Gabon's Health Sector in Crisis

UNCLAS SECTION 01 OF 02 LIBREVILLE 000138 SENSITIVE SIPDIS ABUJA PLEASE PASS TO RMO MONTAUK E.O. 12958: N/A TAGS: ELAB ECON PGOV SOCI GB SUBJECT: Gabon's Health Sector in Crisis REF: (A) Libreville 0096 (B) 08 Libreville 579 (C) Libreville 104 -------------- Summary -------------- ¶1. (SBU) The crisis affecting Gabon's health care system since the beginning of a sector-wide strike in early January appears to have subsided somewhat, with workers resuming essential services. Government and the striking workers remain at odds over fundamental issues, however, as declining revenue and other ramifications of the world economic crisis limit government's ability to respond to worker demands. During the worst days of the strike, patients were denied even a minimum of care, leading to a significant but undisclosed number of preventable fatalities. Military health workers were also dispatched to some hospitals and clinics to replace striking workers. Negotiations continue over worker demands for better pay, equipment, and working conditions. End Summary. -------------- Longstanding Demands -------------- ¶2. (U) On January 12 Gabon's health care workers launched a general strike to demand a salary increase, replacement of dilapidated hospital equipment, and greater resources to carry out their duties. According to Serghes Mickala, Secretary General of the National Health Workers Union (SYNAPS in its French acronym),the workers' demands date back to an earlier strike in 2003. Mickala told Emboffs that the agreement reached to end the 2003 strike was not respected by the authorities. After a protracted standoff, Mickala's SYNAPS union walked out in earlier this year, following the lead of Gabon's teachers (reftels). -------------- Deadly Consequences -------------- ¶3. (SBU) According to the resident representatives of the World Health Organization (WHO) in Gabon, the health sector strike directly contributed to a short-term rise in mortality rates, especially among pregnant women in labor, children suffering from malaria, and HIV/AIDS patients. The WHO representatives also noted that measles vaccinations were not administered during the two-month strike period, a serious public health concern. The government has not released official figures on the increased number of fatalities during the strike, and WHO officials have refrained from making an estimate at this time. Private hospitals and clinics have remained open throughout the strike. During the worst period, military health workers were dispatched to public hospitals and clinics, particularly in rural areas, to provide basic and emergency services. -------------- Resolution in Sight? -------------- ¶4. (SBU) When Gabon's first lady died after a protracted illness on March 14, health care workers temporarily called off their strike out of respect for President Bongo. The strike was resumed after the official mourning period, although an agreement reached in the meantime allowed for the resumption of essential duties. SYNAPS continues to negotiate and Mickala indicated that he is optimistic that a new agreement will be reached. -------------- Comment -------------- ¶5. (SBU) The health sector strike is the latest in a series of labor actions that have plagued Gabon's labor relations over the past year. The most significant of these labor actions was the education sector strike, which led to significant increases in salaries for teachers and other education professionals. Government authorities worry--with good reason--that giving a similar salary increase to health workers will lead to a domino effect of other sectors demanding the same, and Gabon's budget cannot support increased salaries and other benefits at a time of diminishing revenues and global economic crisis. While many workers are arguably underpaid, and government has a poor record of keeping its promises, employment rolls are also bloated across the public sector with workers who draw a salary and either underperform or fail to report to work at all. Some are fully employed in the private sector while continuing LIBREVILLE 00000138 002 OF 002 to draw a government paycheck. We will continue to monitor the situation and encourage effective policies to address Gabon's ongoing labor issues and its pressing need for civil service reform. End Comment. REDDICK