DOMINICAN REPUBLIC: HEALTH WORKERS STRIKE - AGAIN

UNCLAS SECTION 01 OF 02 SANTO DOMINGO 001873

SIPDIS

SENSITIVE

STATE FOR WHA/CAR
NSC FOR SHANNON AND MADISON
LABOR FOR ILAB
TREASURY FOR OASIA-LAMONICA
USDOC FOR 4322/ITA/MAC/WH/CARIBBEAN BASIN DIVISION
USDOC FOR 3134/ITA/USFCS/RD/WH
DHS FOR CIS-CARLOS ITURREGUI

E.O. 12958: N/A
TAGS: PGOV ELAB DR
SUBJECT: DOMINICAN REPUBLIC: HEALTH WORKERS STRIKE - AGAIN

REF: A. REF: (A) SANTO DOMINGO 0537 (NOTAL)


B. (B) SANTO DOMINGO 0794 (NOTAL)


1. (SBU) Summary: A public health workers' strike has
virtually shut down outpatient services at Dominican public
hospitals for five days beginning March 22, following similar
but shorter work stoppages since January. Government, civil
society, and the press, while acknowledging a need for better
pay and funding at the hospitals, have reacted negatively to
the walkout, which is mainly affecting low-income persons who
have no access to the private health care system here. Under
the nation's current difficult financial circumstances, the
strikers are unlikely to achieve their goals of doubling
salaries and alleviating shortages of medical supplies at the
hospitals. The strike's economic and political impact is
expected to be minimal. End summary.


2. (U) Health workers at Dominican public hospitals, operated
by the State Secretariat of Public Health and Dominican
Social Security Institute, began a five-day nationwide strike
March 22, pressing demands for a doubling of salaries and
improvements in the hospitals. The strike, led by the
Dominican Medical Association (Colegio Medico Dominicano) and
other professional groups, involving some 20,000 doctors,
20,000 nurses, 7,000 dentists, plus clinical psychologists,
pharmacists, and bioanalysts, shut down outpatient services
at all 173 public hospitals except for emergency or critical
cases. Thousands of low-income Dominicans who depend on
these services will have to postpone their appointments. The
strike is the fifth -- and longest -- work stoppage by health
workers so far this year. On the first day, strikers carried
out the first of various planned peaceful demonstrations in
neighborhoods near the hospitals.


3. (U) President Mejia threatened to withhold salaries for
each day the employees are on strike, and Chamber of Deputies
speaker Alfredo Pacheco (of the ruling PRD) threatened to
remove a proposed salary increase from the legislative
agenda. Opposition PRSC Deputy and bloc leader Victor (Iso)
Bisono acknowledged the need to raise taxes to provide
additional funding for hospital salaries and supplies, but
asserted that the National Congress could not pass any such
bill in response to the "blackmail" of a five-day
paralization of health services. State Secretary of Public
Health Jose Rodriguez Soldevilla (PRD) characterized the
strike as inappropriate during an election campaign and the
salary demands as excessive in the current economic crisis.
Retired Catholic bishop (and main adviser to Cardinal
Archbishop Nicolas de Jesus Lopez Rodriguez) denounced the
strike as "senseless, imprudent, heartless, and
inconsiderate." Editorials in two major daily papers opposed
the strike.


4. (U) Following the first health workers' strike January
27, Mejia promised quicker disbursements to alleviate
shortages of medicines, supplies, and equipment in the
hospitals and suggested that a special commission propose
legislation to finance a pay increase (Ref A). The resulting
bill, which proposes a tax on alcoholic beverages and tobacco
products to finance the increase, has been referred to a
Congressional committee. Hospital services continue to
suffer from supply shortages.


5. (SBU) Comment: Health workers, like most Dominicans, have
felt severely pinched during the past year between their
stagnating incomes, a declining exchange rate, and inflation.
That said, the millions of low-income citizens who depend on
public health services are unlikely to sympathize with the
increasingly disruptive strikes. The public mood has shifted
since January, when a 24-hour public health workers' strike
was followed by a successful nationwide work stoppage in all
sectors (Ref B). Now, less than two months before the
presidential election, voters are taking to the streets in
campaign rallies, rather than participating in work stoppages
or protests. Moreover, middle- and upper-class patients
generally have access to locally available private hospitals,
which are unaffected by the latest health workers' strike.


6. (SBU) The strike has worthy goals, but is unlikely to
achieve them in the nation's difficult financial
circumstances. The strike's impact on the economy, the
government, and the presidential election campaign is
expected to be minimal. The public health workers have a
history of sporadic walkouts, and the country has learned to
put with them, despite the inconvenience and health
consequences for low-income patients.
HERTELL