of the people is aptly reflected in the results of elections. Thus, elections must be free, fair and transparent. Towards this, WAHSUN-in-session calls on all political parties, particularly those in power, to avoid politics of bitterness and division. WAHSUN member-unions, as leading unions in their different countries and across the sub-region will therefore be at the fore of campaigning for peaceful and issue-based electoral processes;

3.     WAHSUN-in-session was very much bothered by the fact that it is now very clear that countries in the sub-region will not meet the MDGs target, particularly with regards to health. This is very worrisome and avoidable with adequate funding for health care delivery. WAHSUN-in-session noted that most countries in the West African sub-region are nowhere close to meeting the 15% budgetary allocation for health as stated in the 2001 Abuja Declaration of African Heads of States. WAHSUN-in-session thus categorically reiterates its demand for compliance with this declaration towards revamping public health care delivery and thus helping to save the millions of lives;

4.     WAHSUN considers legislation on Decent Work, in general, as a step in the right direction as such could help in ensuring qualitative improvements on working conditions where and when this is genuinely done. WAHSUN-in-session however considers the formulation of the Decent Work Act by the Liberian government, as being questionable and contrary to the spirit of the Decent Work Agenda as enumerated by the International Labour Organisation. This is because it fails to cover civil servants and maritime workers, who comprise 60% of the country’s labour movement. WAHSUN-in-session thus calls for an amendment of the law for it to be universally applied to workers in Liberia;

5.     WAHSUN-in-session viewed the expansion of private sector delivery of health services with concern. This situation is largely a reflection of the cuts in social spending, particularly for public health which started in the 1980s with the Structural Adjustment Programmes. WAHSUN-in-session while calling for increased funding of public health noted that even when provided through private enterprise, health services are public services. The only way to make sure that private sector health providers inculcate this notion is by strengthening union presence in private health facilities, which are unfortunately, quite notorious for their anti-union stance. WAHSUN member-unions thus committed themselves to intensive campaigns at organising health workers in the private sector, both in defence of health workers, and in pursuit of qualitative health care delivery in general; 

6.     The downward trend of inflation in Ghana from 20.74% in 2009 to 9.5% in 2012 seems to be a very welcome development for which the Ghanaian government should be commended. Further GDP growth at 14.3% in 2011 surpassed the earlier projection of 12.3% for the year, which equally could be considered as a cause for cheer. WAHSUN-in-session is however bothered that despite this picture of relative macroeconomic stability the living conditions of working people in Ghana have not improved in a commensurate manner. Unemployment rates remain high and wages low. WAHSUN-in-session thus calls for the immediate commencement of negotiation between the social partners in the country towards establishing a living wage for workers and for instituting pro-people policies that would foster increased employment;

7.     The terms and conditions of work in the Liberian and Sierra Leonean public sectors are appalling to say the very least. With monthly minimum wage of $10, public sector workers in both countries are about the least paid in the world. Considering the nature of services that health workers render, this deplorable situation is particularly unacceptable. Gross under-staffing of the public health facilities, which is worsened by very high rates of migration due to poor wages and terrible working conditions have resulted in serious overworking of health workers.

WAHSUN-in-session views this situation in Liberia and Sierra Leone with grave concern and demands the: urgent upward review of wages in the countries’ public sector; mass employment schemes, particularly within the health sector and; enthronement of Occupational Health and Safety procedures in the workplace;

8.     WAHSUN was bothered by the seeming paradox of increase in both growth and poverty in Nigeria. While its GDP virtually doubled from $170.7 billion in 2005 to $413.4 billion in 2011, the poverty rate rose from 54% in 2004 to 69%, in 2011 with that for 2012 estimated at 72%, by the country’s National Bureau of Statistics. This situation has led to heightened disillusionment and increase in the incidence of social vices.

WAHSUN considered this state of affairs as arising from the mono-cultural reliance of the country’s economy on the oil sector as well as the legendary corrupt character of the country’s ruling elite. WAHSUN-in-session thus calls for an alternative model of economic development in the country which will place industrialisation and re-distributive social policy at its core. Further, the fight against corruption in the country must be hinged on building alternative social institutions which rest on trade unions and progressive civil society organisations that are genuinely interested in making sure that corrupt elite in the country are duly checkmated.

9.     WAHSUN was as well gravely concerned by efforts in the Nigerian Senate and in the Adamawa State House of Assembly at passing anti-strike legislations, aimed at circumscribing the legitimate right of workers including those in the health sector to withdraw their labour power as a final alternative within industrial relations practice. WAHSUN-in-session categorically warns against the consummation of these efforts as such would be vehemently resisted;

10.                        WAHSUN appreciated the fact that managements of public health facilities in countries across the sub-region are committed to the promotion of Occupational Health and Safety (OHS). Considering the peculiarly hazardous nature of work in the health sector, this is a progressive step forward. WAHSUN-in-session however noted that the implementation of effective OHS and policies and procedures require institutionalised collaboration and social dialogue between the trade unions and managements. In this regard, WAHSUN-in-session demands the establishment of bi-partite OHS committees with representatives of both the trade unions and the managements at workplace level;

11.                        The incidence of the cholera epidemic in West Africa is a matter of very serious concern for WAHSUN. In Ghana, there have been 5,800 reported cases with 60 deaths, while in Sierra Leone, a state of emergency has been declared over the epidemic which has claimed 273 lives. In Guinea and Senegal, over 10,000 persons have been affected by the epidemic as well. Similarly not less than 87 persons have died from this scourge in Nigeria. WAHSUN noted that the epidemic has been located in slums within these countries, which have greatly increased in recent times due to rising poverty.

WAHSUN-in-session pledges the commitment of its member-unions to combating the epidemic with all fervour. WAHSUN however notes that at the heart of this health problem are crucial socio-economic questions of destitution, unemployment, poor housing, poverty and pauperization which the governments of states in West Africa would have to address. Further, this epidemic reveals the poor state of public health care, particularly environmental health services, due to inadequate concern by governments, despite the expertise of trained human resource for health.

12.                        WAHSUN acknowledges that the challenge of ensuring qualitative health care delivery for the citizens of countries in the West African sub-region would require the concerted efforts of all stakeholders in the sector and a re-definition of the dominant paradigm guiding policy. Towards placing the common man, woman and child at the heart of health policy and practices, WAHSUN will embark on a 3-year Campaign for Quality Health for All in West Africa, from 2013. This campaign will equally be a major platform of advocacy for improving on issues that militate against qualitative health care delivery such as: inadequate and poor state of equipment and logistics, including standard medicines; unacceptable patient-health worker ratios and; violence at the workplace.

Conclusion
The 9th plenary session ended with a rededication of WAHSUN affiliates to deepening the growth and development of the Network and contributing significantly to the improvement of public health care delivery and the betterment of the lives of the millions of people in the sub-region.

WAHSUN expressed its appreciation and that of all its member-unions from outside Ghana to the Health Services Workers’ Union and the Ghana Registered Nurses Association for their warm hospitality. WAHSUN member-unions equally expressed their warm appreciation for the Public Services International Regional Secretary, Brother David Dorkenoo and the Sub-Regional Secretary, Brother Sani Baba, who participated actively in the session’s deliberations for their continued commitment, to the growth and development of WAHSUN.
    


.................................................
Rev Richard Yeboah
Presiding Chairperson



.....................................................
Com (Dr) Ayuba P. Wabba mni
National President
Medical and Health Workers’ Union of Nigeria (MHWUN)



...................................................
MR. Kweku Asante Krobea
Chairperson
Ghana Registered Nurses’ Association
(GRNA)



....................................................
Mr. Momo J. Kamara
National President
National Private Sector Health Workers union of Liberia
 (NPSHWUL)



................................................
Com. Ansu Rashid Kallon
Secretary General
Sierra Leone Health Services Health Services Workers Union
(SLEHSWU)


............................................
Bro Abu D. Kuntulo
General Secretary
Health Services Workers’ Union of Ghana (HSWU)


......................................................
Dora Etuk
National Association of Nigeria Nurses and Midwives
(NANNM)


..........................................................
Sis. Mukaruzima Dativa
General Secretary
Syndicat du Personnel Desante (SPS)
Rwanda


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