Your opinions on the medical interns’ strike


While a number of other Arab countries have been indulging in what has come to be known in the press as the ‘Arab Spring’ with various degrees of success, here in Algeria, various factions of the ‘civil society’ (if such an entity indeed exists here) have preferred indulging in strikes. The sole objective of all these strikes has been to demand a pay increase. I am not sure how to interpret this turn of events, there is probably a lot to be said and many angles from which these strikes could be interpreted. But in this post, I am going to focus on the medical interns’ strike which has been the longest running strike so far compared to all the other strikes which have taken place in the aftermath of the ‘Arab Spring’ (correct me if am wrong).

It is not easy to get to the bottom of this crisis (in the Health Sector), but the demands of the medical interns’ seem to be around three aspects: (1) more money, (2) fewer exams and (3) no civil service (that is where newly qualified doctors are obliged by legislation to practice (for a government paid salary) in far-off and under-privileged locations such as the desert or other small towns which suffer from lack of health services).

I should mention that in Algeria, university education, even medical studies, remains completely free and heavily subsidised by the government. Regardless of the quality of said education, this is an important factor in the equation. Besides, judging by the relative success of Algerian nationals who have been educated in Algeria and who then decide to practice their skills (and develop them) abroad, the quality of the national education cannot be that dire, even though there has definitely been the equivalent of a landslide in ‘standards’.

The idea of this post is to exchange opinions on this strike and the demands behind it. In order to make it more constructive, I suggest we keep away from casting blame on such or such and focus instead on considering this situation with the aim of extracting what it tells us as individual algerians on the social, cultural and whatever else situation in our country.

I shall inaugurate by giving one aspect that really irritates me about this strike. I couldn’t have expressed it in better words than a commentator on the Guardian’s ‘Comment is Free’ (a comment posted on a totally irrelevant British news story on some trade union):

Dear members of the ‘narrow society’,

I’m part of the ‘wider society’. Please do not frame your attempts to increase your own pay and job opportunities as a benefit to me, when doing so through strike action explicitly inconveniences me and pretty much everyone else.

Thanks,

A normal working person who isn’t a member of a union.

What do you think? Ilaikoum el khat.

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30 thoughts on “Your opinions on the medical interns’ strike

  1. Two of my brothers are interns, one finishes this year his (5 years) Neurosurgery studies, and the other in 3 years his dental surgery studies, along with another cousin too. While supporting the strikes, the older one haven’t had any day off striking, because they need to assure emergencies anyways.

    Not speaking politically, the two of them told me that their main demands is to be considered and rewarded for what they do, according to them, their teachers do absolutely nothing and it’s for the students to keep the work for the whole year (something that I do not understand since I have no idea how hospitals work), and hence, they deserve (maybe) better salaries.

    Then comes the issue of the civil service, I can understand easily why this is a problem for the future doctors, mainly because the lengthy years they take to finish their studies (12 years at best after passing the baccalaureate) imply that they will get married before finishing, and therefore things can get a lot complicated. It is to complicated to move to the Sahara and very far rural areas for working (with not so much interesting salaries I believe) when you have a family to take care of. This is to me one of the important reason that makes students reject such regulations.

    As for the free education in Algeria, I believe that it is a farce, I was once a student in some (prestigious-give-me-a-break) institute in Algeria, and I saw pretty much the price of their free-studies diplomacy. (free) Food that doesn’t differ from rot, (free) rooms that looks like corrals (curious?) and more. Of course the billions are flowing, but under the free-studies claims, money flows to black holes that never reaches the student’s interests.

    After all, I believe all the system is sick, and a change (if it were to happen) in one tiny side, won’t hold enough till it gets flaws from another side.

    • Hi martani, thanks for your testimony.
      Whilst I too can easily understand why the civil service might be a nuisance to individual doctors, I do not consider it to be society’s problem to deal with. Being a doctor is certainly a useful thing for society, but it isn’t exactly a business venture nor does it entitle doctors to have their cake and eat it.

      What I find most scandalous in all this is the total incoherence and utter selfishness of the self-professed ‘elites’ (as these doctors seem to think of themselves just by virtue of having gone to uni to read medicine – that attitude in itself is scandalous enough regardless of all the rest). To top it all, they dare pretend it’s all for the benefit of the patient!!! What utter hypocrisy!!! They’d have had my respect if they just called it as it plainly is: me, me, me. I’d even jave wished them luck. The government is right in the sense of coherence. They finance their studies so they have the legal right to demand the return on investment, even though there are severe lackings elsewhere: the principle remains sound in the absolute sense.

  2. J’ai 2 soeurs résidentes !! Bac+x années d’étude et de travail !!
    Je trouve que leur demandes c’est le minimum de droits! avec les risques de travail (Agression , plus maladie ). savez vous qu’ils demandent aussi l’égalité entre médecins algériens et médecins étrangers ( Un étranger est payé 10 fois plus pour faire des expériences sur les pauvres algériens…Il faut voir ce qui se passe dans le nouveau hôpital de Constantine ) . c’est pas tous, on doit pas oublier que nos chers médecins sont payé moins de 100 euros pour le scandale prés-emplois pour 2 ans et a la fin ya que le chaumage (BAC+7) . j’ai visité l’univ de médecines et j’ai vu les conditions dans les hôpitaux lors de garde de nuit. Moi personnellement je ne veille pour personne a part ma famille! eux ils travaillent par amour de médecines, par humanité qu’on voix rarement (pas tous mais la majorité).
    Et enfin pour parler de manque de médecins a l’intérieur du pays, il faut parler de logement et du salaire “Asssuré” avant d’imposer le service civile contre le diplôme) BAC+12 sans diplôme ! Je connais un médecins qui a fait son service civile (Sans log et 7 mois salaire non versé)

    Mais de quel droit on parachute ces lois M….

    Si j’étais en DZ je sors avec eux !!

    • Hi S M, thanks for passing by.
      You say “Bac+x années d’étude et de travail !!
      Je trouve que leur demandes c’est le minimum de droits! avec les risques de travail (Agression , plus maladie ).”

      An often repeated non sequitur, how long one studies shouldn’t be related to how much they’re paid and in real life it isn’t and that’s just as well. People’s salaries should be determined based on their skills and how useful they are to society. If a plumber is more useful than a doctor (as in they offer better and more valued services) I see no problem in them earning their living much better! Not all doctors are skilled and not all of them are useful to society (in Algeria many are boasting fools who are full of their own importance and I have seen a few showing unmistakable contempt for their patients)- in Algeria many are actually parasites severely wanting in conscience (anyone who lives in Algeria will know this, obviously there are exceptions and thank God for that).

      If becoming a doctor envolves so many risks, the obvious answer is not to choose to become a doctor. Making a conscious choice and then making ludicrous demands and trying to make it look like a noble cause is simple shameful. I don’t see how the health sector will improve should their demands be satisfied.

      • It is true that looking to the fact of “being a doctor” only from the point of view of money is not a honorable act, by I see nothing shameful in expecting a good reward after some 12 years of studies.

        As when you say a plumber should be rewarded according to his skills, a doctor that passed the specialty exams and succeeded in his 5 (more or less) years in this specialty is necessarily a skilled one (not to mention parasites as you say).

        So no, I don’t see anything shameful in demanding a good salary to embrace their hard work, it should be regarded as an impulse for more hard work in real life.

  3. I guess I will just join the wider society (not sure narrow to wider ratio is close to the one in the UK).
    The Algerian university’s problems are known and cannot be linked to the medical interns’ demands.

    Ouyahia said last week that he felt the Algerian ppl thought it’s the right time to make demands because the government was weak and would grant anything in order to buy silence and peace. I think the Algerian people are right, just see how many population categories have gathered since last January before El Mouradia and how most of them got all their requests satisfied. Of course some got beaten by the police but perhaps it is worth it.

    More seriously, I may understand the interns demands on better wages and access to accommodation during the civil service (which lasts only one year and I heard they’re paid 30kDA anyway) but asking to suppress the civil service is something I don’t get. The Free education system in Algeria made it possible for everyone to become a doctor, the poor like the rich, and unfortunately the brilliant like the dumb. So just for this, they shouldn’t dare make such a request. And it’s just one year for God’s sake.

    We still do not know which society and what system we want. Perhaps, we’d be better off if medical students had to pay for their studies and the poor would never have access to such specialities unless they make $$$ loans. Up to them…

    Knowing how most of our doctors act with patients after they get their private offices and even in public hospitals, I feel even less sympathy towards them. Plus, I wouldn’t have studied medicine for the world’s money.

    And since everyone mentions some intern they know, I too have a cousin who’s intern in Djanet. He loves it. The people are very nice and he is happy doing his job.

    • I am 100% with you on this MnarviDZ. The most depressing thing in all of this is that across all factions and all ‘classes’ (if we assume for the sake of debate that Algerian society is composed of the classical classes system (I see that I managed a lovely pun in my fury hehehe)), the strikers have exactly the same demands! And then the doctors come and say things like: “How can a policeman who studied only 9 years whack me on the head when I studied 20+ years!!!”. Well the answer is obvious, you are being whacked on the head because you and the policeman and the plumber and whoever else are similar enough to be striking for the same demands.

      That puts eveyone on the exact same level if you ask me! If doctors want to be respected, it is not higher salaries that’ll make them so, because this is not why they have lost respect in the first place!!! (obviously as in all societies there are people who envy other people who have many provileges but that is not representative of all algerian society and many despise doctors for legitimate reasons).

  4. L’Algérie nage et se noie dans un océan de mensonges. La qualification d’état donnée au pouvoir algérien est un mensonge. Les diplômes donnés à ces médecins et à tous les diplômés sont des mensonges (et ce n’est pas leur faute). Le service rendu est un mensonge et le salaire perçu contre ce service est un mensonge.

    Le mensonge collectif assumé par toutes les parties antagonistes et alimenté par une rente artificielle est, si j’ose dire, la seule vérité certaine. Chacun son mensonge en main réclame une partie de la rente sans que personne n’ose dire à l’autre… mais ce que tu as en main est un mensonge…

    Le pouvoir algérien n’est obsédé que par sa propre survie. Il maintient à un certain niveau de compétence l’unique secteur qui lui semble dans l’immédiat permettre de réaliser cet objectif : les forces brutes, l’armée et la police. Il n’est pas un état car ce terme s’applique à une structure de régulation chargée d’imposer des règles de fonctionnement dont les objectifs sont en général : l’équité, la cohésion, l’émancipation, l’égalité des chances etc… qu’un système livré à lui-même ne peut jamais réaliser. Mais l’état a disparu depuis longtemps du secteur économique livré à l’informel puis petit à petit il a livré l’ensemble des secteurs qui lui sont généralement dévolus à commencer par l’éducation… Certes, il subsiste un mode d’organisation hérité d’une époque passée où l’enseignement est gratuit etc… mais c’est une coquille vide.

    A essayer d’appliquer une grille de lecture rationnelle aux revendications catégorielles isolées du grand mensonge, on trouve forcément des contradictions…

  5. La chose qui me choque la!! c’est que vous jugez un (Bac+x années) en médecine comme quelqu’un d’incompétent!! X années c’est des années d’expérience en hôpitaux avec des vrai malades pas devant des carnet et des PC.
    Les médecins algériens ont une très bonne réputation en France et en Canada et USA. Apparemment, vous n’avez jamais vu des situations de secours et d’urgence
    Pour l’argent je vous c’est vrai que c’est noble de travailler pour l’humanité mais il faut pas oublier que les médecins sont des humaines qui ont besoin de construire leur vie!! devant leur efforts le salaire est minable et ne veux rien dire (Read this http://mstought.blogspot.com/2010/12/axes-de-stabilite-me.html )

    ça reste juste pour ce métier noble من أحيا نفسا فكأنما أحيا الناس جميع .

    • @ChatNoir

      J’aime bien ta lucidité. C’est généralement ma mission de noircir le tableau et du coup je n’ai plus rien à ajouter. Tu m’as rappelé le titre d’un livre écrit par Youcef Zirem, “la vie est un grand mensonge”. Son livre aussi était un grand mensonge, une nullité.

      @ S M

      Je ne leur conteste nullement l’envie d’avoir un meilleur salaire. Mon sujet était par rapport au service civil et leur volonté de le supprimer, et aussi par rapport a ce dont algerianna parlait: le fait qu’ils disent que c’est pour le bien de leurs patients qu’ils luttent.

      Ton premier point est hors-sujet mais je l’admets, je pense que la majorité de nos jeunes médecins sont incompétents et ne méritent pas leur diplôme. Pour le reste, ils sont devenus tout aussi incompétents, comme beaucoup d’autres travailleurs algériens, du fait de leur laxisme, laisser-aller, corruption, etc. Ou pourrait disserter sur les raisons de cet état de fait mais celà n’y changerait pas grand-chose.

  6. One of the main things that I always try to point out with regards to all what is happening in Algeria, vis à vis pay, work and living conditions without talking about politics, where by default and by definition, an Algerian individual is an expert in any field you dare to mention and I do have my theory about the phenomena which can be discussed another time.

    But let’s see, as you point out quite clearly the fact that not only Medical studies are free but also one of the most expensive in the world elsewhere.

    The issue here is pretty simple to grasp: They’re not Doctors yet, they are still Students in Medicine
    and it is part of their studies to work in a hospital.
    Now as a student and part of your studies for your own benefit, you’re acting as if you are doing us a favour to work in Hospital and what work?

    I don’t want want to generalise, because it’s unfair to do so.
    But let us be honest, we all had at least once experienced the type or quality of service offered by these Medical students, and it wasn’t a good one, at least for me, not a single time.
    Yeah let’s blame Bouteflika, even he wasn’t there then!

    What’s the pattern we notice, Algerians want not only the butter for free but also unlimited supply of free milk without ever feeding the cow.

    I’ve studied myself in Algeria (not in Medicine) and always proud of the experience, and civil service was a privilege.
    Let us talk about the details of it that is the civil service, the first 6 months you’re not properly paid, but then for the rest you’re offered a full tax free pays, yes this is what I had.

    Oh.. yes they don’t want to go to work in remote locations!! why is that?
    You’re a doctor for God sake, you’;re not a taxi driver.. your job is not to do people a favour but .. then this shows really that they’re not there for Medicine, but for something else.

    when I mention the details to some of the colleagues over her in the UK, they think I’m making it up when I say that there is free accommodation, heavily subsidised food and in some institutes, students are given free meals tickets packs, special students transports and cheap season transport tickets, subsidised books and not to mention the bursary which up to the early 90’s still correspond the the National minimum wage!

    Yes I know what you’re going to spit, the free accommodation is a shit hole, the food I talked about is rotten, and the free education is rubbish.

    Please go to where you think it’s better and be ready to get enslaved.

    Best regards

    • With all due respect, I believe you still have the vision of the nineties it seems.
      The bursary?? which is less than 40€ for three months or less than 13€ in a month! “not to mention the bursary which up to the early 90′s still correspond the the National minimum wage!”

      Just to mention, these are not medicine students in their first years, they are students who finished their 7 years of studies, and now pursuing more higher studies, in case some will misinterpret the subject.

      • Thanks for the reply,

        There is nowhere mentioned that they are first year students, but this doesn’t mean that they’re not students.

        if it is and it actually is part of their studies to work in a hospital under supervision since they’re not Doctors yet, then they’re are still considered around the planet as students in medicine, they’re not doctors yet..

        Now I mentioned the 90’s as an example and what’s wrong with that , you compare 90’s money with 2000’s currency the Euro didn’t exist then yet and so you cannot be fair talking with regards to past money value in terms of present money.

        What you could get back in the 90’s and even the 80’s with 1000DA is probably equivalent to 10000 DA of our today money, I’m speculating here, and maybe I’m wrong but every person including you know that present money when compared to the past you need to include other parameters, isn’t ?

        Now this is my opinion when I compare the actual situation of education in Algeria, taking into account all the data related one way or another to the subject lead me to believe that we complain a lot without ever wanting to give back an inch, we’re good at organising ourselves for bad things but never for the good.

        Well let’s see isn’t this the reality of their ironic demands?
        On one hand they want to paid more and better quality and at the same time they say well but we don’t want to give back anything.
        in this case I’d love to see paid studies introduced, and only those who could afford them do as for those who can not afford them a bank loan would be a solution, and when they finish thei9r studies they pay back the bank.

        What are you proposing? and with what are you going to back it up with?

        Best regards

    • Dear foralgerian,

      You might want to inform yourself a little more about the students (they are not doctors yet you say, but I believe they are, they just still study for a higher grades) to have a clear idea about the issue. It would be a good idea to give your colleges a fresh picture of what will you discover regarding the education system in general and the intern’s very specif one.

      Again, 13€ a month is the bursary in 2011 (in 2009 it was 9€), it’s not the bursary of the 90’s I am talking about.

  7. Pour avoir eu plusieurs fois à séjourner en hopital (différents) et différents services, pour divers maux, étalés sur plusieurs années, j’ai eu à constater la lente mais certaine déchéance de l’hopital en général. Bien sur, il y a toujours de bons médecins, compétents et sérieux, mais ils nagent (se noient) dans une mare de problemes et de “maux”… Personnellement, je dirai que le système de santé lui-même est en danger. C’est l’hopital en tant qu’institution et en tant que service public qui est à secourir et dans les plus brefs délais, sinon…
    Le service civil est à mon avis une bonne chose, si bien sur il est appliqué pour “tous”, et que aucun médecin, fils de flen ou de felten, n’y échappe. Hadi wahda. Et que bien sur, on assure aux médecins en service civil, un logement décent, des conditions de vie et de travail acceptables qui lui permettent d’assurer sa mission dans de bonnes conditions.
    Sinon, il est plus qu’évident et clair que l’intérieur du pays manque cruellement de médecins et de services de santé. Pourquoi tout le monde doit-il aller à Alger pour se faire soigner?

    • Exactement Oumelkhir. Au leiu de tout ça, ils veulent abolir le service civil parce que la plupart veulent travailler dans le secteur privé illico presto. Moi je pense que le problème de toutes les professions en Algérie est fondamentalement d’ordre déontologique. Mais les plus sensibles à mon avis sont l’enseignement (enseignants) et la santé (médecins etc), c’est pour ça que je trouve les revendications de ces grevistes particulièrement affligeantes.

  8. Thanks for all your contributions. Obviosuly, this is a very delicate and complex issue that hasn’t been dealt with adequately by the concerned authorities. However, I do think that very few people (as in ordinary algerian citizens) support the abolition of the civil service. It is simply a ludicrous demand, however, I’d be interested to hear the arguments offered to justify it (apart from the platitudes the medics have offered us so far, that is to say: “It’s all for the benefit of the patients!” – yeah right, pull the other one!).

    I agree with a lot of the points that foralgerian has put across. I quite like your question foralgerianabout what are the alternatives available to us as a country to salvage our health system. It was addressed to martani, who too has put across some valid points, but I will attempt to give some elements of a possible answer. It is my personal opinion that higher education should no longer be free for all in Algeria, however this is of course problematic as public funds go under the carpet to finance the political elites’ offspring studies in the world’s most prestigious universities. But let us ignore this fact for a bit and consider that the HE sector is a closed system – how could it be reformed?

    I think a crucial element is to make people take responsibility for their future, including students by making them realize that education comes at a price and at an effort – you need to really want it to get it. I also think that higher education should stop being equated with a degree and a job, it is not a sustainable system. And finally, another important aspect is sorting out the taxation policy. It might seem unrelated, but I feel that as long as government relies solely on oil revenues, this mindset will perpetuate and people will never feel responsible for anything but would simply continue wanting their share of the oil money. They need to be made to feel they are contributing from their purse to fund public services and in that way, they will change their way of thinking about them.

    • I always believed that higher education was not a right. It must be something the students must work for and not something they do because they have nothing better to do. So I too think that higher education shouldn’t be free; but such a reform means many other sectors must be reformed almost at the same time (banking system for e.g. but not only). Plus, what would we do with all those who wouldn’t afford to go to university and who would therefore register at ANEM very early?

      As to the population’s contribution to the state’s budget (through taxes), well it is a complex topic. Remember that paying taxes has always been a reason behind revolts and systems changes. It was among the reasons why Kutama tribes supported the Fatimids. It was a reason for many tribes’ revolts against the Ottomans, etc. Today many Algerian do not pay them and they always have excuses ranging from “it is haram, I only pay zakat” to “the money goes in the rulers’ pockets”. Somebody said “there is no state without military, no military without taxes, no taxes without citizens and no citizens without justice”. I think he summed it all.

  9. working for a time in less fortunate places , looking out for the less fortunate people , should not and would not be a mandatory , it should be a giving back to the society that’s gave you all , it’s just like a thanks giving , being a doctor is the most noble job ever , striking and asking for rise is selfish and inhuman to me , imagine how rewarding when you ease the pain of a scared little baby child it is priceless how much more our doctors wants .

  10. Pingback: Algeria: No Protests, but Strikes Continue · Global Voices

  11. Pingback: Αλγερία: Χωρίς διαδηλώσεις, αλλά οι απεργίες συνεχίζονται · Global Voices στα Ελληνικά

  12. @algerianna,

    You wonder if a civil society exists in Algeria. Of course it does and its representatives are gathered by the CNES these days. Here’s one representing the youths, the future of the oumma:

    • Don’t know whether to laugh or cry. I understand what those who say that democracy (in our part of the world) means anarchy mean now. It is such an alien concept to our culture and historic make-up, it is devoid of any meaning. I am more convinced than ever that we need a new political system based on principles that we identify with (most of us). But for that to happen we need to have freedom of exrepssion and freedom of thinking and this needs to be fostered from childhood. We don’t have that unfortunately, most Arab populations are preconditionned and inhibited from childhood. It is a viscious circle that will inevitably implode at some point.

      It would be interesting to see who will take over after the entire sand castle comes tumbling down. My bet is on the Chinese, I think they will conquer Africa.

      • Just a little update on this gentleman (read subhuman).
        This man, former member of the RND and president of some youths’ organisation, just got the system’s approval to create his own party, a sub-RND… I know, nobody thought one could go lower than the RND…

        I wonder what Bouteflika’s supporters, mainly those who criticize the system but spare one of its heads, think now of their dear president’s pseudo-reforms…

  13. The medics have now decided to donate blood whilst continuing with the strike with the possibility of suspending even the minimum service (emergencies etc) according to the national press.

    I fail to grasp the coherence of this gesture (or even the symbolism if there’s supposed to be any), but coherence has never been anybody’s concern in this part of the world. They seem to be trying to gain the public opinion’s sympathy it seems.

    One commentator made me laugh (on one of the national news sites comments section)…he said that the medics have long been on strike and been paid all the same, so he fails to see why the minister has decided to suspend their salaries now under the pretext that he who does not work shouldn’t be paid!

    What a joke! Fully agree with him though – everyone is permanently on strike in Algeria. Don’t know what the fuss is about with all these protests, perhaps it’s because it obstructs the traffic and so it’s a nuisance.

  14. if u buye an algerian for what hes worth and sell him for what he thinks hes vworth ,u became a millionaire.thanks

  15. Pingback: The medical interns suspend their strike « Patriots on Fire

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