Communiqué of the 10th Plenary Session of the West African Health Sector Unions’ Network (WAHSUN) held at the Rwandan Trade Unions Confederation Secretariat, Kigali, Rwanda, on May 14-16, 2013
Introduction
The
West African Health Sector Unions’ Network held its 10th plenary
session at the Rwandan Trade Unions Confederation headquarters on May 14-16,
2013. Members-unions were represented by statutory delegates from the: Burkinabe
Midwives’ Trade Union; Health Services Workers’ Union of TUC Ghana (HSWU);
National Private Sector Health Workers’ Union of Liberia (NPSHWUL); Medical and
Health Workers’ Union of Nigeria (MHWUN); Rwandan Health Workers’ Union (RHWU)
and; Sierra Leone Health Services Workers Union (SLEHWSU), while officials of
the Public Services International Regional Office for Africa and Arab Countries,
member-unions of the Rwandan National Coordinating Committee of the Public
Services International as well as the national leadership of the Rwandan Trade
Unions Confederation graced the opening session of the programme. The Representative
of the Rwandan Hon. Minister of Public Services and Labour, presented a keynote
address and declared the Conference open.
WAHSUN
Plenary Sessions are usually held on a rotational basis amongst its
member-unions in West Africa. The 10th Plenary Session which would
ordinarily have held in Nigeria was re-scheduled to Rwanda, towards expanding
the networking of health workers unions with the intent of the emergence of
similar networks to WAHSUN in all the other sub-regions of Africa, with a view
to establishing a Pan-African health network that is well rooted.
The
meeting deliberated extensively on the state of health services in West and
East Africa, and the national situations in the different countries of WAHSUN
member-unions, and Rwanda. 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 Africa. Convinced that there is a critical need for
health workers on the continent to work ever more closely together in defence
of workers and for the development of healthcare delivery for the African
people; the delegates discussed in depth, on the challenge of building similar
networks in all the sub-regions, which would be united as a Pan-African
platform.
In
the course of its deliberations, the WAHSUN-in-session observed and resolved
thus:
1. The global economic crisis has not abated, after
almost a decade. The living and working conditions of poor and working people
continue to deteriorate, as the banks and other elite whose greed led to the
crisis in the first place remain keen on making the working class bear the
brunt of the present abysmal state of the world economy. But this approach only
worsens the situation, with increasing unemployment resulting in an aggravation
of poverty across countries. WAHSUN-in-session thus reiterates its call for
anti-cyclical socio-economic measures which place people and not profit at the
heart of social, economic and political development;
2. WAHSUN-in-session notes the fruiting of democratic
ethos in Africa and commends the way and manner political parties have pursued
their electoral interests, placing the rule of law over and above “do or die”
politics that had marred the past. This new found maturity of the political
elite on the continent has been aptly demonstrated in general elections that
have held over the past six months in; Sierra Leone, Ghana and Kenya. While
there were winners and losers, there was no slide into anarchy. Instead of
violent contestations, aggrieved parties headed to the law courts. While
acclaiming the politicians, and citizenry for this move forward,
WAHSUN-in-session urges them to maintain and deepen peaceful politics for unity
and progress;
3. WAHSUN-in-session notes that a few countries have made
substantial progress towards achieving the MDGs target, particularly for health.
WAHSUN further notes a correlation between the commitment of resources to
health and such success. Thus, WAHSUN-in-session commends those states that
have implemented the 2001 Abuja Declaration that member-states of the African
Union set aside 15% of their national budgetary allocation for healthcare
delivery, and urges the others to keep faith with this declaration.
WAHSUN also notes that the tasks of “realizing the
future we want to achieve” require greater commitment on the parts of the
governments and civil society in our different countries, and a “renewed global
partnership for development”, as the 2015 target of the MDGs draws to a close.
Thus, WAHSUN-in-session calls on trade unions and other civil society
organisations in the continent to rise up to the task of systematic and
concerted engagement with the ongoing post-2015 global development
agenda-setting process;
4. WAHSUN considered the legislation on Decent Work being
carried out by the Liberian Senate, as a welcome development that could help engender
qualitative improvements in the working conditions of workers in the country. WAHSUN-in-session
however notes with dismay that civil servants and maritime workers are excluded
from the provisions of the intended legislation and thus calls on the Liberian
government through the Senate standing committee to revert this exclusion, which
amounts to deprival of trade union rights and is an outright contravention of
the ILO Conventions 87 and 98. Further, WAHSUN vehemently rejects the provision
in the bill for management to deduct 5% of unions’ dues monthly, supposedly as
administrative charges. This is totally unacceptable and is not applicable
anywhere in the world, as it amounts to indirect charges on the workers;
5. WAHSUN-in-session noted the expansion of private
sector delivery of health services and is bothered by the consequent lowering
of standards in those private hospitals that poor and working people use, while
the others charge exorbitant fees. This situation emerged from the neo-liberal
onslaught on quality public services in the 1980s with the Structural
Adjustment Programmes, and became worse in the 21st Century.
WAHSUN-in-session calls for a reversal of this unfortunate situation and
insists that quality health is a fundamental human right.
Thus, WAHSUN demands increased funding of public
health and the holistic institutionalisation of health insurance for all.
Further, WAHSUN-in-session calls for stricter regulation of private sector
providers of health services. Towards ensuring this, there is a critical need
for greater union presence in these hospitals, which is why as employers of
labour, the proprietors of such private health facilities have been notoriously
anti-union. WAHSUN member-unions thus commit 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, and
calls for labour legislation that will make it more difficult for union-bashing
in private health facilities;
6. Ghana is one of the top-10 fastest growing economics
in the world and the fastest growing economy in Africa and yet Ghana remains
somewhat dependent on international financial and technical assistance.
WAHSUN-in-session is bothered that despite this picture of relative macro-economic
stability the living conditions of working people in Ghana have not improved in
a commensurate manner. Unemployment rates, especially for graduates, 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 remain awful. While WAHSUN notes an increase in
the monthly minimum wage for Liberian civil servants to $125.00, for which it
commends the Liberian government, it is however utterly condemnable that the
minimum wage in Sierra Leone remains $10 per month, this is one of the worst in
the world. Considering the nature of services that health workers render, this
deplorable situation is particularly intolerable. This has exacerbated
migration of much needed human resource for health. The resultant gross
under-staffing of public health facilities, gives cause for apprehension, as it
leads to an overstressed workforce, which could undermine the delivery of
health services.
WAHSUN-in-session thus views the situation in Liberia
and particularly 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. Further, WAHSUN calls on the Sierra
Leone Labour Congress (SLLC) to step in more vigorously to reverse the poor
wages and working conditions;
8. WAHSUN is bothered by the plight of pensioners in
Nigeria, noting that the problem has been particularly aggravated due to
corrupt practices of mind-boggling proportions in the management of pension
funds. WAHSUN-in-session commends the Nigeria Labour Congress and its
affiliates for their concern in addressing this serious problem which
undermines the wellbeing of senior citizens of the country. WAHSUN thus calls
for greater transparency in the management of pension funds, with enhanced
monitoring functions for trade unions, to ensure that the present painful
realities are curtailed and subsequently eradicated;
9. WAHSUN was greatly troubled by the sustained upsurge
of sectarian violence in parts of Nigeria. It regrets the painful loss of five
members of the Medical and Health Workers’ Union of Nigeria (MHWUN) and three
health volunteers, who were killed on February 8 by fundamentalist insurgents,
while they were conducting polio vaccination for children in Kano state. WAHSUN
expressed its condolence and solidarity with MHWUN and is convinced that an end
must be brought to the spate of sectarian insurgency, by any legitimate means
which the Federal Government could muster. WAHSUN however maintains a critical
view of the state of emergency declared in three of the most affected states, because
an earlier state of emergency in some local government areas within these same
states has been merely mute. WAHSUN-in-session thus calls on the Federal
Government of Nigeria to be decisive and proactive in taking necessary action
to curb the sectarian violence;
10.
WAHSUN regrets
the loss of lives and properties in the flood disasters that affected several
countries in the sub-region last year, particularly Nigeria and Ghana. It was
noted that a great deal of this adverse impact that is traceable to climate
change and continued non-sustainable development paradigms globally, could have
been mitigated, if proactive action were taken. WAHSUN-in-session observes that
there are clear meteorological warnings that there could be floods of a similar
magnitude this year’s rainy season and calls on the governments of concerned
ECOWAS member-states to immediately make all necessary efforts to prevent
another round of avoidable loss of lives, of the poor and working people, who
are the most vulnerable in the face of natural disasters;
.
11.
WAHSUN welcomed the Rwandan Health Workers’
Union (RHWU) into the ranks of the Network and expressed its appreciation to
the union for its hospitality in hosting the 10th WAHSUN Plenary
Session. It noted that this is an expression of the expansion of networking
amongst health workers’ unions in the continent towards establishing a
Pan-African platform of health workers’ unions. WAHSUN-in-session observed
that, with 96% coverage of its Community Based Health Insurance (CBHI), Rwanda
is one of the closest countries to achieving universal access to health
services. WAHSUN commends the Rwandan government for this distinguished
commitment to social development, which is also reflected in the utilisation of
a quarter of its total national budgetary allocation to health, and calls on
other states in Africa to borrow a leaf from this. It was further observed that
this is part of a broader dedication of the Rwandan government to good
governance and deep-seated national transformation.
WAHSUN however noted that there was no commensurate increment in the
wages of health workers last year when the government increased the wages of
civil servants. WAHSUN-in-session urges the Rwandan government to address this,
as it places health workers in a position of economic disadvantage, despite the
onerous work they do for the better health of all. WAHSUN-in-session realised that
a major part of the problem is that there is no collective bargaining structure
for health workers, or even the necessary institutional recognition for trade
unions in the country as autonomous, independent bodies, as they are fully
subsumed in the trade union confederation. While standing for building the
trade union confederation, as our strength lies in our unity, WAHSUN considers
it of the essence for sectoral structures and processes of collective
bargaining to be forged, if industrial relations issues in the country are to
be adequately addressed;
12.
WAHSUN noted the
commitment of the Burkinabe government to combating maternal and neo-natal
mortality and morbidity through increased funding and subsidy for health
services related to maternal, child and infant health. It is however bothersome
that there is still a great gap between the required human resource for health
and what subsists. WAHSUN-in-session calls on the Burkina Faso government to
make the training of health workers a matter of top priority. Further, WAHSUN
appreciates the affiliation of two health workers’ unions in the country to the
Public Services International and their relations with the Network. It further calls
for greater unity amongst these unions to make them stronger and better
equipped to defend workers’ rights;
13.
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 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.
Further, towards collectively defending the health and safety of health
workers in the sub-regional generally, WAHSUN will collaborate with health
sector management bodies to develop a sub-regional HIV/AIDS policy that will
bring universal best practice to bear;
14.
WAHSUN considers
the need for periodic immunization of hospital-based health workers against
Hepatitis B, in line with the World Health Organisation Ministerial decision,
as being of the utmost essence. It is unfortunate to note though, that, only a
few states such as Ghana are carrying this out. WAHSUN thus calls on the
governments of other countries in the sub-region, including: Nigeria, Sierra
Leone, Burkina Faso and Liberia, as well as Rwanda, to commence with this international
best practice.
WAHSUN also viewed the continued use of non-retractable syringes in
hospitals with angst as such constitutes putting both health workers and
patients to avoidable dangers such as needle pricks. Countries such as Nigeria
where the use of retractable syringes as policy is being upheld are hereby
commended by WAHSUN, while it calls on those yet to comply, to do so forthwith;
15.
The perennial incidence
of cholera in West Africa is a matter of very serious concern for WAHSUN,
particularly with the onset of the rainy season. 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 calls for the commitment of governments to maintain
their emergency preparedness to combat the scourge in the sub-region;
16.
WAHSUN-in-session
notes and commends the efforts of West African Health Organisation (WAHO) to
develop an improved and harmonized curriculum on emerging new diseases for the
training of health workers across West Africa. WAHSUN therefore calls on
governments of ECOWAS member-states to embrace this progressive effort and ensure that the various relevant institutions
in all these countries adopt the unified curriculum, in promoting the health of
the populace, because diseases have no borders;
17.
WAHSUN notes with
concern the irredeemable damage that brain drain has unleashed on the health
sector, in countries across the sub-region. This is based on the half-hearted
attitude, of many ECOWAS member-states’ governments in handling the people’s
health. WAHSUN therefore calls on the various governments, as a matter of
renewed consciousness, to take pragmatic steps towards arresting this bane,
that has seriously depleted our countries of much needed human resource for
health, that have been trained, more often than not, with public funds;
18.
WAHSUN acknowledges
that the challenge of ensuring qualitative health care delivery for the
citizens of countries in the 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 people 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;
19.
WAHSUN considered the Programme of Action of
the Public Services International as adopted at the 28th World
Congress held in December 2012 at Durban and commended the PSI’s robust sense
of initiative as demonstrated with the POA. WAHSUN-in-session adopted the
programme with a view to implementing it within the sub-region;
20.
WAHSUN-in-session
was greatly pleased by the on-going extension of networking amongst health
sector unions in Africa which the WAHSUN meeting in Rwanda, East Africa, is a
clear manifestation of. WAHSUN is convinced that this should be consolidated on
with the different sub-regions having networks towards the establishment of a
Pan-African platform of the different networks. This would enable health sector
unions to better defend members and also to be able to engage better with the
policy process needed for developing the health system at national,
sub-regional and continental levels, in the interest of the common African man,
woman and child;
Conclusion
The
10th 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 Africa.
WAHSUN
expressed its appreciation and that of all its member-unions to the Rwandan
Health Workers’ Union, the Rwandan Trade Unions Confederation, and the Rwandan
National Coordinating Committee of the Public Services International,
particularly the Energy, Water and Sanitation Workers’ Union, for their warm
hospitality. WAHSUN member-unions equally expressed their warm appreciation for
the Public Services International Sub-Regional Secretary, Brother Sani Baba,
who participated actively in the session’s deliberations for his continued
commitment on behalf of PSI, to the growth and development of WAHSUN.
WAHSUN
also appreciated the honour with which the Rwandan Ministry of Health welcomed
delegates, as high-powered delegations represented the Hon. Minister of Health
at both the opening and closing ceremonies of the 10th Plenary
Session.
.....................................................
Com (Dr) Ayuba P. Wabba mni
Presiding Chairperson
.................................................
Rev Richard Yeboah
National Chairman
Health Services Workers’ Union of the
TUC Ghana
....................................................
Mr. Garlo Isaac Williams
General Secretary
National Private Sector Health
Workers union of Liberia
(NPSHWUL)
................................................
Com. Ansu Rashid Kallon
Secretary General
Sierra Leone Health Services Workers’
Union (SLEHSWU)
............................................
Com Marcus I. Omokhuale
Secretary General
Medical and Health Workers’ Union of
Nigeria (MHWUN)
............................................
Bro Abu D. Kuntulo
General Secretary
Health Services Workers’ Union of Ghana
TUC (HSWU)
..........................................................
Sis. Mukaruzima Dativa
General Secretary
Syndicat du Personnel Desante (SPS)
Rwanda
.............................................................
Bro Nebie Boubie
Vice Secretary (Training)
Burkinabe Midwives’ Trade Union
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