Identifier
Created
Classification
Origin
09LIBREVILLE138
2009-04-03 11:54:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Libreville
Cable title:  

Gabon's Health Sector in Crisis

Tags:  ELAB ECON PGOV SOCI GB 
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VZCZCXRO8904
RR RUEHBZ RUEHMA
DE RUEHLC #0138/01 0931154
ZNR UUUUU ZZH
R 031154Z APR 09
FM AMEMBASSY LIBREVILLE
TO RUEHC/SECSTATE WASHDC 1043
INFO RUEHYD/AMEMBASSY YAOUNDE 0995
RUEHMA/AMEMBASSY MALABO
RUEHBZ/AMEMBASSY BRAZZAVILLE 0911
RUEHUJA/AMEMBASSY ABUJA 0470
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

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Summary
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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

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Summary
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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.

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Longstanding Demands
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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).

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Deadly Consequences
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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.

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Resolution in Sight?
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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.

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Comment
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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