“We might get shot today”
It is a bit alarming when your colleagues turn to you and say, “we might get shot today”. And then put on matching white t-shirts and march out the door anyway.
Primary care physicians in Tanzania have been on strike since January 23. The result is that thousands of Tanzanians have not had access to medical care for nearly three weeks, including emergency services. Those who cannot afford the entrance fee to a private hospital, or a plane ticket to India, are dying. Two days ago, specialists voted to join the primary care physicians and the doors of Muhimbili Hospital, the largest referral-based hospital in Tanzania, closed.
In early January, the government terminated the services of 229 medical interns who went on strike because they had not been paid in two months. The situation escalated and the interns were joined by the country’s doctors, who are requesting an increased salary as well as improved working conditions.
There are approximately two physicians for every 100,000 people in Tanzania, and doctors say they are overwhelmed by the number of patients they are expected to treat. Basic equipment is in short supply. More expensive diagnostic equipment is simply unavailable.
Faced with overwhelming demand, few supplies, and low pay, many physicians are leaving Tanzania to practice elsewhere. It is often said that there are more Malawian trained doctors in Manchester, England than there are in all of Malawi. I’m not sure where this statistic originates, but I’m sure the gravity of the situation is similar in Tanzania.
Two weeks ago, a colleague’s uncle died. He needed heart surgery and had to fly to India to get it. He made it onto the plane, where he collapsed and later died in the airport. A story that is both starkly illuminating and heartbreaking.
In the midst of what can only be described as a national crisis, the Tanzanian government decided to give itself a raise. Parliament recently voted to raise the daily sitting allowance for each legislator from 70,000 Tsh (approximately $42 CAD) to 200,000 Tsh (approximately $120 CAD).
The human rights community in Tanzania has criticized the government for failing to take any decisive steps to put an end to the strike. Some have called for the government to step down.
And so yesterday lawyers took to the streets in illegal protest. An act of defiance in a country where all protestors are required to obtain a permit from the government. An act of courage when one recalls the violent confrontations between protesters and the police in Kampala last spring.
Everyone returned safely, feeling that they had at least accomplished a small, intangible thing in the face of a disaster that is overwhelming.
Another protest was planned for this afternoon. The police intervened, and as I began to write this post I received a message from a friend who was involved, telling me she is at the police station and has been arrested.
The jails are full while the hospitals sit empty.