Dominican Republic: Doctors on Strike

Doctors who provide medical services in public hospitals around the Dominican Republic have been on strike for nearly a week. They are demanding a raise in salary, which is something that the government has rejected on various occasions citing the global economic crisis. Even though to some Dominicans, their demands appear to be fair, there are others who believe that the doctors in the state-run health services should be held accountable because their protest tactics are hurting the county's low-income families, and because the quality of service could be improved.

The Dominican Medical Association [es] (CMD for its initials in Spanish) is the entity that unites the health professionals across the country, who work under the State Secretary of Public Health [es] becoming a guild in 1941. In its more than 100 years in existence, the CMD has often been characterized by a series of work stoppages over long periods of times, most often related to wages. This most recent work stoppage appears to be at a standstill, as described by Joan Guerrero of Duarte 101 [es]:

Y mientras se siguen sacando los trapitos de los funcionarios públicos en todos los medios, los médicos y el resto de empleados del sector salud se quedarán de brazos cruzados, porque el mismísimo secretario de Salud Pública abrio su boca y dijo «no hay dinero para aumento». Lo curioso es que llevan más de dos años con ese pataleo de aumento salarial y el Colegio Médico Dominicano ha hecho de todo en ese tiempo para que atiendan a su llamado. Pero, seguirán así, de brazos cruzados.

While more revelations of mismanagement on the part of the public officials come out in the media, the doctors and the rest of the health sector employees remain with the arms crossed because the secretary of Public Health opened his mouth and said «there is no money for a raise». The curious part of the story is that they have been asking for a salary increase for more than two years and the Dominican Medical Association has done everything it can so that their request is attended to. However, they remain with their arms crossed.

One of the arguments used is that the doctors compare their salaries with the salaries of senators, representatives, and other governmental officials, which often exceed 90,000 pesos per month (approximately 2,500 USD). In comparison, a director of a public hospital earns around 30,000 pesos per month (approximately 833 USD). However, this idea of comparing salaries is not shared by all, such as blogger Paolah of Ahi é Que Prende [es], writes that there are other occupations that feel that they are poorly paid, but they do not resort to these types of protest tactics.

However, some patients wonder whether it is they who should protest the work of some of the doctors, who are said to not complete their work hours. There have been complaints that not all are present in their offices because they have one or two private practices to attend. This is one of the reasons why the state health doctors do not receive the full backing of the public and one of the reasons why state officials have rejected their request of a salary increase.

Another reason there is not the full support of the general public is because of Waldo Ariel Suero, a person who represents the guild and who many consider to be too combative. He has been involved in this struggle for more than 10 years, and has achieved some victories along the way. The Diario Dominicano [es] describes Suero this way:

El doctor Waldo Ariel Suero desde que asumió la presidencia del Colegio Medico Dominicano, ha mostrado una actitud temeraria e irreflexiva que lo coloca ante la opinión publica nacional como una persona obstinada, tozuda, obsesionada, inmadura e incapaz de entender y determinar lo que se denomina “el sentido de la oportunidad” que debe tener presente cualquier persona que dirija o gestione una institución con la historia y la trayectoria de la que agrupa a los profesionales de la medicina.

Ever since Doctor Waldo Ariel Suero assumed the presidency of the Dominican Medical Association, he has demonstrated a reckless and inflexible attitude which places himself in front of the national public opinion as a obstinate, stubborn, obsessive, and immature person incapable of understanding and determining what is known as “the sense of opportunity” that one should have who directs or runs an institution with the history and tradition that groups the medical professionals.

Since April 2008, the doctors have participated in more than 50 strikes and work stoppages, which have had a direct result on much of the population especially those from low incomes, who do not have the financial resources to go to a private clinic. The striking doctors have become a target for criticism and they are often blamed for hospital deaths, rightfully or not. For example, a young man died at the Francisco Moscoso Puello Hospital as a result of a shooting during a robbery, and his mother took out her frustration against the doctors, who have been on strike for six days by throwing stones at them. Lía agrees, as she comments on the story at El Caribe [es] and writes, “All the people who go to that hospital should do the same things, stone them so that they go running for being indolent”.

Pedro also joined the discussion and criticized the doctors:

Eso es lo que deja el negocio de Ariel Suero y la Salud. El pueblo no es tonto. Recuerden que la gran mayoría de estos médicos estudiaron casi gratis en la UASD y ahora quieren vivir como reyes dando la espalda al pueblo pobre. El responsable de esa muerte es Ariel Suero por abusador.

This is the result of the Ariel Suero and the Health's (Department) business. The people are not dumb. Remember that the large majority of those doctors completed their studies practically for free at the UASD (Autonomous University of Santo Domingo) and now they want to live like kings turning their backs on the poor. Ariel Suero is responsible for that death.

The protests continue, and there were a couple of recent incidents when the CMD occupied the Department of Labor headquarters, where doctors and nurses were forcefully removed. In addition, the doctors held a hunger strike in the San Felipe Cathedral in Puerto Plata, much to the dismay of Cardinal Nicolás de Jesús López Rodriguez. These types of protest tactics are confusing to some looking in from the outside. Paolah of Ahi é Que Prende [es] wonders whether the CMD is a “medical association or syndicate?” She wonders what would happen if every occupation that is upset with the salary would stop activities, what would happen?

However, there are also those that blame the government for the current situation. Gustavo summarizes the sentiment of many in the comments section of the El Caribe story [es].

Quisiera saber si de alguna forma estos medicos son responsables por la muerte de este muchacho y quiza mucho mas, si el gob. o los medicos deberian ir a la carcel por este abuso contra la humanidad, esto lo que da es verguenza y asco, ya basta.

I want to know whether these doctors are responsible for the death of this boy and maybe even more, whether the government or the doctors should go to prison for these abuses against humanity, this is what is embarrassing and disgusting, enough already.

3 comments

  • “I want to know whether these doctors are responsible for the death of this boy and maybe even more, whether the government or the doctors should go to prison for these abuses against humanity, this is what is embarrassing and disgusting, enough already.”

    Personally, I think that all many entities are to blame for the death of this young man; Especially, the person who shot him. But, greater blame belongs to the so-called ‘doctors” who take hypocratic oaths to do no harm; When they walk-off their jobs they have forgotten why they call them doctors, and medics. They become a part of the problem, instead of the solution. They defeat the purpose of their training.
    Doctors are not mechanics; If a human being needs medical assistance in case their life is in danger, they should be helped by qualified medical professionals; They can’t willfully refuse to assist in the preservation of the patient’slife. When they go on strike they use extortion to achieve their goal of making money. This is below the profession of doctors, and shameless.

    How much are human lives worth? If they wanted to make money they should either open up their own clinics, practice, or choose another career field. Doctor’s aren’t businesspeople? Or, are they?

    Look at the legislation that is currently in the U.S. Legislature: HealthCare Reform. Do they want Cuban Medical coverage? Ask the Cuban doctor’s in D.R. why they left Castro’s paradise? How much do doctor’s earn in Cuba? US$300 p/mo.?
    Strikes are for laborers, not for professionals in a civilized nation, folks!

    Rocio Diaz, my compliments for your exemplary impartial analysis of this issue. This is true journalism. Gracias por mantenernos al dia! Adelante!

    Arsenio.

  • Thanks Arsenio for your assessment. This comment you made about doctors and the hippocratic oath they make when they choose that profession is at the core of this particular case. It is inhuman to deny medical assistance to people of low income who do not have any other choices. And the way they carry themselves is absolutely dismal.

  • Flores

    But doctors also deserve to be paid well enough to be able to do their jobs properly and not corrupt the medical system to bribes as you see in some countries, or as you say force doctors to take on second jobs privately. As I read it, doctors are striking to earn $1700 per month, pensions etc and are currently earning $1000 at the very most. That does not seem like a lot of money. It’s true in the short term it is very disturbing not to have a full staff of doctors, but long-term higher wages are what it takes to have a healthier system, and stop well-educated people from traveling abroad where they can earn much higher wages. I just find it hard to believe so many thousands of nurses and doctors would strike unless it were really important. I hope their salaries will be raised, and their work valued appropriately, so they can get back to work.

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