Ukraine: "We form independent unions in hospitals


Patrick Le Tréhondat Oksana Slobodiana

April 3, 2023

For several months, in Kyiv, Lviv and other cities, hospital workers, especially nurses, have been mobilising to defend their rights. The main issues are unpaid salaries, working conditions and hospital closures. Independent grassroots unions have emerged. Oksana Slobodiana of the movement "Be like Nina" was kind enough to answer our questions on this situation.

Please introduce yourself for our readers.

My name is Oksana Slobodiana. I am the leader of the health sector movement "Be like Nina", the independent trade union in the Lviv region, and I work as a nurse in a children's hospital. I am also a mother of four children, three of whom are still minors.

Could you introduce us to the "Be like Nina" movement, its history, its role and the reason for its name?

Our movement was born out of a grassroots initiative of health workers (nurses) in 2019. Since then, we have been protecting the rights of health care workers. If we can't solve problems through dialogue, we organise demonstrations. Our main task is to improve the working and training conditions of health care workers. To do this, we use all methods, of course, within the law. The name of the movement "Be like Nina" comes from the name of the initiator of the first nurses' demonstration, Nina Bondar. Nina, who worked in a hospital in Kyiv, decided one night to voice her dissatisfaction with working conditions, pay and the management's attitude towards nurses. She posted this message - a cry from the heart - on Facebook. Overnight, she had more than 20,000 views. Since then, health care workers have been uniting to defend their professional rights. Like Nina, they all want to stop ignoring the violations they face in the workplace.

The hospital and health care sector is strategic, especially for a country at war. Yet we see that health workers are facing many difficulties. Can you tell us about the current situation of doctors and nurses, and the state of the health sector in Ukraine in general?

Since 2018, Ukraine has been implementing a healthcare reform. Since then, medical institutions are regularly closing, hospitals are being optimised and merged. This has a significant impact on health care workers, who are losing their jobs. This process did not stop during the war. The situation worsened considerably: many medical institutions were closed as a result of bombing and artillery fire. At this point, it would be useful to put an end to this so-called "optimisation".

But the main mistake of the reform was the decision to transfer the management of the health care sector to local authorities. Today, it is local officials who decide whether a health facility is needed or not. Municipal authorities have become the de facto owners of hospitals. People who have no special training, who do not understand how it works in practice, decide on the fate of medical facilities and, at the same time, on their employees and patients.

We have seen demonstrations by hospital staff in Kyiv and Lviv. I think that unions have also been set up in these cities. Could you tell us about these demonstrations and the demands they express? What are these new unions or organisations that exist in hospitals to protect employees and their health?

Demonstrations are banned in Ukraine because of "martial law". But health care workers are not resting on their laurels and are beginning to create independent unions on the ground. Until then, "state unions" operated in medical institutions, supported by "administrative" resources while ignoring the views and interests of their members.

Today, everything is changing. Employees are coming together to defend their professional rights. In the past, these independent unions only existed in the big cities, but now we are helping them to appear in small towns and villages as well. Workers in small towns and villages must also feel protected.

What kind of support do you get from the public?

People's attitudes towards doctors change at different times. Sometimes patients could blame the medical staff. Then came the Coronavirus pandemic, and people saw how doctors, nurses and junior staff, without special protection, risked their lives to save them. The health staff then gained respect. Today, things are different. To be honest, not all Ukrainians are well informed about the current health sector reform and its consequences, so they often complain about us. But we are actively communicating with the population, informing them about the real situation. People are starting to think about this issue more deeply and to support health professionals.

Do you think that health professionals can propose an alternative plan to the government's health policy?

Of course, because changes can only be proposed by people who work in this field and know its problems from the inside. Indeed, sometimes it seems that random people with no particular experience have taken over the reform of the health sector in Ukraine. For example, they want to reform health care in Ukraine according to the "British model". But our realities, the economic situation of the country, the mentality of the people and the situation of health care, which has never been properly financed, are very different from the UK. Moreover, we should not forget that our country is currently engaged in a full-scale war.