Now That's a Labor Problem

I remember back in a previous life when I was an intern at General Motors (good thing I didn't stick with that career path!) everybody was worrying about a possible auto workers' strike. The impact would have been...I don't know...decreased productivity and profit, some extra time with the family for the workers. Half of the French population strikes each year because they want a 4-day weekend. But in the end, I'm not sure how much these disputes affect daily life. Now imagine a labor dispute causing the hospitals and clinics in your country to close for months. Unthinkable? Not in Benin.

For three months now, nearly all public health services throughout the country have been closed, including even emergency care. Some open just one day a week, others not at all.

Not only have routine health services shut down, but due to the strike, Benin failed to take part in an 11-country polio vaccination campaign that was supposed to start on May 29th. In unrelated news, Benin has recently reported 20 new polio cases to date in 2009, compared to six cases in all of 2008 and zero cases from 2006-2007. 19 cases may not seem like a lot, but this is a disease that is on the brink of being eradicated. One polio case in a country is a failure. This news from Benin is an unmitigated disaster. Only three countries - Nigeria, India, and Sudan - have had more cases this year. That's a country with over a billion people, one in endless war, and one that's Nigeria (the perennial problem child when it comes to polio and vaccination rates). In terms of cases per population, Benin is number one. It's not known when the campaign will take place here.

So how does this happen? I don't know all the details, but it seems clear that a large portion of the blame has to go to incompetent management within the Ministry of Health and questionable priorities at higher levels. The whole problem started when the Ministry granted a bonus to doctors at the central level. This set off a chain reaction with every other level of health worker demanding a similar bonus. Unfortunately, the government doesn't have nearly enough money to pay for this. They approached international donors about covering the gap, but this goes against pretty much every donor's policies. So, they didn't pay and the health workers striked. And kept on striking.

To make matters worse, a couple ministers reportedly made a deal (without the approval of the president) to pay the bonuses to a larger number of health workers. Then they went on the news and announced the strike was over. Unfortunately, there were two problems: 1) they don't have the money and 2) the deal still didn't cover a large number of lower level health workers (who basically are the health system in Africa) and so the union was not satisfied. So, the doors remain shut.

I sure hope I don't get sick.