Ethics and Survival

The result of last year's May protest of Serbia's medical workers, when they managed to attain their rights for a salary increase by some thirty percent on the streets, had melted by October 1996. There have been no salary cuts; however, those employed in medical and social institutions are receiving them with an approximate one and a half month delay. As things now stand, the state owes the health services three salaries. Multiplied with the number of employees (140 thousand), the debt amounts to 550 million dinars. With each further 12-day-delay, the debt rises by another 212 million dinars. "The issue here isn't new union demands nor salary increases. We won that battle last May. The only thing we are demanding is that the agreements signed between the government of Serbia and the union on the dynamics of paying the leftover wages be observed. In short - that the government observes its obligations and signatures", says Dr. Stevan Djordjevic, president of the Republican Board of the Union of Health and Social Insurance for VREME. He does not hide his satisfaction with the response of its members for a protest which, by his evaluation, is more massive than last year: eighty percent of all employees are on strike. Protests are held in Nis, Belgrade, Kragujevac, Novi Sad and other cities in Vojvodina, Smederevo. Hospitals and medical centers have on-duty staff as during state holidays, and only clinics handling urgent cases, general medicine and pediatrics are normally operating.

The strongbox of the Social Insurance Fund had rapidly started to empty towards the end of last year when the government of Serbia decided to protect social peace in the country by relieving a large number of companies and funds from paying social insurance. A number of 10,000 so-called economic entities are mentioned. At the last session of the Health Board of the parliament of Serbia, the Satrid 1913 case was mentioned (better known as a "successful" company owned by Dusan Matkovic) as one who has been given permission to cease all insurance payments during the last two years, allowing him to pay off his debt by installments.

Dr. Milomir Novakovic, President of the City Health Board of Nis, says for VREME that non-payment of insurance policies has become a thing of prestige and that even well-off companies are competing amongst themselves as to which company is more adroit at evading this social and legal obligation.

Around seven thousand employees in Nis's medical centers were the only ones in the republic who demanded the resignation of the Minister of Health Leposava Milicevic. They justified that by the unfulfilled promises and incapability of the above mentioned minister to improve the situation in the health institutions by one iota.

If we were to judge by the reactions of the leader of the Republican Union, Dr. Stevan Djordjevic, the remaining employees who are unsatisfied with their wages are satisfied with the work and engagement of Dr. Leposava Milicevic. "She sticks by her promises and does not go back on what she has signed and what she has agreed upon. It is not a question of personal liability but rather a chronic lack of funds as well as non-observation of previous agreements. Her official letter of March 18 confirmed our indisputable right for minimum working conditions, regardless of what is stated in the provisions of the Law on Strike." Following up on our remark that she is announcing improved conditions in statements given every few months, Dr. Djordjevic answers that the problem is within the government rather than with the head of the Ministry of Health.

Except during strikes and negotiations, the government does not communicate with the union, even when it decides on reducing the obligation of health insurance. During tumultuous public reactions over the gradual abolishment of free medical treatment, the health union issued no statements. Dr. Djordjevic confirms this information, explaining that no one had officially informed them of this.

In the existing situation, not all medical employees are equally interested in the strike. The directors who are very carefully, in terms of loyalty, appointed by the government are not supporting the strike in most cases and are not acknowledging the catastrophic state in the medical institutions. They are even issuing commands by which their doctors cannot inform the patient that the hospital is out of certain pharmaceutical products, along with gauze and alcohol. Those holding the highest titles are receiving at least two salaries as doctors and university professors. "Ordinary" doctors are accused of accepting bribes and they often supplement their income by working in private clinics. Those remaining are nurses, orderlies, cleaners... The President of the Republican Board of Unions, Dr. Djordjevic, says that they are the fiercest people in the strike, the most solidary and most rational ones. "They are the members one can count on."

Reacting to the remark that doctors should not be on strike nor should they take bribes, Dr. Djordjevic says that a man today is forced to divide himself between the ethics of the vocation and survival: "How can anyone be condemned in this situation? By dragging out the already meager salaries, the government is aiming towards an illegal "by-pass" and we are constantly being accused of not understanding the situation of the economy, the crisis. This strike is aimed against the government, not against our patients who must understand that a person cannot work without a decent salary for years. Not to mention the conditions in the hospitals. And when something goes amiss, it is always the doctor's fault."

It is difficult to predict how long the protest shall last at this moment. If all are waiting for the government to procure funds by which they would cover their debt towards the medical employees, according to the statements of the top officials, that shall not be in the near future. Dr. Leposava Milicevic, opening up a new surgical wing in Pozarevac's hospital these days, according to Nasa Borba Daily, has pointed out the impotency of the ministry as regards authorization to procure the necessary funds. She reminded that during the negotiations on a salary increase she had warned "that any increase would make the payment of all salaries irregular. Prior to September, that shall prove to be extremely difficult without any interventions. However, if the government interventions were possible, they would already have been made. We wouldn't have waited for the strike to be announced. It is utterly ludicrous to believe that the condition could be improved and that someone does not wish them to..."

The union is not negotiating with the government at this moment, since, as they say, they have nothing to negotiate. They have agreed on everything a year ago. Still, Dr. Djordjevic leaves room for a possible compromise on the dynamics of paying out the government debt to the medical sector. The only thing the union members fear is the appearance of Dusan Vlatkovic, the Minister of Finance, on state TV, because his appearance signifies that no funds are available while accusations are hurled upon the union that they are demanding more than they need.

A street rally is scheduled this Thursday in front of the Government of Serbia Building, while the union leaders are equally fearing both their members and the government. As for the outcome of the strike which was being prepared from March, as they themselves say, they do not even dare think about it.