By Hanifa Manda
Part of the group of health workers displays their wrists spotting campaign wristbands inscribed with the hashtag #IStandWithHealthWorkers
Following the release of our research report, “Silent Killer: When Institutional Obligations Restrict Public Health workers’ Moral Duty to Save Lives”, in March this year, we (Campaign for Free Expression) visited Tshepong hospital in Klerksdorp in the North-West on Friday 19 May in a display of solidarity with public health workers to advocate for their freedom of expression through our campaign, #IStandWithHealthWorkers.
The campaign seeks to contribute to addressing some of the drivers of a culture of self-censorship that currently prevails among public health workers who fear facing disciplinary action under the Public Service Code of Conduct if they go beyond internal procedures to raise grievances.
We aim to build a solidarity network with healthcare professionals to offer support and protection for those who face victimisation after speaking out. In our research report, we highlighted how the Public Service Rules and Regulations prohibit all public workers from engaging the media without the approval of their supervisors, instead requiring workers to use internal procedures to address any grievances. However, we found that internal procedures only work to address grievances when systems work the way that they should, and management boards are independent. This is not the case in most public hospitals where our research found that there is no transparency in the appointment of hospital boards. They are made up of individuals handpicked by the Minister of Health with little apparent regard for their skills and competencies to govern such institutions. Our campaign aims to increase health workers’ awareness around their right to speak out.
We gathered close to 40 doctors, nurses and medical students for a presentation and discussion on our research findings. The presentation highlighted gaps and opportunities in the law that can either be utilised or need to be amended to allow health workers to publicly raise grievances within reasonable limits and if it is in the best interests of the public when internal systems don’t work.
As part of the meeting proceedings, participants filled in pre-meeting evaluation forms where I (as the Project Manager and meeting facilitator) asked specific questions to gauge the level of freedom that they enjoyed at the institution. In keeping with the wider research findings, I found that a majority of the workers at Tshepong are afraid to air their grievances freely. Many cited fear of victimization, potential job loss, being labelled an instigator and therefore being discriminated against, and being accused of putting the hospital into disrepute as some of the reasons for not speaking out. Even the anticipated discussion on the report findings did not go according to expectations as many participants remained mum following the attendance of some senior officials at the hospital. It was apparent that prior to the coming of the senior officials, participants had hoped to participate freely, as evidenced by their responses to a question in the pre-meeting evaluation, which asked what participants’ expectations were from the meeting.
Over and above familiarising health workers with our research findings and assessing their reactions to them, we seek to widen our research by documenting unpublicized cases of victimization of those that speak out, particularly through prolonged suspensions. All things being equal, we hope to visit more hospitals and use lessons learnt from our experience at Tshepong Hospital to navigate around the barriers to freedom of expression in the public health sector.
When public health workers speak out about their working conditions, they do so to perform their moral duty of saving lives. It allows members of the public to access crucial information that enables them to hold authorities to account. This in turn will improve citizens’ access to quality health care services. Look out for the hashtags #IstandWithHealthWorkers and #TogetherWeHaveOneVoice on all social media platforms to follow our updates on the campaign.
Hanifa Manda is a Project Manager at Campaign for Free Expression. She is a human rights, democracy and governance enthusiast who has researched and contributed to the design and delivery of projects to enhance Freedom of Expression and Access to Information in Africa, including through the provision of technical support to the office of the Special Rapporteur on Freedom of Expression and Access to Information at the African Commission on Human and People’s Rights. hanifa@freeexpression.org.za
