We break down the recent industrial action by nurses (SWADNU) at Mavuso makeshift COVID-19 hospital.

 

Breakdown of the January 2021 Nurses sit-in strike at Mavuso COVID-19 makeshift hospital.

A Nurse displaying a placard inscribed “Help us save our people, Bafa bantfu emahhulumbeni” during their industrial action

 

The Mavuso Trade Centre Makeshift Hospital Nurses Speak Out!!!

Nurses organised under the Swaziland Democratic Nurses Union (SWADNU) ( Swaziland Nurses Association (SNA)) and stationed at the Mavuso Trade Centre makeshift hospital, recently engaged in a sit-in industrial action over a range of grievances including that government must fulfil their promise to make proper modifications at Mavuso to make it habitable as a place to provide healthcare, to compel government to make provisions for equipment to enable nurses and other professionals to assist patients and the nurses demand to be paid risk allowance for their frontline work on COVID-19.

Their choice to engage in a sit-in strike action compared to engaging in a full strike action was a logical choice given that nurses are precluded by law from engaging in strike action due to their work being categorised as an essential service. Essential services are those services whose withdrawal may lead to a loss of life.

During the escalation of their grievance into the public domain the government has not been shy to point this fact out to the nurses, threatening them with serious consequences if they went ahead with their intended industrial action.

The government’s strategy entailed utilising the employment policy that places nurses as essential workers together with the vulnerability of nurses on fixed term contracts to weaken the industrial action, ensuring that those who are on fixed term contracts did not join the industrial action.

In media reports government representatives including the Principal Secretary could only threaten to take action against the striking nurses as the industrial action as illegal regardless of the fact that it was, by definition, not a strike action given that the nurses would report at work but not engage using their rights in the Occupational Safety Act (2005) which gives workers the right to remove themselves from work situations they deem hazardous to their lives.

The trigger that let off the latest steam of anger by the nurses seems to be the government’s move to award constituency headmen (Tindvuna Tenkhundla) back pay dating back years in the midst of indifference to nurses grievances.

 

The mainstream local print and electronic media pushed a narrative of nurses who were negligent by leaving patients on their own to fight with the employer. (Picture below)

 

 

Picture credit:  Eswatini Observer,19 January 2021

 

Picture credit: Eswatini Observer, January 19,2021.

 

Background to the grievance

Mavuso nurses gave a brief background to the grievances that gave rise to their industrial action. This is their story;

Working conditions at Mavuso

They related that Initially the government had earmarked Lubombo referral (Siteki) and the TB Hospital to be COVID-19 treatment centres. The TB hospital was however soon discarded as it was found in a bad state and needed renovation. Infact there were reports that the ministry had plans to refurbish and repurpose the TB hospital even before COVID-19 cases rose in early March 2020.

Seeing these complications at the TB hospital, the government then opted to convert Mavuso Trade Centre Pavilions (Mavuso) into a makeshift hospital. When Mavuso was setup there were serious concerns raised about several structural deficiencies of the pavilions including the acute lack of proper ventilation and the lack of key installations such as washing bays and ablution facilities for patients.

Initially the Ministry of Health and the government in general had promised to make carry out the structural modifications necessary to make the makeshift hospital to function at the required standards. One of the deficiencies that required modification was in the area of ventilation of the pavilions. They were found to be have poor ventilation and therefore poor air circulation, a condition that according to nurses disqualified them to be utilised as wards as without proper air circulation there could be high transmission of infection diseases even to nurses and other health workers. The pavilions were also not air conditioned and therefore prone to getting extremely hot in hot weather.

The Pavilions also did not have proper ablution and washing provisions for patients. For nurses and health workers one of the major deficiencies was the absence of wash areas where they could wash their hands as required.

Initially, in early 2020, these structural deficiencies did not have serious negative bearing on nurses and health workers because Mavuso only accommodating patients showing mild symptoms then. These patients could move on their own to other pavilions for ablution and other necessities.

However, as the second wave kicked in, at the end of 2020, this all changed as Mavuso started taking in critically ill patients and the manifestation of these challenges made the operation of the makeshift hospital extremely difficult, cumbersome for nurses and other health workers.

 

Equipment Shortages

What made matters worse was the fact that Mavuso has not been provided with sufficient equipment that would enable nurses to properly attend to patients in their critical state. For instance, Mavuso does not have any high intensive care unit available for patients, as oxygen provision alone does not solve the challenge in some of the patients.

This has been the source of otherwise avoidable loss of life to patients with nurses and other health workers feeling helpless. The 18^th January 2021Eswatini Observer reported that at that time there were about six (6) deaths at Mavuso per day.

Other critical equipment that is in short supply and infact for which only one item is available throughout Mavuso, leading to sharing between pavilions include, the glucometer, Pulse Oximeter and Monitors used to check vital signs in patients.

Nurses often have to walk from pavilion to pavilion looking for these critical working tools.

 

Healthcare workers plight

It is said that Nurses are now exhibiting signs of acute fatigue as many of them wanted to take leave towards the end of 2020, however due to the second wave they were recalled from their leaves and or denied the right to proceed to same.

In the week of the sit in around 10 workers had been hospitalised, not for COVID-19 related illnesses, but rather for fatigue related conditions. Secondly nurses who have developed symptoms of COVID-19 have only been given medication to deal with their symptoms and not been tested for COVID-19 and asked to isolate at home. It seems that government is avoiding having to quarantine health workers infected with COVID-19.

Health workers have also, from inception, demanded 20% risk allowance to compensate them for the risk to their lives that they are subjected to everyday while caring for COVID-19 patients in an environment characterised by uncertainty and a high level of fear amongst patients and their families.

 

 

 

 

 

 

 

In December 2020 SWADNU and the government were locked up in a court wrangle over the issue of PPE. The industrial court in its wisdom summarily refused to resolve the matter. Instead of issuing an order compelling the government to provide for the health workers as per their petition to the court, the industrial court instead ordered the two parties to go back to engage. This ruling by the judge threw nurses under the bus since their approach to the courts was as a result of governments indifference or intransigence, if you will.

SWADNU had accused the government of taking lives of health workers lightly by not providing Personal Protection Equipment (PPE) leading to infection of health workers and even death to others. The government had retorted that it had provided enough PPE and it was only that Nurses were stealing the PPE and that is what creates shortages.

It is also been noted that in the first weeks of February 2020 Paramedics also engaged in an industrial action (A sit in work stoppage) to protest against the fact that the government still effuses to grant them adequate PPE amongst other complaints. But more on that on the next article later this week.