If nurses' salaries do not increase and if their working conditions do not drastically improve, South Africa's healthcare system will fail, Democratic Nursing Organisation of South Africa (Denosa) president Simon Hlungwani said in a letter to President Cyril Ramaphosa.
The open letter, penned on Thursday, outlined how nurses had worked hard during the Covid-19 pandemic with little reward.
Hlungwani said that in Ghana healthcare workers were given a tax break for three months starting from April, while in Zimbabwe, government started to pay healthcare workers a Covid-19 risk allowance.
He said that in the state of Louisiana in the US, legislation was passed giving healthcare workers on the frontline in fighting Covid-19, a rebate of $250.
"The salary increase for public servants for this financial year should have been paid on 1 April 2020 in line with the collective agreement that was signed by both government and labour representatives in May 2018," said Hlungwani.
He added: "Despite this failure by the employer to honour its side of this agreement, government workers have continued to do their work diligently."
He claimed government defied paying public servants their salary adjustment for the 2020/2021 financial year for six months – this, after a resolution was signed in 2018 between labour unions and government.
Hlungwani said more than 27,300 healthcare workers contracted the virus and that 240 had died.
"Despite this high death rate among healthcare workers and many challenges that confront them in the workplace daily, they have continued to throw themselves in their work selflessly."
He lamented that workers had tried their utmost to address their concerns through the usual channels.
"As a matter of context to the non-adjustment of workers' salaries, the Labour Court is the third avenue that labour unions like Denosa are going through to force government to be honourable and pay salaries of public servants."
Hlungwani claimed there were "endless delaying tactics by government".
"The collective bargaining platform is the only way that nurses can get their bread and butter issues addressed. But the technical route this platform has taken recently, often because of government representatives, no longer inspires confidence that it will resolve this urgent matter."
He added that there was a shortage of human resources, leaving staff working on skeleton levels at "the time when we have longer queues in facilities".
"The nurse to patient ratio, according to reports from our members in facilities, is at an alarming rate of 1:45 (one nurse per 45 patients). In public hospitals, the ratios range from as high as one nurse per 20 patients to as low as one in 45 patients.
"Anecdotal evidence from a province like the Eastern Cape suggests that it has reached one in 50 patients in some general wards, one in 10 patients in some post-natal wards and one in 80 patients in clinics."
He added: "The direct translation of this, Mr President, is a severely compromised quality healthcare service for patients."
Hlungwani said there was also a persistent shortage of equipment and medication.
"There is often no medication for chronic conditions like ARVs, TB, hypertension and others.
"Often, there are no oxygen gouges and BP machines in clinics. Currently, there is no nursing strategy in place within which the nursing profession in the country operates. We are operating willy-nilly."
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