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A High Court judge in South Africa granted an urgent interdict to the Treatment Action Campaign, the largest AIDS activist group in the country, compelling the government to rescind dismissal notices it had issued to striking nurses. The nurses would otherwise have been staffing several clinics in Cape Town's poorest areas.
These clinics, some operated and helped by the humanitarian group Médicins Sans Frontières, provide antiretroviral treatment for local people with HIV as well as treatment for tuberculosis. Any break in the treatment of these two conditions leads to resistance and consequent failure of the treatment. The clinics provide a full range of primary health care and also emergency treatment when needed.
The public service strike has been a bitter fight, with nurses among the most angry (BMJ 2007;334:1240, 16 Jun doi: 10.1136/bmj.39245.485579.DB). Monthly salaries can be as low as 2500 rand (£180; €260; $360) for a nurse with 20 years of experience.
During the strike,which came to an end on Wednesday night this week, the government dismissed hundreds of striking nurses. But it did this haphazardly so that several nurses who were working and many who were on leave were also dismissed.
The Treatment Action Campaign asked the court to reinstate the nurses working in the clinics so that basic services could be returned to the community to meet the requirements of the constitution, which provides for access to health care.
The government contested the request saying that it had earlier obtained a court order that banned nurses from striking. It therefore deemed the strike illegal, and it was, therefore, not willing to reinstate the nurses.
The judge asked if there had been a mistake because one nurse with 19 years experience was shown in the court papers to be earning only 2500 rand a month. He was told that it was correct and was informed that that was what the strike was about. The nurses will now get rises, along with the rest of the public sector, of 7.5%. This is widely seen as a victory for the government because when the strike started the government was offering 6.5%, and the unions wanted 12%.
A lawyer with the AIDS Law Project, which helped the group in bringing the action, Fatimah Hassan, said that the clinics in the township Khayelitsha had made a plan to keep emergency services running and had given out drugs for chronic care such as HIV/AIDS and tuberculosis. The dismissals had meant no services had been provided. The army, she said, had been brought in but was unable to fulfill the needs of the clinic. The dismissals included pharmacy staff, so drugs could not be given out, she said.
The strike ended a day after the court order was handed down, and part of the agreement at the end of the strike was the reinstatement of dismissed workers—including nurses.