Interns complain of poor pay, heavy workloads and repeated over-time, inadequate facilities.

The protests that started recently by final-year medical students and interns working in government hospitals in Jimma town and later in Assela which was met by a crackdown by government security forces has mobilized others in different parts of the country. This past week in Addis Ababa and other regional towns such as Bahir Dar, Mekele, Jigjiga, Haromay, the interns took to the streets to express their plight and frustration, something that has been simmering away for a number of years. The issue has been kept in the dark in the past years because protests have been barred, the intern said. Since a new administration came to power a year ago, they have taken advantage of their new freedom to hold protests, though the conduct of security officers in some areas contradict the claim. The federal government officials’ reaction, vague and general declarations are not helping to appease the protesters, critics say.

The interns’ plights

The interns complain of poor pay, heavy workloads and repeated over time, inadequate facilities, the rising cost of the cost-sharing scheme, and concerns of not being able to land jobs. One of the marchers, an intern at Tikur Anbessa Specialized Hospital of the Addis Ababa University told Fana TV that: “Most of the cases that come to us are severe and complicated. They need much more care than those patients who are treated in a day’s visit. But we have only a few resources for our disposal. The culprit is tighter budgets, we are told. Even with the budgets, the allocated sum ends fast, since Tikur Anbesa provides free service, they say.” The intern added: “However, the truth is most of the problems are related to administrative issues and managerial capacity. This has exposed us to lack of basic stuff such as examination gloves, tools to check blood sugar level, even the tiny blood pressure monitor. Other tools such as MRI or CT scan rarely function, only three or four months a year.”

Another intern at Tiku Anbessa said: “Most patients come to the hospital and wait in line without getting attention soon enough. This is because of bureaucracy, they are told to go here, there. There is a long process to get care. ……….We have also work-load and stress related to duties including working on outside of daytime hours or through the night at weekends. The 36 hours duty is not only unfair but also inhuman. We don’t get any payment for that. We are asking for the changes in the duty hours. If that option is not considered, we should be paid for it.”

Most of the interns also complain about the cost-sharing scheme, a government loan program for higher education students to cover partial cost of teaching and learning, which they feel is too high, more than 400,000 thousand birr. Graduates stepping out of training programmes not being employed by regional governments under the excuse of lack of budgets, they also say.

The official’s reactions

Two officials who were interviewed in the state media offered no tangible solutions, only making vague remarks that cloud the issue than providing the real fix. Dr. Yekoyesew Worku Director-General of Operation sector at the Ministry of Health told Fana TV that: “Concerning recruitment, this is the mandate of the regions. In the federal structures, regions are autonomous. They allocate their budgets. They determine their demands and costs over a number of hires. Our role is providing them with a list of candidates. Of course, we also collaborate on a number of things with the regional health bureaus. It is true the country’s need for health workers is not yet fulfilled. But still hiring remains their mandate.”

Dr. Samuel Kifle, State Minister for Ministry of Education’s Higher Education Sector, says: “The government is working on strategies to provide inputs and increase capacity at educational facilities with a strong commitment. In the past years, education, especially higher education, has been one of the sectors that were allocated with higher budgets. The large parts of that budget goes to boosting capacity and developing infrastructures. However, that doesn’t mean that the whole thing is completed. There are many unfulfilled requirements, basic infrastructures that require huge finances. This will change and improve gradually with the commitment mechanisms the government put in place.”

The stale responses from the officials so far display the government’s reluctance to acknowledge the interns’ concerns, and the poor handling of public communication, critics say. In an open letter they wrote to Prime Minister Abiy Ahmed, the medical students demanded for concrete answers and urgent action to the questions.

A study which was done in 2017 showed that the country has among the lowest ratio in sub-Saharan Africa of healthcare workers, only 22 doctors for a million people. In what’s good news for the physician shortage, enrolment at medical schools has increased by more than 50 percent since 2006, the number of medical schools rocketing from 3 to 33.

Main Image: Medical students at St. Paul’s Medical College visit patients as part of their training. (Photo: Anders Kelto)

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