Health care strike in Mozambique

When I was in Maputo last week, the big ethics issue in the country had nothing to do with biomedical research. There was a buzz about a possible doctor's strike. But the doctors I met said it was actually a bluff: the government would open negotiations before the strike deadline, the medical association would craft some sort of compromise, and the whole thing would blow over. On the other hand, Doctors in Mozambique did go on strike back in January for nine days, though there are conflicting reports as to the extent of the strike.

Well, today they are striking again. According to the newspapers, doctors are demanding a base salary of $3000 per month, while the government is offering between $600 and $1200. Much of the problem has to do with equity: the doctors in the public sector in Mozambique are government employees, and there is a strong sense (rooted in Mozambique's Marxist tradition) that there should not be significant inequities in pay between public sector jobs. If the government raises the base salary of doctors, but does not offer something similar to other public sector employees, they may have a more general strike on their hands. However, if they do not satisfy the demands of the doctors, the lives and welfare of citizens may be in danger: even if the Mozambique Medical Association insists that essential services will remain open, I heard much dispute about what should count as 'essential' in such circumstances. In any case, it would not take much of a strike to have a significant impact on patient health, given that the physician/patient ratio is 1 to 22000.