Doctors suspend strike after State House meeting

By Florian Kaijage

Medical Doctors in public hospitals have unanimously agreed to call off the strike and go back to work, saying they have taken the decision to give President Kikwete ample time to solve their problems.

The dramatic shift came one day after representatives of the Medical Association of Tanzania (MAT), an umbrella organisation for the profession, met with the Head of State at the State House on Friday.

Announcing the move to end the strike yesterday, the doctors also declared that the Minister for Health and Social Welfare, Dr. Haji Mponda and his deputy, Dr. Lucy Nkya were their biggest enemies.

“This matter was well communicated to the Head of State, that these two heads of the ministry of Health and Social Welfare have failed to deal with matters raised by doctors and they (doctors) have no confidence in them, therefore there is no way we can carry on working together,” MAT Secretary General Rodrick Kabangila underlined.

Kabangula insisted that the doctors’ strike did not aim at making the public experience hardships in accessing medical services but rather it was intended to push the government to improve the health services.

On the demand that the duo (Dr Mponda and Dr Nkya) should be immediately fired so as to pave the way for negotiations, Kabangila said this demand was not a new one as claimed by the government since it was among the eight demands submitted at the beginning of the crisis.

The decisions were announced at the end of a three-hour meeting held at the Don Bosco Hall, Upanga suburb, in Dar es Salaam under chairmanship of MAT President, Dr Namala Mkopi.

Briefing the media, Dr Mkopi said after extensive discussions with the Head of State on Friday during a closed-door meeting, they agreed among other things to call off the strike as well as giving the feedback to their colleagues.

“Doctors have heard the report from our discussion with the President, whom they thanked for showing a good spirit to deal with the current situation especially after he revealed how he was touched by the crisis,” the MAT president told reporters yesterday.

Mkopi affirmed: “Following this decision to end the strike we call upon all doctors to resume work immediately as we pave the way for the President to solve the current crisis.”

But the MAT president was quick to appeal that the move should be well understood among doctors, intoning that there was no show-off aimed at lining up winners and losers.

The main reason for ending the strike is to ensure that while the President works on the current crisis there is a positive atmosphere, which needs that doctors resume work “to rescue the crippled health sector that has suffered major setbacks since early this year.”

Other demands put forward by doctors were an increase of On Call allowance, introduction of risk allowance, reinstatement of housing facility or housing allowance as per Civil Services standing orders of 2004 and 2009, introduction of hardship allowance, transport allowance or loan facility for vehicles, rise of monthly salary, medical insurance, and improvement of medical services to minimise the number of officials who are being treated outside the country.

MAT president Mkopi said President Kikwete assured them during their Friday meeting that he was very aware of the demands from the disgruntled doctors to fire the two ministers but he insisted that he should be given time to act as he may deem fit.

The ending medical doctors’ strike begun on Wednesday March 7 following refusal to fire the Health Minister and his deputy.

As the probable strike loomed, the previous day Prime Minister Mizengo Pinda had addressed a press conference urging the doctors to change their minds as the strike would affect innocent people. He also emphasized that it was impractical for the doctors to compel the President act severely on cabinet ministers.

But on the third day of the strike, the effects were increasingly being felt, prompting the Head of State to hastily call a meeting with Dar es Salaam elders at Diamond Jubilee Hall only to be cancelled and substituted by the meeting with doctors at the State House.

The President was forced to intervene as the nation risked a paralyzed health sector as it relatively was for 17 days when public hospitals medical doctors went on strike from 23rd January onwards.

Then the strike was called off after the Prime Minister announced the suspension of Ministry of Health Permanent Secretary Blandina Nyoni and the Chief Medical Officer, Dr Deo Mtasiwa, to permit investigation into allegations facing them.

Early this year President Kikwete stated in an article published in the Global Health and Diplomacy Magazine that: “Maternal and child health are at the top of the list. But we are governments of poor countries. There is a scarcity of medical personnel in Africa. The ratio of doctors to patients in Tanzania is 1:25,000 and the ratio of nurses to patients is 1:23,000. While the ratio in the United States is 1:300.”

He added: “Our government has taken serious measures to address this shortage of health professionals by increasing enrollment in health colleges. In fact, enrollment has increased fourfold over the past three years. In 2007 there were 1,013 students attending health colleges and now there are 6,713. Our goal is to reach 10,000 students by 2015.”

By mid 2011 Tanzania had 4,649 medical doctors and 377 medical specialists but about 80 percent of the specialists were at Muhimbili National Hospital in Dar es Salaam.

As doctors agreed to end their strike the Trade Union Congress of Tanzania (TUCTA) yesterday issued a statement, arguing that if all professional and social groups follow the doctors’ style of calling for their political representatives to resign as a means to settle their demands it is likely the country will be in a shambles.

TUCTA reasons that almost all groups in the country have one or two demands that require the government to address, but demanding a leader, especially a politically responsible cabinet member to resign, is far from being the relevant way to resolve the contentions.

TUCTA sought to make sense of the doctors’ call for the Minister of Health and Social Services Dr Haji Mponda as well as Deputy Minister Dr Lucy Nkya to step down, saying this was an unusual negotiation tactic.

As the major organ for tripartite negotiations between government, employers and employees, TUCTA reiterated their support for the demands of the doctors but faulted their impatience for not allowing the government to work on their claims.

“The fact that the government gave room for discussion with the doctors and formed a committee to closely address their concerns and later went public and promised to handle the demands gave hope that it was willing …the doctors should be patient and give the government time to fulfill their promise,” reads part of the TUCTA statement

TUCTA Secretary General Nicholas Mgaya said that the politicians are not basically the core executives. “These are people who know nothing technical about what the doctors really want. They are just politicians, receiving reports and advice from their subordinates such as the ministry’s Chief Medical Officer. ”

He said when particular leaders like ministers resign, in most cases it doesn’t mean they are directly involved or have anything to do with the misconduct, they are simply practising collective responsibility.

Mgaya cited the example of former President Ali Hassan Mwinyi who resigned as Home Affairs Minister in the First Phase Government after his subordinates made serious mistakes, saying “Mwinyi’s decision was clearly not arising from his own mistakes, thus he later ascended to the presidency.”

Mgaya said he didn’t see any reason for doctors to hold the ministers accountable and advised they should instead put more emphasis on the needs related to their employment and working conditions.

TUCTA warned though that when civil servants are ready for “whatever may come,” it is not a good sign for the nation and the situation sends a message that there are two social groups in the nation, namely the exploiters and the exploited

As the umbrella union appealed to doctors through the media to resume duties at health centres, the doctors were also holding a meeting with the media at the Don Bosco centre following the audience of MAT with President Jakaya Kikwete yesterday.

• Meanwhile, as doctors were meeting to announce their resolution following their meeting with President Kikwete, a handful of them showed up in some hospitals in Dar es Salaam and attended to patients who needed emergence service.

• At Ilala hospital, a few patients who spoke to The Guardian on Sunday admitted to have been treated but said only a few doctors were present compared to the days when there was no strike.

• Dr Christopher Mnzava, head of emergency unit, said: “We are attending to referred patients and doctors continue to come…the situation is not as bad as some media are reporting. If you say the situation is critical, then tell us the number of deaths.

• “But I allow you to go to the mortuary and observe the situation by yourselves.”

• At the mortuary, the medical attendant Yolanda Wana said the number of deaths is much like that of any other day when we receive a maximum of five bodies. He added: “Yesterday there were ten bodies because relatives had not picked them up.”

SOURCE: GUARDIAN ON SUNDAY

President Kikwete meets with striking doctors at state house

Fake malaria drugs flood Tanzania

By ALVAR MWAKYUSA, 6th March 2011 @ 11:00, Total Comments: 0, Hits: 2738

ALMOST a third of anti-malaria drugs sold in Tanzania are substandard, according to the latest survey by the World Health Organisation (WHO).

This means that at least three out of ten people prescribed to use antimalarials in the country are administered with inferior medicines.

Malaria is the leading cause of deaths and disease burden in Tanzania. It accounts for about 40 per cent of all outpatient attendances.

According to the findings of the survey, one in ten samples showed "extreme" deviations in active ingredients or other standards, which could have life threatening implications.

The survey, called 'Assessment of Medicines regulatory systems in sub-Saharan African countries,' synthesized findings of rapid assessments performed at national medicines regulatory authorities (NMRAs) in 26 countries over the last eight years between 2002 and 2009.

Released on February 25 this year, the report also mentions Cameroon, Ethiopia, Ghana, Kenya, and Nigeria as countries whose markets are flooded with substandard anti-malaria drugs, just like Tanzania.

Although the health implications of failing drugs was not examined in the survey, WHO did not distinguish between counterfeit and substandard drugs in its overall statistics, the organisation said the results should not be regarded as "catastrophic" in health terms.

Contacted for comment yesterday, the Chief Medical Officer in the Ministry of Health and Social Welfare, Dr Deo Mtasiwa, said the ministry was unaware of the survey.

"I have not heard about it yet... I will follow up with other departments in the ministry tomorrow (today) to find out," he pledged during a telephone interview yesterday.

The Tanzania Food and Drugs Authority (TFDA) Acting Director General, Mr Hiiti Sillo, who was in Geneva, Switzerland during the launching of the report, said he will comment on the matter today.

"I am attending a meeting at this time, call me tomorrow, I will be in a better position to comment," he said.

It was also learnt during the survey that countries with domestic production of antimalarials fared slightly worse.

"It seems that regulators are focusing mainly on the quality of imports," said Jitko Sabatova, the WHO's technical officer responsible for pre-qualification of quality control labs.

Sabatova noted also that countries with the smallest number of suppliers to the market tended to have lower failure rates while the report pointed to important gaps in regulation and quality control within countries.

The highest incidence of failure was in Nigeria, with two-thirds of all samples failing WHO quality tests.

"That means in Nigeria a patient is more likely to be treated with a substandard drug than one which meets quality specifications," said Lembit Rago, the WHO's coordinator for quality assurance and medicines safety.

Ghana and Cameroon, with failure rates of 39 per cent and 37 per cent respectively, are not doing particularly well either.

Ethiopia, Kenya and Tanzania fared better, with failure rates of below 11 per cent. In these countries the WHO regards the quality of antimalarials to be reasonably under control. In Ethiopia no samples failed, in part because of a tight regulatory regime.

Kenya's failure rate of five per cent was a big improvement from studies carried out in 2003 when the failure rate for some samples was as high as 54 per cent.

taarifa ya MAT ya kuendelea na mgomo

THE MEDICAL ASSOCIATION OF TANZANIA

MSIMAMO JUU YA UTEKELEZAJI WA MADAI YA MADAKTARI

Kama tulivyotoa taarifa kwenye kikao cha Madaktari cha Machi 3, 2012 ni kwamba makubaliano yaliyofikiwa na hatimaye kutiwa saini kati ya Serikali na Madaktari tarehe 2.3.2012 ni kuwa, ili meza ya mazungumzo ya kujadili madai ya Madaktari iweze kuendelea na hatua ya pili, ni lazima Waziri wa Afya (Dkt. Mponda) na Naibu wake (Dkt. Lucy Nkya) ama wajiuzulu au wawajibishwe kama ilivyokuwa imeahidiwa na Mh. Waziri Mkuu Februari 9, 2012 alipofanya kikao na Watumishi wa Afya pale Hospitali ya Taifa, Muhimbili.

Aidha, kulingana na makubaliano haya, kikwazo kikubwa cha kutokuendelea kwa majadiliano ya madai ya Madaktari (Uboreshaji wa huduma wapatazo wagonjwa, mazingira mazuri ya kufanyia kazi na maslahi kwa ujumla wake) ni kuendelea kuwepo kwa Dkt. Mponda na Dkt. Lucy Nkya kweney nafasi zao za Kiuongozi.

Hivyo basi, kwenye huo mkutano wa Machi 3, 2012, baada ya majadiliano na tafakari za kina, ilikubaliwa kwa pamoja kuwa watu hawa wawili wanatakiwa kuachia ngazi mara moja ili haki za wagonjwa na madai ya Madaktari yaweze kujadiliwa na kutekelezwa.

Hivyo basi, iliamuliwa kuwa kama mpaka siku ya Jumatano, Machi 7, 2012 bado akina Dkt. Mponda na Dkt. Lucy Nkya watakuwa bado wapo madarakani, wataanza mgomo rasmi kushinikiza ama wajiuzulu au wawajibishwe ili taratibu nyingine ziweze kuanza.

Kama ilivyo taratibu ya chama kutoa taarifa kwa wanachama kote nchini, ifahamike kwamba mkutano uliamua kuwa Madaktari wote kuwa kuanzia Jumatano (Machi 7, 2012) watasitisha kutoa huduma zote za afya katika hospitali zote nchini mpaka hapo Serikali itakapoonesha utayari kwa kutimiza ahadi yake ya kuwawajibisha watajwa hapo juu ili hatua nyingine za utekelezaji wa madai ya Madaktari kwa manufaa ya Taifa yawze kuanza kushughulikiwa.

Ifahamike kwamba chama kinasikitishwa sana na kitendo cha Viongozi Waandamizi wa Wizara ya Afya ambao wanajua umuhimu wa kuwajibika kwa mara nyingine tena wanafanya Madaktari waendelee kutetea haki za Watanzania katika njia ngumu na kwa nia ya kufanikisha malengo haya kwa faida ya Watanzania wote.

IMETOLEWA NA OFISI YA M.A.T MAKAO MAKUU.

DR. NAMALA MKOPI
RAIS WA MAT
05/03/2012

All correspondence to: the Hon. Secretary General, MAT.

Tel. +255 22 2151835
Fax: +255 22 2153514
e-mail: info@mat-tz.org
website: www.mat-tz.org

Muhimbili University Complex,
Ruvu Block – Ground Floor,
P.O. Box 701,
Dar es Salaam,
Tanzania.

Source: http://www.wavuti.com/4/post/2012/03/msimamo-wa-mat-juu-ya-utekelezaji-wa-madai-ya-madaktari.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+wavuti+%28Wavuti%29&utm_content=FaceBook#ixzz1oSIDtH8h

Crisis deepens as doctors reject PM’s emissary

Wednesday, 25 January 2012 22:48
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The Citizen Reporters
Dar es Salaam. There’s no let-up in the battle of wits between the government and striking doctors, which the former is anxious to end, but the latter are determined to escalate if their demands are not met.Prime Minister Mizengo Pinda told senior journalists and editors in Dar es Salaam yesterday that he had instructed his subordinates to arrange a meeting at which he would have discussion with representatives of the doctors and resolve the issue.

But, at a separate venue in the city, the chairman of the caretaker committee under the auspices of the Medical Association of Tanzania, Dr Ulimboka Stephen, said they would write a letter to the Premier, whose message would be that they would not resume working until their problems were solved.

Speaking at the Don Bosco centre – the rallying point of the embattled medics ‑ Dr Stephen said: “We have resolved to continue with the strike… we are asking our colleagues across the country to join us, because the outcome will benefit all of us and the general public at large.”

He rejected the proposal that the doctors outline their grievances to an emissary of the Prime Minister – a senior police officer – who would subsequently give him a feedback.

Dr Stephen was emphatic that they wanted a direct audience with the PM, because executives at the ministerial level with whom they had engaged had failed to solve their problems.

At the press conference, Mr Pinda said he was deeply disturbed because the issue was taking too long to resolve, at the expense of suffering patients. He appealed to doctors to attend to patients as efforts were being made to resolve their problems.

“I am still hoping that I will meet with them before I leave for Dodoma on Saturday for the National Assembly session,” said the Prime Minister, who explained that a meeting that had been scheduled for Monday aborted because their representatives did not turn up.

He said the government had delayed payment of November and December 2011 allowances amounting to about Sh800 million to doctors, because the priority was to pay salaries. He conceded, however, that a mistake was done: “The government should have communicated with the doctors and told them the real situation,” said Mr Pinda, adding: “My meeting with them will enable me to know what had exactly transpired.” In a another development, retired specialists who have been recalled on special contracts, were organising a meeting with the Muhimbili National Hospital (MNH) management in a bid to review their job description.

They lamented that they are overwhelmed by the worsening situation.
One of them, who spoke on condition of anonymity, complained: “We cannot work like this; it is unprofessional as two doctors, whether specialists or not, cannot attend 150 patients. Report for duty every day, do theatre jobs and later do ward rounds, is extremely burdensome.”

Reached for comment, the MNH Public Relations Officer, Mr Aminieli Aligaesha, was mum, merely claiming that the hospital directors were holding a mid-week meeting which, among other issues, would come up with a statement on the saga. The doctors are demanding salary increases, improved working conditions and being valued by the government.

Chadema
In his statement, the Chadema Director for Publicity, Mr John Mnyika, who is also Ubungo MP, said the opposition party has been touched by the strike and blamed the government for what is happening.
Mr Mnyika said Chadema has contacted the shadow minister for Health and Social Welfare, Gervas Mbassa, and asked him to support the strike by the medical workers.

Shinyanga
Reports from Shinyanga say doctors continued with their normal routines as they were not informed of the strike. Patients who went to the regional Hospital yesterday said they were attended normally and activities and services at the hospital were uninterrupted.

Mbeya
A total of 75 doctors as well as nurses at Meta maternal hospital in Mbeya moved to support their Dar es Salaam colleagues by boycotting work, save for a few doctors and nurses who were attending to emergency cases.
“If we had enough money we would have gone to private hospitals… the government should immediately deal with this problem,” pleaded Neema Emmanuel, noting that the strike was affecting poor people.

Reported by Lucas Liganga and Alex Bitekeye

should doctors know how to fight for their rights without jeorpadising health of the citizen?

More that a week now, medical doctors in Tanzania are in unresolved conflict with the government. The saga started when the government reallocated intern doctors working at Muhimbili national hospital ( the biggest hospital in the country) to other other hospitals in the country . This reallocation was seen innappropriate as it was taken as a punishment after the interns boycotted in order that they can be paid their monthly allowances by the Minstry of Health and Social welfare. Since then medical doctors ( genealists and specialists) have joined the intern doctors to fight against this seemingly humiliation to the afflicted inten doctors who were demanding for their basic rights as it was part of their contract that they must be paid monthly. The Medical association of Tanzania, has taken a lead to mobilise doctors across the country to discuss this issue and other doctors welfares that have been neglected by  the current government. Different govenment officials including the minster of health have given the government stand on this issue but this has not satisfied the medics and are still  on a go-slow in order that their demands are met.Among other things,they are demanding  that the government should stop reallocating the intern doctors and  meet other doctors welfare such as night call allowances . Pointing to the recent increase of the sitting allowances given to the Members of parliament that has increased from Tsh 70,000 ($44) to 200,000Tshs ($ 126) , medics have questioned the government on why their call allowance have not been increased since early ninetees where they have been paid 10,000 ($6.3)Ths per night call?
While this saga is ongoing, there are posibilities of mobilising all the doctors in the country to strike offering medical services untill their demands are met. This will cost the government and the citizens at lage. Critics are asking why has the matter been allowed to deteriorate to this stage? Is it the medical professionals, the government, the media and by extension the society at large?. Commenting in one of the social media, one senior citizen asked that should the doctors know how to fight for their rights without jeopardising health of the citizens? These questions seems to be difficult but each group has a part to play!

The miracle cure ; implications for improvement in care of chronic diseases

In 2011, thousands of people in Tanzania and neighbouring countries flocked to the remote Samunge village in Ngorongoro, Arusha region for a cupful of retired pastor Ambikile Masapile's "miracle cure". Later on, the country experienced a proliferation of herbalists and faith healers who claimed that they can treat chronic illnesses such as HIV/AIDS, Diabetes and cardiovascular diseases. With some imitating the dispensing of cupful of herbal concoctions .This has put the country in dilemma with critics warning that the government risks serious embarrassment for its apparent silent approval of a trend that has sparked medical concerns only to gain political mileage.

For almost a year , he is offering the medication for a mere Sh500 per cupful, the young and old and the low and mighty - drawn from all corners of the nation, the neighbouring countries and beyond - have been trooping to Samunge. Many have braved several nights in the cold in motor vehicles stuck in queues stretching up to 50 kilometres, determined to reach the cleric and receive their dose of the "miracle cure".Although he is no longer popular today, but a significant number of people have received his medicines.

Reflecting on this, one would ask a question as to why these people are flocking to Sumunge rather than going to the health facilities that are scattered through out the country? Does it mean that people have lost hope on the country's health care system? May be these questions might go beyond the national level to the global medical comunity, has the global community lost grip on care of chronic diseases?