This resource is hosted by the Nelson Mandela Foundation, but was compiled and authored by Padraig O’Malley. It is the product of almost two decades of research and includes analyses, chronologies, historical documents, and interviews from the apartheid and post-apartheid eras.
Organising Nurses
GWEDE MANTASHE, assistant general secretary of the National Union of Mineworkers and SACP Political Bureau member, draws organisational lessons from the recent nurses' strike.
The recent nurses' strike has highlighted the question of organising nurses. While the grievances of the nurses were generally legitimate, as COSA'I'U, the ANC NEC and the SACP asserted, the manner in which they attempted to take up these grievances often reflected serious weaknesses. In speaking with nurses I often heard comments like "we don't need an organisation, we need money". This kind of confusion sometimes took a political turn, there were even some placards that read "De Klerk save us", or "Vote NP", as if over 40 years of NP misrule and racism had nothing to do with the appalling crisis in our public health system.
In this climate of confusion, every manner of opportunist jumped on to the platform. The DP's leader Tony Leon, whose present election manifesto is all about law and order ("COPS, COPS, COPS, Vote DP"), had the hypocrisy to visit liaragwanath Hospital in the midst of the anarchy. He came out claiming that it was the first time that he understood how little nurses earned.
The PAC, in some regions, momentarily hijacked the nurses' strike, and opportunistically drove a wedge between the nurses and other sectors of the community - patients, non-professional health-workers, and progressive administrators. The Nurses Forums, in some regions, wrote letters to government on PAC letterheads. For its part, the NP has been rejoicing in the crisis that is the direct product of its decades of misrule. It is trying to blame the ANC for failing to correct the chaos in a mere 18 months.
However, despite all of this, it would be a grave error on the part of the ANC-led Government of National Unity to resort narrowly to law and order measures against the nurses. This would simply play further into the hands of opportunists. We need to understand that a nurse who goes through a three year basic training course, and a four year course including midwifery and Striking nurses at Baragwanath Hospital, Soweto community health, earns a gross salary of about R3000, while a secretary in the public sector, with one year's training, earns R4000 and more. Unlike the private sector, in the public sector there are inexplicable gaps between professionals and bureaucrats.
For me this is the background for developing an organisational approach for nurses. Organisation is the solution, and COSATU should now take the lead.
COSATU and the nurses
COSATU failed to take the opportunity that was presented earlier by the formation of the Concerned Nurses, and of the Transitional Nurses Organisation of SA. This failure to respond to these initiatives was clue to an emphasis on one-inclustry one-union at the expense of one-federation one-country. I make this observation because nurses were always told to go into NEHAWU. Some of us within COSATU argued that the approach used in respect of teachers (where we recognised the professional union, SADTU) was correct, and should have been applied to nurses. We argued that it was necessary for COSATU to consciously address the desire of nurses to be organised as professionals, and the need to link professionals to our federation. This double approach (recognising the relative autonomy of professionals, but linking them to a working class dominated federation) would bring about the necessary balance between working class leadership and the intellectual and skill input necessary for any working class formation.
I believe that this approach was correct then, and it is correct today. The structure of industrial unions can be discussed within the federation after we have allowed those unions outside of the federation to affiliate to COSATU. The price we are paying for this lack of innovation is the chaos we see in the health sector.
As we all know, nature does not allow a vacuum to exist. If progressive forces are not close enough to the nurses, anti-democratic forces, opposed to transformation, can hi-jack their struggles. Asa federation, COSATIJ has a responsibility to help nurses organise themselves. This should start by assisting in areas where help is urgent. We need to assist in the Eastern Cape and break the logjam. We need to change the approach from that of anarchy to that of collective bargaining. If need he, we should offer to second people to assist setting up organisational structures, with COSATIJ paying the wages. This assistance should he given unconditionally, without demanding affiliation to COSATC. The key consideration should he helping nurses to get organised, and helping them to understand that their collective power is more important than short-term demands. Affiliation to COSATti, or otherwise, should he a decision taken by the organisation after it has been set up.
In engaging the nurses, we should strive to find a link between the ground already covered by DENOSA and the emerging Nurses
Forum. There may be no obvious link, but the organisational work of DENOSA may have had an awakening effect. This will need consolidation. There should be no hang-up about the name of the organisation. This should be an issue for a launching congress.
I want to emphasise that it should not he COSATt1 starting an organisation for nurses, but COSATIJ assisting nurses forming their own organisation. We have the necessary experience within the federation. Affiliates should be approached to second staff for this project.
Nurses and transformation
Our overall approach in organising nurses must he informed by the need for transformation of the state machinery. In this case the need for transformation of the public health sector is glaring. Professionals in this sector need an aggressive and intensive programme to help open up discussion around transformation. In the process, nurses will come to understand their broader role in society.
The above remarks are an attempt to come up with a practical approach, rather than a theoretical approach to a very complex problem. If the framework outlined here can be used by both the national and regional structures of COSATIJ, we can make a very important contribution to organisation and transformation of the health sector. Hopefully, this input will provoke a wider debate.