Doctors’ strike: When govts cut off flow of information, they get gangrene

Saturday February 18 2012
jason lakin

Over the past year, East African governments have been confronted with numerous strikes and strike threats by public service providers, particularly teachers and doctors. This paper carried a cover story on the issue last September, highlighting industrial action in Kenya, Tanzania and Uganda. More recently, nurses in Kenya undertook a go-slow at Pumwani Maternity Hospital in search of better working conditions and higher allowances. This followed almost identical action taken nearly a year ago, in March 2011 by the same nurses at the same facility.

But the most distressing industrial dispute in the region so far in 2012 was the doctors’ strike in Tanzania. Doctors stopped going to work in late January, and resumed work only about three weeks later on Friday, February 10, after reaching a deal with the government. During the strike, services virtually ground to a halt in the country’s major referral hospitals.

By and large, East African governments have not acquitted themselves well in handling these labour disputes. The striking workers have won sympathy for their causes, which, in the Tanzanian case (as in others), have appeared to go beyond purely self-interested demands for higher pay to include improvements in staffing, equipment and the physical plant in which workers are expected to provide services to the public.

Governments for their part have failed to articulate a coherent narrative explaining why workers’ demands are unreasonable, or why officials have failed to prevent strikes with a high human cost. Instead, they have seemed surprised by industrial action that was relatively predictable, and have tended to act as though it were normal to set government policy in reaction to strikes, rather than proactively according to a strong vision of reform.

Government antagonism

In the Tanzanian case, the government appears to have exacerbated a crisis of its own design, dating back to its treatment of striking interns in December last year. After refusing to pay them, officials did an about-face and paid them legally required allowances, but then proceeded to transfer them willy nilly to district hospitals in a move that unnecessarily antagonised doctors. This turned out to be a tipping point, as doctors exploited this particular grievance to agitate for a much broader set of longstanding demands.


The Tanzanian government also responded in a heavy-handed fashion to the crisis by arresting civic leaders who were pushing for a negotiated solution. After a peaceful protest march on February 8, some 16 activists were arrested when they tried to visit Muhimbili National Hospital, where a meeting between doctors and Prime Minister Mizengo Pinda was finally taking place. They were released relatively quickly on bail, but charges of unlawful assembly were not dropped. The charges appear dubious, since the activists were mostly arrested in their cars before they could assemble.

The overall impression created is that the government is inclined to use more brawn than wit in dealing with serious social matters. This may be effective in the short run. Likewise, the government’s capriciousness — paying and then firing interns, calling for dialogue but then pulling back, allowing protests but then arresting participants after the fact — can undermine the capacity of critics to effectively strategise. If dissenters cannot guess how a regime will respond to them, it is hard to confront it.

Yet this combination of muscle and unpredictability also has its limits. Authoritarian and one-party dominant governments often fail because they lack information about what is happening in the societies they are trying to rule. All governments must adapt to survive; knowing how and when to do so depends on having reliable information about the needs and demands of citizens. These in turn can help governments to achieve greater legitimacy and provide better services. When governments make it unappealing for citizens to express themselves through the media and associational life, they cut off this flow of information.

If Tanzania’s government has throttled information flows by impeding civic life, a recent report suggests that in Uganda, the media too has been under attack. It is widely known that civic protest in Uganda was repressed by security forces during the Walk to Work campaign last year. A recent report by the Human Rights Network of Journalists in Uganda states that, in addition, there was nearly a doubling in attacks on journalists in this period, from 58 attacks in 2010 to over 107 in 2011.

Not all of these incidents involved assaults by the state, but many were directly carried out by state security forces, and in the other cases, the government failed to protect reporters, or prosecute responsible parties.

When citizens hit the streets to complain peacefully about fuel prices and closed hospitals, governments that hope to survive should listen. They will be forced to hear about it eventually. It is for them to decide if they will still be in power when they do.

Dr Jason Lakin is a programme officer and research fellow at the International Budget Partnership. [email protected]