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FRONTLINE DOCTORS: Who defends their rights

Author: Cornelia Cozonac
02/10/2020 15973

Healthcare workers were among the first to be hit hard by the coronavirus pandemic. Exhausting shifts, extensive work, work for two, three or more colleagues who either got sick or left the system for good, always exposed to contamination, due to insecurity at work, doctors, nurses and technical staff in hospitals are resolutely dealing with the situation imposed by the coronavirus pandemic, even though the system has not always defended their rights.

Official statistics report daily cases of infection among health care staff. The latest data, seven months after the pandemic, show that about 6,000 healthcare staff had Covid and 40 of them died. These heavy figures reveal the vulnerabilities of the healthcare system in Moldova in the face of a large pandemic. Insecurity at work, lack of quality protective equipment, delayed testing, stress and extensive work are the sources of violation of the rights that the healthcare staff should benefit. The situation has worsened amid antagonistic relations between the healthcare staff and the administration of the institution.

Report of the Ministry of Health, Labor and Social Protection as of September 30, 2020

"We suffocate in PPE suits, we are depressed, but we can't give up work"

They haven't seen their families for months, it's hard for them, but they don't complain. These are frontline doctors and nurses who save lives at the Emergency Hospital in Chisinau, the institution that receives patients with suspicion of Covid. Olga Cuconașu is a nurse in the ward for the treatment of covid patients. It is exhausting, but she says she cannot give up her job during this difficult time: “We are out, exhausted. When you start dressing in that PPE suit (protective suit, n.r.), you are still not fully clothed and you seem to have a fear and you suffocate, the heat from the coverall suffocates you and you don't seem to have enough air. We are allowed, if we feel bad, or if the mask is wet, to leave the area for 15-20 minutes, after which we return. We work four hours each. We do three shifts four hours each. The shifts are difficult, there are many patients, there is shortage of staff. I like the profession I chose and I don't give it up ", says Olga. She has been working in the intensive care unit at the Emergency Hospital since 2006. When the pandemic began, she has moved to the Covid Section. For almost seven months, together with other colleagues, she has been living in the "Așchiuță" House, offered by the NGO "Ave Copiii".

First-line employees from the Emergency Department who have not been going home for seven months, in order to protect their loved ones. They are hosted by the Ave Copiii Association

Irina Surdu, another nurse, has only been working for a year. She joined Intensive Care immediately after she had graduated from the College of Medicine. "In the first month we worked by three days of rest between shifts, now we have only two days of rest. At first it seemed ok, we will resist. In fact, it is very exhausting. We are extremely exhausted. Two days pass very quickly. On the first day, we sleep actually all day, as it is very hot and the heat exhausts you even more ", says Irina. She says the hardest part was wearing the suits in the Covid area. "You feel stressed in the suit, lack of oxygen, I had panic attacks, I started to cry from nothing, sweat. I always get wet; the surgical suit looks like it's taken out of the washing machine. Sweat runs down my eyes and stings me. Another hard part was to see people who come here and are hospitalized, panicked people, who do not know what is happening to them. The hardest part was getting used to seeing so many people in critical condition”.

"Honestly, we are more psychologically affected. If we used to smile, we tried to motivate each other, we already have a few shifts with quarrels, we don't even know what we're arguing about, we're annoyed by any small thing. We are always upset; the irascibility is up. Psychologists do not work with us. We motivate ourselves, we think that we will live after the covid, that this is our job, to save lives. I tested seven or eight times. All of them negative. And my friends calmed down and started going for walks ", says Irina.

Initiatives to ensure the rights of healthcare workers

Amid the ongoing pandemic in Moldova, the cases of violation of the rights of employees in the health system intensified. Almost every third of the about 10,000 doctors and over 20,000 nurses were infected with Covid since the beginning of the pandemic, and the situation is worsening. In some healthcare institutions, over 80 percent of the staff fell ill in the first months of the pandemic.

If in some institutions, doctors and nurses were treated with indulgence, encouraged to work in Covid wards where those infected with the new coronavirus are treated, in other institutions this was done by harsh orders of the administration, without taking into account the employees’ wishes.

"We had complaints related to the dismissal of employees on the grounds that they refused to be transferred to the Covid-19 sections. People said that they were determined to leave not because they do not want to work, but because they either have chronic diseases or are part of the risk group given their age and thus endanger their lives. Two people told us that they were forced to write resignation requests, so it is a violation of the right to work ", says the lawyer Olesea Doronceanu from the Institute for Human Rights (IDOM), NGO, which initiated from the first month of the pandemic a care center for people whose rights have been violated. The experts provide free assistance primarily to doctors to ensure their rights. Olesea Doronceanu says that initially the employees from the healthcare system complained about the lack of protective equipment but now they are also talking about other violated rights.

In quarantine - at work

A case in which the lawyers from IDOM intervened happened at the Psychoneurological Boarding School from Brânzenii-Noi, Edineț district, an institution that, in April, had over 80 percent of beneficiaries and employees infected with the new coronavirus. Several employees who were supposed to be in quarantine were forced by the boarding school administration to work for two weeks. The daughter of one of the nurses posted videos on her Facebook page with the conditions in which the employees had to work. Olesea Doronceanu says that the documents of this case were prepared to go to court. "These are serious violations. The administration of the institution not only kept them for two weeks, apparently in quarantine, ie in isolation, but forced them to work. They also contacted the beneficiaries of the institution ", says the lawyer.

Collage: CIJM

One off allowance and salary benefits, paid arbitrarily

In order to encourage the frontline employees, the Government decided in March to grant a one off allowance of 16 thousand lei to those who contracted the virus at workplace. To the frontline employees - in the covid sections, the relevant ministry decided to grant them a remuneration amounted to a monthly salary, ie to double their salary. But the way the allowance and the 100% salary supplement were granted aroused suspicion and discord. As the number of infected people started to increase considerably, the authorities started to accuse doctors of not protecting themselves, of misusing protective suits and that most people do not contract the virus at work. Several healthcare workers complained that they contracted the virus at work or were infected from family members working for another healthcare institution, but hospital administrations rejected the doctors' claims.

By September, according to official information, just over 2,000 one off allowances had been granted, which means that only one in three employees of the healthcare system who fell ill received the promised money.

Healthcare authorities argue the slow pace of decision-making in this regard by making it difficult for them to determine whether one doctor or another was infected at work.

Data of the Ministry of Health, Labor and Social Protection from September 30, 2020

At the Clinical Hospital in Bălți (SCB), as well as in other healthcare institutions, in the first months after the onset of the pandemic, all patients were screened at the Emergency Unit. Doctors and nurses, as well as technical staff, were at risk of infection and more than half of the employees contracted the virus, especially because they did not have protective equipment in the first weeks. Subsequently, a Covid ward was organized in the hospital and patients with coronavirus symptoms are directed on a special corridor to this ward. None of the employees working at the Emergency Unit received the salary benefit for the first months, at least for April, when they have been in contact with covid patients. Some employees who became infected found it very difficult to obtain the indemnity of 16 thousand lei, in some cases after the intervention of lawyers or under the pressure of medical colleagues.

"In the first months we worked without equipment, we had simple masks. But we received all the patients who came. We performed the triage, we did the radiological examination and if they were confirmed that they have Covid symptoms, we sent them to the Covid section and in such a way we were in contact with them. When some colleagues contracted the virus, the hospital administration did not want to admit that they became infected at work. Eventually, they received the allowance of 16 thousand lei, but it was difficult to get it ", says Igor Calistru, doctor in the Emergency Unit of the Clinical Hospital in Bălți.

Doctors in the Emergency Unit who worked with Covid-19 patients made several requests to the hospital administration to be given the salary benefit, at least for April. They even notified the Ministry of Health, but by September they did not have a clear answer.

"Even if a corridor for covid was opened in the hospital, the emergency unit is at risk of having patients with covid, because we perform the triage, but the administration considers that we are not in a risk zone", says Dr. Calistru.

The Emergency Unit had about 70 medical workers who were in contact with at least 92 patients who were subsequently tested positive for coronavirus. Employees did not receive a salary supplement for April. At least six doctors and five nurses from the Emergency Unit became infected with Covid-19. SCB has two deaths among doctors as a result of complications caused by coronavirus.

Early in September, the Government led by Ion Chicu decided to give up the single allowance of 16 thousand lei, on the grounds that the doctors' remuneration has increased, and the institutions have the necessary equipment. The decision of the Government, hidden among other decisions and not publicly discussed, aroused the revolt of the employees in the healthcare system, who say that, although it is not a large amount, it was mostly a moment of encouragement. However, the large number of infected people among the healthcare employees - a few dozen every day - shows that securing jobs in hospitals is far from a good way to protect them. In the end, the Parliament rejected the Government's proposal, leaving in force the provisions of the legislation for granting the support of 16 thousand lei for the employees who are infected at work.

Why are the doctors leaving?

Tired of fighting for his rights, Dr. Calistru recently applied for dismissal. He was at his wit’ s end. "The work schedule is not respected. These are arbitrary decisions of the administration ", says the doctor. Doctor Gheorghe Brânză has worked in the Intensive Care Unit at SCB for seven years. He resigned at the SCB one year ago and he commutes on his own weekly to two district hospitals. Three months ago, Dr. Valentina Baltag also quitted the hospital, she has worked as anesthesiologist-resuscitator in the Resuscitation Department for 8 years. "Working conditions were deplorable, all my colleagues got sick, they were hospitalized with infectious diseases. It was such an ugly, serious and oppressive situation both morally and physically. We weren't paid, they said on TV that they would offer to doctors a double salary. Initially, we didn't get anything, we asked for answers or made a post on Facebook and asked where our salary is, where is what they promised us, later we were insulted, others threatened, they forced us to delete the posts and warned us with criminal cases ", says the doctor.

The doctors from Bălți say that at least 10 doctors have left the Resuscitation Department in recent years alone. They even made a list of the names of the doctors who had to look for another job. Proof that the institution is facing a lack of staff in this section is also an announcement on the hospital's website about vacancies. Most vacancies - exactly six - are in the Anesthesia and Intensive Care Unit.

Protest action at the Clinical Hospital in Bălți carried out by the Alternative Trade Union "Support"

Diana Grosu, president of the NGO "Lex XXI" in Balti, which helps doctors defend their rights, says that there are already hostile relations between the hospital administration and several doctors and nurses, which makes it difficult for doctors to work and many of them leave the institution: “There are many problems at this hospital. The management admits abuses, doctors see, revolt, demand their rights, and the administration puts pressure on them. ANI is now investigating a potential conflict of interest and a case of failure to file a declaration of assets and personal interests. The management pours its dissatisfaction on the doctors. The situation worsened during the pandemic. A large number of doctors and nurses are about to leave the hospital. Many have quitted. This is what happens", said the lawyer.

Lack of reaction from the SCB administration

We tried to talk to the SCB administration, but we could not. Initially, the representatives of the hospital's management were willing to discuss the problems invoked by the doctors, they promised to give us documents, but after several days of delay, the deputy director Ala Condrea did not answer the phone. For the portal Nordnews.md, Ala Condrea rejected the accusations that pressure would be put on the doctors and said that those who were fired did so on their own initiative.

"Doctor, you have rights too!"

A law firm decided to offer its services free of charge in support of frontline doctors. The "Doctor, you have rights" campaign, launched by the Associate Law Firm "Legal Service" gathered dozens of complaints from employees in the healthcare system.

"We helped several doctors to challenge abusive orders of the administrations, to write requests when they their rights are violated. Most cases involved the transfer of doctors to Covid wards without their consent. Doctors who are specialists in certain fields had to work as infectionists", says the lawyer Ion Botnarenco. A similar case happened at the District Hospital in Straseni. The administration ordered that neurologists work as infectionists, even in a higher position than the one they held, but the doctors were outraged. Following the lawyers’ intervention, the administration was forced to withdraw its order.

Non-transparent labor relations

Among the system problems noted by lawyers is the fact that doctors, for the most part, do not know the provisions of the employment contract, do not know much about employment relationship, and the administrations of some healthcare institutions are not open to make clear these reports and the employee’s rights.

"In most cases, when a doctor agrees to be hired by application, the documents subsequent to the exercise (employment order, employment contract, salary conditions according to the staff statements, job description are formally presented for signing). etc.), but only in the copy signed for the subdivision responsible for staff. It is a situation that crossed a serious line of the person in charge of "staff" in relation to the naivete of the employee, to consider that the personal file in its own copy is a tertiary problem, a situation speculated by the administration ", says lawyer Eduard Hadei.

"Feudal behaviors of the manager of the hospital unit"

The situation at the Clinical Hospital in Balti is similar to that of other healthcare institutions. Several doctors I spoke to complained about the authoritarian and unilateral actions of hospital managers. The complaints of some doctors also reached the Associate Law Firm "Legal Service" within the "Doctor, you have rights" Campaign.

Lawyer Eduard Hadei says that these problems have worsened during the pandemic.

„The managers of the hospital units are most often appointed on clientelistic criteria, they show authoritarian attitudes, like holding medieval fiefs, having the support of decision makers, those who enthroned them (political criteria / caste / kinship). On the other hand, all employed doctors are treated as his subordinates in terms of the unipersonal decision of the manager regarding salary / promotion and working conditions.

In the event that a doctor claims his legal rights, through elementary requests to provide him with the documents that determine employment relationships (especially salary, the limit of obligations in the job description), medical unit managers do nothing but ignore / intimidate / obstruct, which means they violate the employee's rights. Illegal actions occur through precise instructions given by the accounting managers, the staff manager - to refuse or to delay the provision of data or documents, on the grounds that "your request is to the boss, we are waiting for instructions", followed by instructions given to direct bosses of the employee, to intimidate and put administrative and executory pressure on doctors, by creating unfavorable working conditions ”, says lawyer Hadei.

The doctor Calistru from the Clinical Hospital in Bălți tells us that the employees cannot verify the accounting information, even if they would have suspicions that their rights are being abused. "The administration is free to do what it wants and how it wants. We can't check anything. And no one does it. Because everything is allowed by the top management. From Chisinau. Only an independent audit would reveal many violations, but this will not be done in the near future ", says the doctor.

The state of affairs in some healthcare institutions is known by the Healthcare Workers' Trade Union "Sanatatea". The deputy president of the Trade Union Igor Zubcu says that he knows at most three healthcare institutions in which the chief doctor would be an authoritarian one while such problems are not registered in other institutions. "In all healthcare institutions, especially in the district ones, the employees are divided into camps, some even on political criteria. Some are supporters of the institution's leadership, and others are on opposite side of the barricade. And hence the dissensions ", says Igor Zubcu.

Refusal to test doctors

Expert Ala Nemerenco, former Minister of Health, considers that the healthcare workers' right to health has been violated by the fact that they were not tested when the situation required this lab examination: " When half of the healthcare staff was in quarantine, the people whom the doctors contacted, were not tested, and thus violated their right to health care. They are just not ordinary citizens who contracted the virus in a supermarket, they are in daily contact with patients, they are exposed to this risk and when they had to be tested according to international protocols, this right was violated ".

At the beginning of April, a nurse from the Institute of Oncology informed us on the Anticoruptie.md portal that the administration of the institution would have refused to test the employees who have the symptoms of the virus. "All of us had or have it. Some of us have been ill since February, when we had patients who came from Italy. We asked to be tested, but our superiors do not dare to request this from management. I think they are afraid that they will not have anyone to work with or they are forbidden to do that ", said the nurse. She herself later had a severe form of covid. She was treated at home, on her own, because she had no one to leave the small children with. Although she became infected at work, as well as other colleagues in the department where she works, the administration of the institution did not include the case among those with covid and, respectively, did not pay her the allowance of 16 thousand lei. "I didn't have the test, I was sick, I couldn't go and do it. I couldn't even leave the children alone. When I got back to work, I took the antibody test and it's positive. I did not insist that the case be investigated and proved that I had covid. It was made clear to me that if I did not have the test, my case would not be analyzed. I am happy that I am OK now and I can return to work. In this difficult situation, I think that the administrations of the healthcare institutions should pay more attention to the employees, this is what we need now”, the nurse tells us.

Another complaint came in July from a group of doctors from the "Sfinta Treime" Hospital, who wrote on the Corruption Map of the Center for Investigative Journalism portal, www.anticoruptie.md, about the fact that the institution, which is not a specialized hospital in covid had an outbreak of infection. "Last week, a doctor and three nurses tested positive. Now a few other medical workers, with fever, are waiting for the test results. The administration says it is "sorry", but does not intend to test employees or quarantine them. We are told that we will work to the last doctor. In other hospitals, employees are tested every two weeks, but at the Sfinta Treime Hospital they do not want to spend money from the budget, although employees have asked for tests several times. We, the healthcare workers, endanger our families and our own lives ", the doctors wrote in an anonymous message. The hospital administration initially told us that it did not have a covid outbreak. "The regulation clearly stipulates the need to test people who have clinical signs. No symptoms, no test", said the spokesperson of the institution, Galina Alcaz.

Only after we requested information from the National Agency for Public Health, which confirmed in its reply that at the "Sfinta Treime" Hospital there are at least 10 infected employees, the hospital administration decided to test all employees.

The doctors from the Bălți Clinical Hospital also say that the hospital administration refused to test the doctors who were in contact with the covid patients. They were tested under pressure of doctors.

Many doctors, worried about the situation and the state of their health, do covid tests, by paying the costs on their own. The Ministry of Health, Labor and Social Protection refused to tell us how many healthcare employees bore the expenses on their own, noting that it has no such data.

Doctors obliged to bear the costs of Covid-19 treatment

Iurie is a family doctor at a healthcare institution in Chisinau. He was at home when we talked. He received coronavirus treatment. He says he contracted the infection at work, but has to bear the costs of treatment on his own. The administration does not admit that we contracted the disease at work, because other employees are not infected. At home, family members also were infected - his wife and two children. The treatment makes him take out of the family budget an amount almost equal to his salary as a doctor, the doctor tells us. I asked him why he was not trying to do the medical treatment at the expense of the health insurance policy. "Not working. It is only for show", the doctor replied.

The situation is similar at several healthcare institutions. At the Mother and Child Center, the director of the institution, Sergiu Gladun, issued an order at the beginning of September, obliging all employees to sign, by September 30, a declaration on their own responsibility by which they assume all risks and consequences of Covid-19 infection. The document reads: "I voluntarily assume all the risks and consequences on my life and health (including financial expenses from my own sources), during my activity in the BMI, including during my physical presence at work , including the period of travel to and from work, being aware of the epidemiological situation in Moldova and the risks to my health and other people I will be in contact with, in case of symptoms (cough, fever) and the use of disinfectants. I undertake to respect the recommendation to self-monitor my health daily, and when the clinical symptoms of respiratory infection appear, I will go to the family doctor, I will avoid contact with other people and I will inform the head of department in writing, by e-mail or SMS ".

The text of the statement was amended only after several employees were outraged.

Representatives of the administration argued their decision by the fact that the first document was developed for the purpose of informing and empowering employees to comply with the rules of protection against Covid 19 - to wear a mask, to disinfect hands, to prevent infections.

The president of the "Sanatate" Trade Union, Igor Zubcu, claims that he heard about the situation at the Mother and Child Center, but that no doctor notified the Union about the situation, as it happens in other cases when abuses are committed by the administration. "If there are no complaints, notifications, we cannot act to help the doctors. Employees' rights must be negotiated, obtained by the team through discussions with the administration. It is easier to turn to lawyers, because that is how you delegate actions to them. But the union process presupposes that employees must collectively claim their rights, to obtain decent, safe working conditions. It is a process that brings long-term dividends for all employees ", says the union leader.

The hospital without infected employees

The municipal clinical hospital for contagious diseases of children in Chisinau was named a strategic hospital for the hospitalization of Covid-19 patients. Not only covid children are hospitalized here, but also one of the adults, usually the child's mother, who in most cases is also infected. In these conditions, the institution did not have any case of illness among the healthcare staff due to a strict care of procedures and a very good management in terms of very good delimitation of contaminated areas and work in reds and greens and strict wearing of protective equipment despite the unbearable heat, said the doctors from the institution.

Collage: CIJM

Although she has the situation under control and all the doctors are healthy, the director of the hospital, Ludmila Bîrcă is cautious. She says that this period of pandemic is a stressful and complicated one. "We had help from international organizations, especially from UNICEF, which gave us the necessary protective equipment for employees", says the hospital's director.

"This helps us not to wear the suits eight hours a day, but to be better able to work. However, that half hour, an hour we spend in the living room with the patient, is enough to suffocate. We go out wet, drink water and enter the next salon ", says the doctor of the hospital, Tatiana Știrbu.

"It was difficult, because it's a new infection, we don't know what can happen next. We have patients who need long-term treatment. Protective suits must be changed every time we enter a salon, when we visit a patient. When we have quality protective equipment, we work safer. Only patients with Covid confirmed from Moldova come to us. Some patients have family members in other healthcare institutions, some lost a loved one while they were in the hospital with us. You have to help them to overcome this situation. Others do up to eight tests until they get a negative test and this is difficult ", says Diana Vlad, head of the intensive care unit.

Working overtime

An old problem, which has worsened since the beginning of the pandemic, is working overtime, especially due to the shortage of doctors and nurses in hospitals where Covid-19 patients are treated, says Ala Nemereco: "In our country one person works for ten, there is shortage of nurses in resuscitation area. If in the USA, a nurse is responsible for a resuscitation bed, in Moldova an assistant is responsible for several beds while at the Republican Hospital, a nurse is responsible for seven beds. The situation has worsened since the pandemic started. In many hospitals, employees got ill, had to be treated, quarantined, and those who remained worked overtime. And hence other illnesses - depression and burnout. Here are two factors - physical work, burnout, stress. A small mistake and you got infected ... ", says Ala Nemerenco.

In several healthcare institutions there is a common practice for years, that employees work in shifts, 24 hours a day, although the law prohibits working more than 8-12 hours a day. Some doctors say that they are sometimes at work for two shifts of 24 hours in a row. This is because there are not enough doctors, nurses. And some ambulance drivers are at work for 24 hours. In the healthcare institutions in Chisinau, the nurses come from the suburbs and it is convenient for them to work 24 hours or 36 hours, after which they have a break of one or two days. Maria is a nurse at the Oncology Institute. She says that for years, there is a shortage of nurses in the ward where she works and the ones who are there have to work long hours, make double and even triple effort. "We go to work in the morning and go out the next morning. It suits us like that, because after that we have another 24 free hours. It is true that after a tiring job you have to rest. Now, in the pandemic, things are much more stressful. Initially many nurses did not resist and quitted the system. Now there is no one to leave. We get sick, we treat ourselves and we go back to work ", says Maria.

At the Clinical Hospital in Bălți we encounter the same situation. Doctors tell us that there are more shifts than before because there are not enough employees, but the salary has not increased. For example, if previously for a salary there were six or seven shifts, now there are 11-12 shifts of 24 hours each.

A few years ago, in a journalistic investigation, I found at the District Hospital from Cimișlia, the surgeon Sergiu Budei, on the third day of continuous work at the hospital. Details you can find in the investigation "Doctors also get tired".

The situation has not changed in recent years. Moreover, since the beginning of the pandemic, many institutions have regularly faced a shortage of staff, as some of the employees were either in quarantine, on hospital beds or at home for treatment. And those who remained at work had to deal with the exhausting workload and far beyond the schedule.

"We will not find inconsistencies in the employment contracts, they are usually perfected as cumulative work, but, in fact, this is how the work over the schedule is camouflaged", says the vice-president of the "Sanatate" Trade Union Igor Zubcu. He points that he has been discussing this issue for several years, but it arouses dissatisfaction among employees, who say that these situations suit them, that they spend less money on transportation. Cumulative contracts allow them to have a higher remuneration. However, experts in the field say that if the pay for eight hours of work were decent, which would allow employees in the system to cover their daily needs, support their families and have resources for rest, they would not have to work on two or more shifts.

The bosses received their salaries, but the employees didn’t

Ludmila David is a doctor of medical sciences, an internist, and she has been working for several years at the sanitary healthcare institution "Constructorul" in Chisinau. She says that as of the beginning of the pandemic, she has not received her monthly salary like many of the institution's employees. "The administration received a constant salary throughout this period, but most of the employees did not receive anything. We were not even told if we were technically unemployed or not. For example, I worked all this time, but from April to now I have not received a salary ", says the doctor. From the beginning of the pandemic, the institution ceased its activity, initially during the state of emergency, then it acted as an institution for receiving Covid patients. Ludmila David tried to demand her rights, but the tough attitude of the administration refused any discussion. The case was sent to court. The doctor was helped by the Associate's Legal Office, which carries out the "Doctor, you have rights" campaign. "Her labor rights were violated. The administration did not want to explain to us our requests. We will ask for them in the trial ", states the lawyer Eduard Hadei. I called the director of the Sanatorium "Constructorul", Alexei Zlatovcen, who told us briefly that there would be no conflict and that Dr. David would not have written an application for job during that period, that she would have worked in parallel in another healthcare institution. When he was asked about the dispute in court, the director recommended that we talk to the institution's lawyer and ... he ended the call.

Launch of the Alternative Union "Support"

Alternative trade union in Balti

In order to better defend their rights, doctors and nurses from the Clinical Hospital from Bălți and doctors who previously worked in this institution decided, in July, to create a new, alternative trade union. The "Sustinere" trade union was launched in July, in Bălți, and now it has 16 members. Initially, 33 healthcare workers joined the union, but soon 17 of them withdrew their applications. The newly created organization was registered in the State Register of Legal Entities on August 12 this year. Diana Grosu is a lawyer and, lately, she has helped doctors to defend their rights. She was elected vice president of the newly formed union. "A group of medical employees decided to join an alternative trade union in order to be able to defend their rights, to change things in the healthcare system. The old union does not defend their rights. There were many situations in which the union was not present. Now, when "Sustinere" Union was launched, the existing union has also been active, it purchased protective equipment. The "Sustinere" trade union is open to all employees in the healthcare system and aims to defend their rights, to be transparent", said Diana Grosu in the launch conference.

The president of the "Sustinere" Trade Union, doctor Gheorghe Brânză, says that the doctors who joined the union have written requests to leave the hospital union, but are facing pressure from the administration and the trade union management. They consider that it cannot defend their rights, as its president is part of the hospital's administration, she is the head of the SCB Advisory Center, and in fact, is in a conflict of interest. Moreover, those who applied to leave the union say that the administration would put pressure on them.

"All nurses withdrew their applications to join the" Sustinere " Trade Union. Some were told directly that they would have problems, that they would no longer benefit from facilities from the administration. There were tough discussions. Some even received tough rebukes. For example, the doctor Igor Calistru has been working at the Balti Clinical Hospital for 20 years. He never had any disciplinary action. He was one of the few who demanded fairness in the payment of salaries for his colleagues during Covid-19. Sanctions are now being "fabricated" against him. He is found guilty for problems that have nothing to do with him ", said Gheorghe Brânză.

Gheorghe Brânză

"Doctors were deployed from one department to another, to work with covid patients without their consent. They were simply informed that tomorrow you will go and work there. The work schedule is roughly violated. A salary unit is about six to seven shifts of 24 hours each. Now for the same salary there are 11-12 shifts. For the simple reason, shortage of doctors. Now in the Intensive Care Unit two neurosurgeons work for the same reason, that the department cannot cover the necessary staff and they employed two neurosurgeons for shifts. Resuscitation doctors are on duty at the covid Department. The salary supplement is paid only to doctors working with covid patients. At the Emergency Reception Unit, which receives all patients, some of them with confirmed covid, they are not paid that benefit ", said the doctor Gheorghe Brânză.

Marcela Bagrin is a nurse in the Emergency Unit. She said at the union's launch conference that for four years, since she has been working at the hospital, she has not known about a trade union at the hospital: "She was not present when the positions were reduced, when the doctors had to leave. We work under great pressure. The hospital administration tells us, if you don't like it, leave. It's not normal like that. We want support, we want to defend our rights. Many of the colleagues who initially joined our union later withdrew their applications. They say that they are afraid and they do not want to have problems ", says Marcela Bagrin.

One of the first actions of the "Sustinere" Trade Union was the notification of the hospital management regarding the need to pay the salary supplement for doctors who worked with Covid patients, each second of them was infected at work, but also a notification to the Ministry Health, Labor and Social Protection to analyze the case of Dr. Calistru, which the Union considers a harassment based on opinion and membership in the new union.

What the "Sanatate" Branch Trade Union says 

The new union created in Bălți requested to be accepted as a full member of the healthcare trade union. The vice-president of the "Sanatate" Trade Union Igor Zubcu says that trade unions are organized on the principle of solidarity and it is the right of doctors to organize in a primary trade union organization, if they consider that this is how they can defend their rights, only a union must work collectively based on some rules.

"The doctors from the Hospital from Bălți alone chose their union leader, no one imposed him from the top management. In many institutions there are several camps, some are more active, they demand their rights to assemblies, but when you propose them to lead the union, to negotiate their rights with the administrations, then you don't hear them anymore ", says Zubcu. The union leader pointed that the situation regarding the new trade union from Bălți will be analyzed at a meeting of the Healthcare Union council and a decision will be taken.

What doctors fear

Several doctors we talked to and who talked about the problems in the system, asked us not to reveal their names. Most of them are afraid that they will have problems, that they will have to look for another job. Doctors tell us that when an employee is dissatisfied with working conditions and tries to claim his rights, he quickly becomes undesirable. Problems and shortcomings are sought with him. It involves even patients who complain about doctors. In this way, the administration can more easily use various levers against rebellious doctors. Doctor Calistru from Bălți says that, after he addressed several problems at the institution where he works, he got a tough rebuke from the administration “A patient complained that he was not given chemotherapy procedures. And he complained to the ministry.

We, doctors are not guilty because such decisions were taken at the level of the ministry, the hospital, in order to give up during the state of emergency several procedures, treatments considered not so urgent. But in the end, they found me responsible and rebuked me. Without any notification, without convening a council to analyze the situation, to make the necessary expertise and to see if I am the culprit, responsible for that situation. Nobody defended me. I found out from the accounting service that I have a tough reprimand ", says doctor Ion Calistru. Another doctor was forced to leave the Hospital in Balti, after he has for several years as a resuscitator. It is about Gheorghe Brânză who now commutes several times a week to several hospitals in northern Moldova. He says that the heads of hospitals know each other and often when a doctor leaves the institution because he was dissatisfied with the conditions or he defended his rights, they call and talk about that doctor. Most of the time, the discussions are not for the benefit of those who leave and want to work in other institutions. "It is quite difficult to get hired at another institution after a recommendation has been made to you that you are scandalous, that you interfere where you should not, that you are dissatisfied and so on. The fact that you demand your rights is not treated as something appropriately", says Gheorghe Brânză. The doctor says that, in recent years, at least 10 doctors quitted the department where he worked.

Mariana Colun, Mădălin Necșuțu and Marin Bogonovschi contributed to this investigation.

This article appears in the project of the Friedrich Ebert Foundation Moldova "Promotion of social reforms and employees’ rights in Moldova: Journalistic investigations".

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