I was not sure to expect when I was told by one of the nurses that a strike had begun at Hospital Nacional Dos de Mayo (HNDDM) in Lima, Peru. I had read about strikes or huelgas happening throughout Peru but often times its impact on the civilian population of the country is rarely the focus of attention. This time the affected ones were not only part of the civilian population but they were patients within a hospital. As I went about recruiting Health Care Workers (HCWs) into my TB project I tried to ask the nurses and doctors about how this strike affected both the health care worker and the patient. I was shocked by their replies. It seems that the end result is not only an overworking of the personnel, at one point the head nurse was covering the entire Pulmonary Department by herself, in addition the patients are the ultimate payers. One nurse told me that one horrible aspect of the huelga was due to the cooks going on strike. This resulted in the patients only getting a fraction of the food they were used to receiving. She made a gesture with her hand which showed me they were consuming about a third of a cup of soup for lunch. This is a nightmare for a patient suffering from Tuberculosis; a disease known to be affected by nutrition. I asked many HCWs when would the strike end and thier answers were confirmed when I came across the chalkboard with the with the words HUELGA INDIFINIDA; Indefinite Strike. It began on Monday, January 10th. It was unknown when it would end.
On the other hand I couldn’t help but empathize with the physicians, nurses, and other HCWs at this hospital. In addition to receiving a small pay check their annual bonus, which I am sure they had already spent on gifts for Christmas, was taken away. I could not help but think what would I do in their position. Would I just stand and watch that happen being content with only complaining to my peers. Or would I take action? Medicine is an interesting field because when a strike occurs it much more than a loss of profit for a company, it is also a loss of care for a patient. Although I will probably work in the US where a strike if often unnecessary, it is often times a real dilemma for HCWs working in developing nations and the topic demands attention.
In Peru most companies give their workers a Christmas bonus. Yesterday a taxi driver driving my sister and I from the airport told us that he received 6 kilos of turkey as his bonus. This was the first year that the government decided not to give the HCWs at HNDDM their annual Christmas bonus of 200 soles, equivalent to approximately $67. I couldn’t help but wonder is these cuts were a result of the decrease in social spending secondary to the government agreeing to demands made by the World Bank and IMF. This then lead to my next question: Now that H.R. 3688, the United States-Peru Trade Promotion Agreement Implementation Act has passed, what do we expect the end results to be? I have read that there are provisions in the agreement that undermine the right to affordable medicines; this has yet to be investigated. What impact will the US-Peru FTA have on Health Care? Will we see more cuts in social spending and as a result more strikes nationwide? And more importantly what will its impact be on the civilian population of the country? If we want to make the link between socioeconomic factors and health care more than a discussion but rather evidence for systematic long-term sustainable change it is imperative that we answer these questions now.
