US embassy cable - 04SANTODOMINGO4403

UNCLAS SECTION 01 OF 02 SANTO DOMINGO 004403 
 
SIPDIS 
 
DEPT FOR WHA/CAR AND WHA; WHA/PPC FOR ERIC FALLS; DRL FOR 
ARLEN WILSON 
 
E.O. 12958: N/A 
TAGS: PGOV, ELAB, DR 
SUBJECT: DOMINICAN DOCTORS STRIKE FOR SALARY INCREASE; 
OTHER SECTORS STANDING BY 
 
1.  SUMMARY.  Public sector physicians and the GODR have 
clashed on wages and hospital conditions, leading to several 
strikes and protests and a continuing reduction of medical 
services, especially for the poor.  Doctors demand better 
salaries and better conditions in the hospitals, while the 
Dominican governent counters that the present state of the 
economy precludes an expenditure of that size.  END SUMMARY. 
 
DOCTORS TAKE TO THE STREETS 
 
2.  The Dominican Medical Association (CMD) represents the 
more than 18,000 doctors and health workers at public sector 
hospitals.  The CMD, led by its president, Dr. Waldo Ariel 
Suero, has adopted aggressive tactics toward the GODR with 
respect to salary and other issues.  Salaries for doctors in 
the public sector currently average between US$300 and $400 
per month, a figure that continues to fall due to high 
inflation.  In real terms in pesos, doctors make less than 
half of what they were earning just five years ago.  Ariel 
Suero is demanding an immediate 40 percent pay raise followed 
by an additional 35 percent raise in 2005. 
 
3.  Hospitals are also seriously affected by the energy 
crisis, which has led to frequent blackouts, and by 
inadequate budgets funded with delays if at all.  There is 
also a shortage of medical equipment, and some patients have 
complained that they have had to purchase their own basic 
supplies in order to receive treatment.  The CMD demands that 
the GODR work to improve the conditions in the hospitals. 
The CMD would have the government pay for these improvements 
by earmarking taxes on alcohol, cigarettes and weapons 
licensing.  In that way, the CMD says, the cost of public 
health will fall on those who can better afford it. 
 
4.  The CMD has undertaken several highly publicized work 
stoppages, during which certain hospitals treat only the most 
critical cases.  The CMD has also arranged several protests 
and marches in a successful attempt to garner press coverage 
and public support.  The CMD has technically been on strike 
since last December, and it has scheduled work stoppages of 
varying length and scope during that time.  In April, when 
President Mejia received a CMD delegation, Ariel Suero agreed 
to suspend strikes until after the May 16 election, 
apparently on the understanding that Mejia would take some 
action after that date.  However, when Mejia received the CMD 
again in mid-July, he was explicit that there was no money in 
the budget for salary increases. 
 
5.  The physicians' work stoppages, combined with the power 
blackouts and the high cost of electricity and medical 
supplies, have partially paralyzed the public health sector. 
The press has run a series of exposes, articles, and 
photographs about hospital conditions.  The hospitals that 
remain open for emergencies report crowded conditions.  In 
one maternity hospital in Santo Domingo, two or three 
expecting women have to share the same bed.  Many elective 
surgeries have been postponed indefinitely.  Mejia visted a 
Santo Domingo hospital on July 26 with Health Secretary Jose 
Rodrigues Soldevilla in an effort to counteract these 
impressions.  He took the press along as his "jury" as he 
visited a dialysis unit and the laboratories, which appeared 
to be functioning normally.  "The medicines are here 
somewhere, because we paid a mountain of pesos for them," 
declared Mejia.  "These stories are their way of pressing me 
to increase their salaries before the new government gets 
here.  It would be immoral of me to do so - the physicians 
have no right to be treated differently from other 
professionals." 
 
MORE WORK STOPPAGES IN THE FUTURE? 
 
6.  The crisis in the medical community will not be resolved 
until well after the new administration takes office on 
August 16.  Last week, an encounter between Soldevilla and 
Ariel Suero at a hospital nearly degenerated into fisticuffs. 
 There is no longer any dialogue between the two sides. 
 
7. The PLD party of president-elect Leonel Fernandez has been 
much more conciliatory towards the CMD, calling for dialogue 
and consensus and an end to disruptions of medical services. 
Fernandez's word carries some weight, as the last pay raise 
for doctors was in 1999, during his first administration 
(1996-2000).  Even so, the 1999 pay raise was achieved after 
a series of smaller the CMD strikes, and because of this 
previous success it is unlikely that the CMD will abandon 
this tactic when Fernandez takes office.  Rather, the CMD 
told poloff it will continue periodic work stoppages in order 
to maintain momentum and encourage Fernandez to address the 
issue quickly.  Ariel Suero informed poloff that the CMD is 
willing to give Fernandez until next February to commit to a 
salary increase before taking more drastic action. 
 
8.  In public the CMD has said that it is considering a 
nationwide walkout, which would leave responsibility of 
public health to the approximately 2,400 military doctors, 
who would be quickly overwhelmed.  This is probably just a 
negotiating ploy, and there is no indication that the CMD 
would actually take such a drastic step. 
 
OTHER SECTORS WAIT QUIETLY... FOR NOW 
 
9.  While the CMD is making news, other labor organizations 
that have also demanded salary increases are impatiently 
though quietly awaiting the arrival of the new 
administration.  Fernandez has said that an increase in the 
minimum wage will not be feasible until the economy 
stabilizes; unless inflation is controlled, he has told labor 
leaders publicly, a wage hike will be meaningless.  Trade 
unions differ and would like to see an immediate increase. 
However, the unions recognize that little can be achieved in 
the last days of the Mejia administration and they are 
willing to give Fernandez time to implement his strategy. 
 
10.  Labor organizations' respect for Fernandez is bolstered 
by the presence of vice president-elect, Rafael Alburquerque, 
a former minister of labor who is well liked in labor 
circles.  Last week, Maribel Batista Matos, lawyer for the 
National Concil of Unions (CNUS), told poloff that there was 
"hope" that salaries would improve under the Fernandez 
administration.  Nonetheless, if Fernandez does not move 
promptly to placate the unions, which may be difficult with a 
Congress that is heavily balanced towards the opposition, it 
is likely that the labor strife in the public hospitals will 
spread to other sectors of society by the end of the year. 
 
11.  Drafted by Jay Raman. 
HERTELL