Sri Lanka: Hospital Emergency

Sri Lanka’s public health-care system has historically been considered remarkable for a developing country plagued by two decades of war. But on Sept. 17, for the third time in less than six months, Sri Lankan health facilities were nearly shut down when 54 health-sector trade unions in the Health Services Trade Union Alliance went on strike. Demanding salary increases, more than 80,000 health-care workers throughout the island, including clerks, cooks, attendants, drivers, and laborers, joined the strike. This latest labor unrest followed a two-week strike by doctors in June and a subsequent walkout of about 4,000 of the National Hospital’s support staff.

The strikes have centered on a 1993 government decision to increase salaries of all health-care personnel by 14 percent. When doctors’ salaries increased by 44 percent as a result of their strike in June, other medical staff demanded that their salaries be increased by the same percentage.

Although doctors weren’t involved in the September strike, services at government hospitals came to a near standstill. After negotiations failed, the government called on the armed forces and police to assist in major hospitals, which further angered the unions. The government also threatened to replace striking workers.

Although commentators in Sri Lanka agree that the health-care system needs to be reformed, much of the media were highly critical of the use of strikes as a bargaining tactic. “Down the years, all these interest groups have found it convenient to callously disregard the public good, to meet their selfish pecuniary ends,” wrote the Daily News (Sept. 19). An editorial in The Island (Sept. 20) expressed a common sentiment: “It has to be pointed out that all that highfalutin ethics about the Hippocratic oath have flown out of the window, and it’s the cult of the coin that is worshipped in our health sector.”

Lakbima, commenting on the right of workers to protest, stated that the majority of strikes initiated today are unruly and supported only by a few: “Many workers...have been coerced by union leaders, so they have to participate” (Sept. 17). Meanwhile, Thinakkural blamed the Ministry of Health: “Neither the health minister nor the ministry has the capacity to solve this problem. The prime minister should intervene....The problem did not arise overnight” (Sept. 24).

Ultimately, the government backed down, allowing striking temporary workers who had been fired to return to work. The unions suspended the strike on Sept. 30, agreeing to await a Treasury decision in November on the salary claims. Sri Lanka’s Minister of Health, Nutrition, and Welfare P. Dayaratne told World Press Review, “We had to give in, and there’s nothing wrong with that.” He ex-pressed optimism that the salary anomalies that sparked the recent strikes would be addressed. But despite the minister’s confidence, no concrete solution has been drawn up to ensure that the health-care sector will not strike again.