Patrick Le Tréhondat Oksana Slobodyana
On 31 October, around 150 medical workers at the Oleksandriya hospital were made redundant and received nothing at the time of their dismissal, i.e. they were not paid for the last few months of work and received no compensation for unused leave. "We are outraged by the fact that salaries have not been paid for two months. Some of my colleagues cannot afford basic living conditions because their salary was their only source of income. The management has given no explanation to the staff and has not discussed the situation at a meeting", said Natalia Dimura, head of the employees' initiative group and a nurse at the hospital.
At the beginning of November, in the Khmelnytsky region, staff had to inform pregnant women of the closure of the maternity unit. They had to find another medical facility to give birth to their child. Nurses of the hospital who informed Be like Nina of the closure believe that the closure of this service could be the administration's revenge against the staff. There are activists in this maternity unit who run a collective labour council and are organising a union. "We are denouncing those who have taken public funds, we are fighting against corruption and those who are using the war for their own enrichment. We are fighting for our survival", say the nurses.
These two events illustrate the importance of the Be like Nina organisation in defending the Ukrainian healthcare system and workers' rights. Oksana Slobodyana, President of Be like Nina, was kind enough to answer our questions.
Can you tell us what the current situation is for nurses and hospital staff? Have working conditions and pay improved?
I will begin to answer this question by quoting Vitaliy Yunger, Deputy Chief Physician for Outpatient Care at the Feofaniya Clinical Hospital in Kyiv, who has clearly outlined all the problems facing Ukrainian medicine. He wrote on his Facebook page: “In fact, the Ukrainian healthcare system has long been suffering from a number of illnesses that have become chronic:
Shortage of staff. There is a shortage of qualified healthcare professionals. In recent years, this trend has been exacerbated by large-scale migration processes. Including those linked to war. Some medical workers have been mobilised. The state of medical care on the front line and in the liberated territories deserves particular attention. The workload of healthcare workers has increased significantly in all regions. Doctors are looking for jobs abroad. They are safer there, can plan their future with peace of mind and the salaries are much higher.
Low attractiveness of certain medical professions. This situation is the result of a shift towards medical specialities with a strong commercial component. Emergency medicine, including emergency medical care, family medicine, paediatrics, the nursing and paramedical sectors and a number of other specialities are the areas in which we are experiencing the greatest shortage of staff. At the same time, the healthcare system puts up barriers to entering the profession: it's expensive, it takes time and it's difficult to study. Secondly, it's not easy to find a suitable job in your chosen speciality, which, combined with low pay and exhausting working hours, makes the medical profession unattractive to young future professionals.
The management of healthcare establishments is not always efficient. The lack of strategic planning and effective operational management of healthcare establishments can lead to an irrational allocation of resources, both material and human. All this leads to demotivation and dissatisfaction among healthcare staff and, as a result, has a negative impact on the quality of healthcare services.»
As for the Ukrainian nurses, I'll say this: they've always had a difficult job. The situation was further complicated by the coronavirus epidemic, and then by the outbreak of large-scale war. Although we managed to get a pay rise before Russia invaded Ukraine, unfortunately not all healthcare workers now receive a pay rise. The war has also deprived some medical institutions of funds intended to improve the health and work of staff. In addition, the number of days of annual leave has been reduced. Despite this, care staff continue to do their work conscientiously. They no longer have the opportunity to defend their rights through demonstrations, but the health and interests of their patients remain their absolute priority.
Working conditions are also a difficult issue. The workload has increased: there are sometimes 30 to 40 patients per nurse. Psychiatry suffers the most: one nurse can manage up to 60 patients.
Health establishments continue to be closed, leaving many employees without jobs. For example, in the Kirovohrad region, the Oleksandriya hospital was closed without payment of salary arrears for several months.
In your recent statements, Be like Nina mention the problems of sexist discrimination against women in hospitals, particularly nurses, and gender equality. Can you tell us more about this? Is Be like Nina a feminist organisation? Do you have any links with Ukrainian feminist organisations?
Women, especially Ukrainian nurses, have an excessive workload. In the workplace, they are responsible for patients' health, must react in a timely manner and provide prompt medical care. At the same time, the majority of Ukrainian nurses are denied career development and are not encouraged to upgrade their skills. In addition to her work, a woman has to bring up her children, look after the health of her family and loved ones and look after the running of the home. That's why Be like Nina raises this issue time and time again. We're looking for an equal distribution of responsibilities in society. This is important to us, because our organisation is made up mainly of women and has over 85,000 members.
Be like Nina has always been supported by feminist organisations such as Feminist Workshop and Women’s Perspectives. Together we organise seminars and public events.
You also mention the creation of a platform to bring together healthcare professionals. Tell us more about this project.
In many hospitals in different parts of Ukraine, employees wanted to have independent trade unions. So we started to actively create local branches of trade unions. Be like Nina became the platform for their formation. We have our own regional union in Lviv, which has initiated the signing of an agreement with other independent unions. In the future, we plan to create a Ukraine-wide agglomeration of independent unions. Together, we will be able to protect our labour rights, develop health care and live in dignity in our own country.