Military sent into hospitals

Striking Sri Lankan health workers defy intimidation

By Ajitha Gunaratna
27 September 2003

More than 80,000 public sector health workers in Sri Lanka continue to strike after trade union leaders failed in their attempts yesterday to reach a deal with the government to shut down the dispute. The ruling United National Front (UNF) offered none of the concessions expected by the unions, which face mounting opposition from striking workers against any backdown.

The strike, which began on September 17, has continued despite government intimidation and the widespread use of the military as scabs. It is the largest and most protracted public sector industrial action since the UNF came to power in December 2001. Hospitals and medical institutions throughout the island have been paralysed as paramedics, clerks, drivers, public health inspectors, midwives and nurses walked off the job.

The Health Sector Trade Union Alliance (HSTUA), an umbrella organisation of 54 health sector unions, was compelled to call an indefinite strike after their attempts at bargaining a compromise deal failed. Over the last month, the unions launched two token strikes but the government failed to respond to the workers’ demands.

The union is calling for a pay rise to end an anomaly created by a 43 percent increase given to medical officers last April. Hard-pressed by the rising cost of living, virtually all health workers except for doctors have joined the industrial action. This includes indigenous medicine (Ayurvedic) practitioners, who have not joined previous campaigns.

Thousands of striking nurses have defied their Public Service United Nurses Union (PSUNU) leaders, who refused to support the campaign. PSUNU leader Muruththetuwe Ananda, a Buddhist cleric, tried to justify the union’s stand with the divisive argument that the proposed pay rise would create new salary anomalies between paramedics and nurses.

On Monday, about 30,000 striking health workers rallied at Lipton Circus in the heart of Colombo to demonstrate their determination to continue the campaign. Despite all efforts to divide workers, the protest was remarkable for its diversity. It involved both Tamils and Sinhalese, health employees from diverse occupations and workers from other sectors, including the banks, railways and the press, who showed their solidarity by participating.

The government has mounted an offensive to attempt to crush the strike, which constitutes a direct challenge to the program of economic restructuring demanded by the IMF and World Bank. Its plans include further budget cutbacks, including to public health and education, and steps towards the privatisation of these services. The Treasury has complained that it will have to provide 3,300 million rupees ($US35 million) annually to pay the country’s 98,000 health workers if their demands are granted.

A day before the strike began, police were deployed at the main hospitals and at the National Hospital of Sri Lanka to disrupt a union meeting. The following day, the Health Ministry cancelled all leave for health workers and sacked 1,600 substitute and casual workers who joined the strike.

Thousands of army, navy and airforce personnel have been sent into the public hospitals to take over the duties of the striking workers in direct contravention of Sri Lankan law. Under the country’s draconian emergency laws, the government can deploy the armed forces, but only if it issues essential services orders. The precedent for its illegal action has been set by the use of the military against hospital workers in July and against a protest strike by railway workers. None of the unions has challenged the legality of these actions.

Police arrested the Matara branch secretary of the All Ceylon Health Services Union, H.L.Nishantha Lekamge and union member G.A.Candrasena on Tuesday. The two were later released later on bail. Several workers have been victimised, including an administrative officer, Mala Siriwardane, and a paramedic in Ampara, both of whom have been forcibly transferred.

The government has recruited 700 new workers to replace the sacked contract workers and recalled some retired workers. Health Minister P. Dayaratna has announced that India has been asked to send a team of technicians to carry out the duties of radiation therapists. In a bid to bolster the government, leading private hospitals have indicated they will provide some services for free.

The state and private media have viciously attacked the “mafia tactics” of the health workers, blaming them for the deaths of patients and calling for even tougher measures. The pro-government Daily Mirror declared that the government should follow the example of Tamil Nadu, where a public sector strike in July was banned and hundreds of thousands of workers sacked. It also called for patients to organise protests against the strikers.

The Liberation Tigers of Tamil Eelam (LTTE) has rallied to the side of the rightwing UNF government and called on workers in the north and east of the island to end the strike. Some workers returned to work, fearing they may face reprisals, including physical attack. But at the main hospital in the northern town of Jaffna, employees defied the LTTE and held a picket on September 25.

Union deal falls through

While workers have indicated their determination to continue the strike, union leaders have been desperate to find a way to call it off. On Thursday night, the HSTUA leaders held a four-hour marathon discussion with a cabinet sub-committee in an effort to reach a deal. An arrangement was reached whereby the government would reinstate the sacked workers and, in return, the unions agreed to await a Treasury decision on November 4 on the salary claims. This was the very issue on which the strike erupted—workers were rejecting any further postponement.

The union leaders spent all of yesterday hanging around the offices of the Health Ministry awaiting confirmation of the agreement. To their dismay, however, the ministry refused to reinstate all the workers, indicating only that it would consider their appeals. Faced with hundreds of workers at their offices opposing any sell out, the unions announced the strike would continue.

A hospital attendant told the WSWS: “We are on strike to increase our wages. If the alliance leaders are preparing to call off the strike and are deceived by a government document we will oppose it. The government has issued this sort of document previously, promising to grant our demands. But it gave us nothing.”

Another worker added: “Now the leaders of the alliance seems to be wavering. We started the strike by rejecting the government position that a decision would be given in November. Why should we accept it now? We should continue until we get our demands.”

In response to widespread concern about the government’s repressive actions against health workers, the leaders of more than 100 other trade unions met in Colombo on Wednesday and Thursday. The meeting, however, offered limited support to the strikers, simply proposing another rally and march next Monday. Like the HSTUA leaders, they promoted the illusion that more pressure would compel the government to back down and refused to even call for the removal of troops from the hospitals.

Central Bank Employees Union President Mavikumbura Kiribanda, a member of the Socialist Equality Party, insisted that the meeting had to demand the immediate withdrawal of the security forces from the hospitals and oppose the privatisation of the health service. Rather than appealing to the government, the striking workers had to appeal to the masses, he explained. It was not workers who were endangering the lives of patients but successive governments that had slashed health services. What was required, he said, was the building of a mass socialist movement to defend jobs, social programs and living standards.

Most health workers, particularly those on the lowest pay, live under terrible conditions. The monthly salary of a junior grade worker is about 3,400 rupees ($US36). Dental technicians receive only 6,160 rupees ($66) while an administrative officer gets 7,925 rupees ($84). Hundreds of workers cannot afford to pay for board and lodging in Colombo, and are forced to sleep in hospital corridors. Others are mired in debt.

Health expenditure as a proportion of GDP has been steadily declining and now stands at just 1.6 percent. The 2002 Central Bank report admitted: “Public health services have been deteriorating quantitatively and qualitatively due to limitation in available resources.” But it then proposed that the government intensify measures to further privatise the health sector, which already accounts for over 50 percent of curative health care services.

“The cost of living is unbearable”

A number of strikers spoke to the World Socialist Web Site.

H. Manel, a nurse at the National Hospital of Sri Lanka (NHSL), opposed his union’s refusal to back the strike. “I don’t know why our trade union [PSUNU] is retreating from this common struggle. At least they should have condemned the deployment of security forces in hospitals. We won’t be able to fight for our rights in the future if things go on like this.”

Sunitha Pushparani explained it was difficult to live on the present pay. “I work as an attendant in the NHSL. My basic salary is 4,365 rupees [$US46] per month. How can we live with this meagre salary? I have to spend 52 rupees for my daily bus fare. Now the cost of living is unbearable.”

A worker in the hospital’s Epidemiological Unit said: “I am completely against the government moves to break our struggle. All the sacked workers must be given their jobs. The government should withdraw all the security forces from the hospitals. We will not go to work without our sacked workers.”

A group of workers at the De Soysa Maternity Hospital denounced the attempts to blame workers for the conditions faced by patients. “Why is there a long delay from the government’s side in settling our demands? We are not demanding the sun and the moon. We are in dire conditions. We do not even have a place to change our uniforms and to eat our meals. Our promotions have been stalled. We get low pay. The government should account for both the lives of the people and our extremely poor living conditions.”