Russian health workers fight back


By Poul Funder Larsen

CHELYABINSK — After picketing the city administration building for 10 days, health workers in this city in the Urals region of Russia went on strike on April 20. There were predictions that their stoppage, called in protest against miserable wages and the run-down condition of health services, could develop into an all-Russian action.

With its population of one and a half million, Chelyabinsk is among the main industrial centres of the Urals region, the backbone of the Russian military-industrial complex. During the second world war, Chelyabinsk was dubbed "Tankograd", because every third tank used by the Soviet Army was made in the city's huge tractor plant. To this day, as much as 90% of the industry in the Chelyabinsk district is geared to some extent to military requirements.

In 1957 the region suffered from a major leakage in a nuclear installation, and local sources claim that a second large-scale release of radioactivity, never officially acknowledged, took place in 1965. As a result of these accidents and heavy pollution from other industries, the environmental situation is catastrophic, with grave implications for the health of the population.

Chelyabinsk is one of the places in Russia that most needs a modern, efficient health service. Instead, cuts in public spending by the Yeltsin government have brought the city's health care system to the point of collapse. Centralised distribution of medicines to hospitals and clinics has ceased. There are virtually no antibiotics in the pharmacies. Medicines can be bought on the black market, but only at outrageous prices.

The buildings and equipment of the health services are falling apart. In Hospital No. 1, the gynaecology department is located in a hut that dates from pre-revolutionary times. Next to it, a nearly completed 12-storey building is deteriorating, because there is no money to finish the construction.

When the Chelyabinsk health workers began their actions, the city authorities tried to intimidate them. Yelena Kuklina, one of the striking doctors and also an activist of the workers' club "Rabochy", explained:

"The city administration tries to present us as supporters of individual payment for health care, but this is absolutely false. We want a free health service. It's ironic that when people took to the streets a year ago this was described as 'the voice of the masses', while now when we go into action the administration attacks us as 'the red-brown hordes'."

Until recently health workers were considered one of the least combative groups in Russian society. But with prices skyrocketing over the past four months, and with no real indexation of wages, this passivity is evaporating. Vadim Shramchenko, the head of the strike committee at Hospital No. 1 in Chelyabinsk, explained the situation as follows:

"We used to be firm supporters of the reform, but we've been profoundly shocked by its recent trajectory. We're now in a state of utter destitution. A qualified, experienced doctor gets at most 1000 roubles a month, which is not enough to buy even one shoe! Nurses and other health workers get far less.

"A year ago we started to organise. At that time we were aided by the trade union leaders. However, they proved ineffective, so this year we set up a strike committee on the level of the city and the province, relying on grass-roots forces. The trade union has provided a certain moral support, but they're not leading the movement. There are suggestions that we form an independent union, but this project is still in embryo.

"In our struggle we're posing broad demands for the improvement of the health service, and also calling for a substantial rise in our own wages. We're receiving support from various other workers in the region, including the miners — we collected money for them during their strike. I have the impression that, in general, the members of the population understand and support our actions."

The strike by the Chelyabinsk health workers has attracted attention throughout Russia. It comes at a time when other groups of low-paid state employees — for example, teachers in the Kuzbass region of Western Siberia — are also on strike. Since the price rises in January, there have been more than 400 strikes by workers in health and education. Industrial workers have been comparatively passive.

Because of negotiations with the government, the proposed all-Russian strike by health workers was postponed. But as the example of Chelyabinsk shows, the situation at the local level remains extremely tense. These struggles clearly have potential to develop into a movement openly challenging the government's economic policies.

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