Be Like We Are
This is a broad international campaign of solidarity with health workers in Ukraine, focusing on the grassroots network of nurses and other health workers Be Like We Are, originally called Be Like Nina. The original name in maintained here when it still applied. The campaign aims at:
- Solidarity: providing material support to health centres
- Raising funds to help the work of Be Like We Are
The network was formed long before Russia’s invasion of Ukraine (in 2019), mobilizing health workers against the negative consequences of the neo-liberal reform of the public healthcare system in Ukraine, such as closure of hospitals, reduction of staff, low salaries and delayed wage a and salary payments, increased workload and lack of social security. Women health workers bear most of the burden of social reproduction, providing care, support and education essential for the survival of society, but their contribution is undervalued.
Today, while Ukraine is suffering the disastrous effects of war, the role of health workers is more important than ever and crucial for the Ukrainian resistance.
Backgrounder: Nurses speak out about their situation and struggles
Source: International Labour Network for Solidarity and Struggle
On Nurses' Day, 12 May, activists from healthcare workers' union Be Like We Are presented the results of the study "One for Three: How Ukrainian Nurses Work" and told the stories of doctors working in front line hospitals, psychiatry, ambulance services and school teaching.
Participants at the event pointed out that both the World Health Organisation and the Ukrainian Ministry of Health note that the number of nurses in the country is falling sharply.
“Per capita, the number of nurses in Ukraine is now less than half the EU average. This obviously poses risks for the quality of medical care and the functioning of the healthcare system in general," stresses Olena Tkalich, one of the authors of the study.
According to the participants, the main reason why nurses are leaving the profession is that in 2016-2020, Ukraine deregulated nursing, allowing hospitals to drastically reduce the number of nurses and junior staff and create conditions in which the remaining staff work more intensively without receiving significant additional remuneration.
“During the study, I was struck by the frequency of words or phrases such as "we constantly have to be on time", "we are constantly torn between different responsibilities", "we physically don't have the time to do all the work that is expected of us and on which the lives and health of the people we work with often depend", says Oksana Dutchak, another author of the study. €
Such working conditions, without adequate remuneration, have led to a rapid exodus of nurses. The trend has also been exacerbated by Russian aggression, which has complicated the situation for surgical and psychiatric nurses. In the latter field, according to Natalia Lomonosova, co-author of the study, nurses often carry out physically demanding work, as patients are often unable to move around on their own, and they also complain about risks to their own safety, as there are often no security guards or 'red' buttons in hospitals.
"Due to staff shortages, it is not uncommon for a nurse to find herself on the ward, especially at night, literally alone with a large number of patients, with only a junior nurse accompanying her", explains the researcher.
This was also confirmed by Larysa Matrashak, a nurse in the psychological department.
"Last year, our hospital had 80 patients per shift for one nurse and one care assistant. Although there are now two nurses on duty, the workload is still excessive", she pointed out, noting also that the salary for this work is around UAH 10,000 a month [€205], making it extremely difficult to find staff. Oksana Dutchak, co-author of the study, pointed out that because of the low salaries, despite the intense workload, nurses also have to look for part-time jobs, do the gardening or try to feed their families in some way.
“This enormous workload and the chronic lack of rest result in physical and emotional exhaustion. In an interview, one person said that after finishing her work on the site, she felt as if she had been "run over by a patch of asphalt", notes the researcher.
We know that last year the Department of Health began to develop new standards for doctors' workloads. However, this work is being carried out secretly and it is not known whether any progress is being made. According to Oksana Slobodiana, head of Be Like We Are, nurses have actively invited officials to discuss the issue, but they have not responded.
“But we've been around for five years, we're growing, we're getting stronger, we're not losing hope. And believe me, we have survived more than one government, and we will continue to work so that nursing care can reach the European level", declares Oksana Slobodiana.
She therefore insisted that they were planning to make changes that would make nurses' work easier by creating independent unions.
Olga Lisivets, a nurse from the town of Nizhyn, explained how she and her colleagues managed to create a union that "is interested in the development of our medical institution and believes that there is no place for corruption, moral harassment and that a pleasant atmosphere must be created within the team".
For her part, Hanna Zhadan, a nurse from a frontline town in Sumy oblast, pointed out that despite the standard that medical workers in frontline areas should receive 15,500 UAH [€317] , their hospital salaries are lower.
“During the night shift, after 6 p.m., there is one nurse and one care assistant for every two floors, and the number of children can range from 7 to 18. In general, drone or missile attacks start at night, and the nurse and care assistant have to evacuate the children from the two floors, wake them up, gather them and take them to safety. The children may cry and not want to leave, and not all the children in the hospital are with their parents. And we have very little time to evacuate, as we are 40 km from the state border", explains the nurse.
At the same time, she says, in 2022-2023, despite these difficult conditions, there was a constant backlog in wages. However, thanks to the creation of an independent trade union, this problem has been resolved.
"At the beginning there were seven of us, today there are 33. There are doctors, nurses and orderlies. Our salaries were constantly delayed. Thanks to our actions, we will now receive them on time. What's more, in January 2024, we all received pay slips with a minimum salary of UAH 7100 [€145]. Thanks to our swift reaction with the hospital administration, the local authorities and the town mayor, our salaries have been recalculated to an average of UAH 12,500 [€256]", explains the nurse.
Olena Steshenko, an ambulance nurse from the Zaporizhzhia region, pointed out that the work is physically demanding, as ambulance drivers often have to carry people on stretchers, and also very dangerous, as they never know what to expect during a call. Drivers and paramedics are paid the minimum wage, while nurses are not much better paid.
“I would like to mention the emergency problems in Zaporizhzhia. It is a town on the front line that is constantly suffering from enemy bombardment. Before the total invasion, there were 158 brigades, today there are 34-36 brigades, and 80% of the brigades remain in occupied territory. The personnel situation is critical. Rural brigades are often transferred to towns to make up for the lack of personnel. However, this does not solve the problem, because the workload is increasing, travel time to patients is getting longer and the time spent on a call is getting longer. People are fleeing not so much the war and the bombings as the appalling conditions and low wages", stresses the nurse.
In her turn, Antonina Shatsylo, a former radiology laboratory technician, reminded the nurses of the importance of ensuring that the medical establishment provides safe working conditions for healthcare professionals.
“You have to take care of yourself and not neglect personal protection, and check that the medical institution carries out dosimetry, which must monitor the laboratory worker's personal exposure every three months. You also need to ensure that the medical institution carries out workplace certification every five years, as this has an impact on benefits, including preferential retirement," she stresses.
During the round table, participants also drew attention to the psychological condition of nurses. The moderator of the event, Yulia Lipich, who also conducted the interviews for the study, noted that "48 nurses were interviewed and almost all of them said that they felt exhausted at work, that they did not receive adequate psychological support and that there was rarely a professional psychologist in a hospital to whom they could turn".
Ruslana Mazurenok, a nurse at Khmelnytskyi and a participant in the study, reminded us that the nursing profession "requires constant psycho-emotional stress and moral tension".
"Without access to such professional help, burnout is not just the problem of one employee, it affects not only the nurses themselves, but also patients, the medical establishment, as burnout leads to a deterioration in the quality of patient care, frequent errors and mass resignations of experienced staff," she stressed.
The round table also looked at the situation of school nurses, most of whom learn close to the minimum wage. According to school nurse Tetiana Hnativ, because of their special status, they cannot submit their requests to the Ministry of Health or the Ministry of Education.
Roksolana Lemyk, lawyer of the union, gave a legal overview of the standards on which nurses must rely to protect their rights.
In conclusion, Oksana Slobodiana said that the nurses would launch a petition demanding that the basic salary of healthcare workers at all levels should not be lower than the minimum guarantees, with annual indexation to inflation, so that the salary is at least equal to 80% of the national average (UAH 17,708 [€362] in 2025) and that a number of other improvements should be made.