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Pediatricians Strike in Russian Republic of Udmurtia

A blogger in Izhevsk, the capital of Udmurtia (a republic located between Tatarstan and the Ural Mountains) has been single-handedly trying to bring attention to a story that has been all but ignored by mainstream RuNet. Starting in early March, Andrey Konoval [ru], an Izhevsk-based journalist, activist, and former deputy, has written over 20 blog posts covering the ongoing battle of local doctors and nurses working at Izhevsk's state-run outpatient children's hospitals against Udmurtia's health ministry.

Anonymous doctors on "Action" website. Funny, yet not very confidence-inspiring. Screenshot, April 10, 2013

Anonymous doctors on “Action” website. Funny, yet not very confidence-inspiring. Screenshot, April 10, 2013

The healthcare professionals in question are members of a medical workers union called “Action” [ru], which was formed late last year [ru], with the mission of “Stopping the Collapse of Healthcare.” (Judging by its official website, “Action” appears to be quite radically inclined, and perhaps a bit too self-consciously hip. One image used to illustrate an article is of doctors wearing Guy Fawkes masks — a visual reference to the anarchic hacking collective Anonymous. Another image portrays two children wearing scarves tied to cover their mouths in rioter fashion.) Izhevsk pediatricians and members of “Action” picketed the local government in December, 2012, lodging grievances, including [ru] complaints about low pay, institutionalized overtime, and forced work at “secondary stations” (local outpatient offices with no permanent staff).

Anarchist children and "Action - Izhevsk" logo. Screenshot, April 10, 2013

Anarchist children and “Action – Izhevsk” logo. Screenshot, April 10, 2013

While the government appeared to agree to address these grievances during talks [ru] with the picketers on January 31st of this year, workers saw no tangible action since that time. Konoval reports [ru] that:

[...] прошедший месяц показал, что никакой реальной работы с администрацией поликлиник чиновники не провели и проводить не намерены. [...] В больницах, по-прежнему, пытаются принудить людей к работе на втором участке (не трогая, правда, уже активистов, а кое-где и повысив оплату этой дополнительной нагрузки), зарплата в целом не только не повысилась (в сравнении с прошлым годом), а даже снизилась за счет 1) инфляции, 2) задержки выплаты “стимулирующих”. 3)и введения системы “штрафов”

[...] the past month has shown that bureaucrats have done no real work with hospital administrations, and aren't planning to. [...] Hospitals are still trying to force people to work at a secondary station (not touching, though, the activists, and in some places raising the remuneration of this extra workload), on the whole pay has not only not increased (in relation to last year), but actually decreased due to 1) inflation, 2) delay in the payment of “bonuses”. 2) and institution of a systems of “fines”

Apparently [ru], Udmurtian healthcare authorities do not release enough funds to pay everyone a “stimulating” bonus, prompting hospital administrators to increase the rigors of performance review in order to withhold bonuses. Without these extra funds, the doctors in question are paid [ru] the equivalent of approximately 500 USD per month. (Konoval believes [ru] that this is being done in order to speed up the transition of patients into private healthcare.)

These developments have forced the activists to carry out their threat of launching a so-called “Italian strike” (also known as “work-to-rule”), a type of worker action where rather than simply refusing to work, strikers precisely fulfill every letter of law and regulation in order to cause a slowdown and to the detriment of daily business [ru]:

Это переполнило чашу терпения педиатров. Сейчас только закончилось собрание актива медицинского профсоюза “Действие”, которое длилось шесть часов – с 12.00. Мораторий на “итальянскую забастовку”, который был принят на время эпидемии гриппа и переговоров с чиновниками, решено аннулировать.

This was the last straw for the pediatricians. Just now, a meeting of the “Action” activists has finished — it lasted for six hours, from 12:00. It has been decided to annul the moratorium on an “Italian strike”, which was accepted for the time of the flu epidemic and talks with bureaucrats.

This type of action can be particularly attractive since it does not require coordination with the authorities. According to a statement by the strike committee [ru], as reported by Konoval, the upshot is that during the strike doctors will spend 13-20 minutes per child, instead of the usual 5-6 minutes. They will also refuse to work overtime (usually anywhere from 2-6 hours).

Originally [ru] the strike was planned to last from April 2 to April 9, 2013, and 34 people were to be involved, affecting over 15,000 children in Izhevsk. However, between the announcement in late March and the start of the strike, many of the participants were intimidated into backing down. Konoval describes [ru] the pressure:

Репрессии развернулись и на уровне поликлиник, где людей опять же запугивают словами о якобы незаконности “итальянской забастовки”, пытаются найти компромат на активистов и оформить нарушения. [...] Во всех трех больницах людей вызывают по одному на проработку и пытаются заставить подписать отказ от “итальянской забастовки”. [...] В 5-й поликлинике после оказанного административного давления детский врач Татьяна Семенова почувствовала себя плохо (проблемы с сердцем) и была вынуждена с сегодняшнего дня уйти на больничный.

Repressions were also at the level of the hospital, where people are being frightened off by the supposed unlawfulness of the “Italian strike”, and they are trying to dig up dirt on the activists and issue violations. [...] In all three hospitals people are being called in one at a time, and being made to sign a rejection of the “Italian strike”. [...] In Clinic #5, after the administrative pressure exerted on her, pediatrician Tatyana Semyonova started feeling unwell (heart problems) and had no choice but to go on medical leave.

As a result, at the start of the strike only 11 doctors [ru] in two of the hospitals ended up participating. Nevertheless, the cause is not a complete failure. Since the authorities failed to address the strikers’ complaints, on April 8 the committee decided to continue the strike indefinitely, with the option of going on hunger strike if there are no talks by April 15, 2013. Konoval also reports [ru] that the strike has attracted additional participants from other city hospitals.

While the story has been picked up by some online publications, as well as local newspapers, it is oddly absent from the usual opposition blog and Twitter circuit. Unfortunately, although healthcare is a potentially unifying issue, such regional news frequently end up in a blind-spot on the RuNet.

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