Decent working conditions for the young health workforce: what are the challenges and can we find solutions?

This article was exclusively written for The European Sting by Mr. Francis Oluchukwu Francis, currently a 5th year Medical student in Ambrose Alli University, Edo State, Nigeria. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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“It is unethical and short-sighted practice to compromise the health of workers for the wealth of enterprises.”   Evelyn Kortum, WHO. Health workers all over the world are exposed to certain risks and hazards that are inherent and peculiar to their work environment on a day-to-day basis. Some of these can pose serious long and short term health risks. The importance of a decent working condition can never be overemphasized especially for the young health workforce who are relatively fresh in the medical space. Creating better working conditions in terms of workload, occupational safety, environmental care, hygiene and toxicology can greatly improve the overall productivity of young health workers. WHAT IS A HEALTHY WORKPLACE? According to the WHO,  a healthy workplace is  one  in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety  and well-being of all workers and the sustainability of  the workplace by considering the following, based on identified needs:

1. Health and safety concerns  in the physical work environment.
2. Health, safety  and well-being concerns  in the psychosocial work environment including organization of work and workplace culture.
3. Health resources in  the workplace and
4. Ways of participating in the  community to improve the health of workers, their families and other members of the community.

Here in Nigeria, during my clinical postings in internal medicine and Pediatrics, I have seen a number of young health workers breakdown in tears during morning reviews due to the ever increasing intimidation from superiors and verbal abuse from patients coupled with the never ending stress. One peculiar scenario was a young doctor who collapsed in his room after his routine ward rounds and attending to patients in the clinic. Luckily a friend found him on time and he was rushed to the hospital. It was later discovered he has been on call for 4 days straight with no time to eat and rest properly. Decent working conditions go beyond the comfort and luxuries at the work place even though that can be factored in but it includes things as minute as the workload on our young health workforce, the communication and interpersonal relationship among workers and a safe and secure work environment. There is an important opportunity for effective interaction between the workplace and the community. The Jakarta declaration and the global Compact both indicates that interactions  with the community are therefore expedient and considered to be an essential component to be borne in mind when efforts are being  made to create a decent and healthy workplace. WHY DEVELOP A DECENT AND HEALTHY WORKING CONDITION? There are inumerable reasons why a decent working condition among the young health workforce is a requisite to ensure work enthusiasm and safety which will ultimately be reflected in increased productivity, reduced accidents and overall patient satisfaction. Firstly, it is the right and ethical thing to do. The most basic of  ethical principles deals with avoiding doing  harm to others and this can be extended to any harm that may come directly or indirectly to the young health worker at the workplace in the event of carrying out his duty of saving lives due to poor working conditions. The Seoul Declaration  on Safety and Health at Work, specifically asserts that entitlement to a safe and healthy work environment is a fundamental human right. Doing otherwise would be a direct infringement on the human rights of the young health workforce. Furthermore, It is the smart and legal thing to do if viewed from a business and legal perspective. Some countries have legislation that require a certain standard of safety and decency and will attract fines and imprisonment when these standard are not met. It is also a proven fact that when health workers are mentally and physically healthy they work more effectively and generate more revenues. WHAT ARE THE CHALLENGES? In May 2007, the World Health Assembly endorsed the  Global Plan of Action on Workers Health  (GPA). The  aim was to move from strategy to action by Member States. Some of these actions include primary prevention of occupational  risks, protection and promotion of health at work, and  improving the performance of health systems. Unfortunately there have been poor implementation in so many countries, especially in developing countries  with small and  medium-sized health institutions,  where lack of community  resources may have a significant impact on the working conditions of young health workers. The poor interpersonal workplace relationship is a challenge that increases emotional and mental stress while the lack of basic medical equipments like surgical gloves, face masks and theater aprons increase exposure of the young health workforce to unhealthy elements within the workplace. In more developed climes, there is still the challenge of increased workload, patient hostility to young health workers and management indifference in private establishments. In many countries across the world, young health workers are underpaid and underappreciated and this is a major challenge to the creation of a decent working environment. WHAT ARE THE SOLUTIONS? What can be done to ensure a decent and healthy working condition for the young health workforce? We now know that poor working conditions can lead to poor mental and physical health in the young health workforce. In turn poor mental or physical health will result in poor performance and productivity at work which will be reflected in poor patient satisfaction. The implementation of the global plan of action on workers health (GPA) in many countries especially developing countries will go a long way to ensure a basic standard of occupational safety in health institutions as well as improve the performance of health systems. Safety and health promotion within the workplace will place emphasis on addressing any specific cause of mental and physical stress among young health workers. A good and satisfactory pay must be borne in mind if a decent working condition is to be achieved even though this is relative and varies among specializations and countries. Great interpersonal relationship among health workers irrespective of position and stride will provide a conducive environment where excellence will flourish and accidents minimized. A detailed workplan must be constructed to ensure that the young health workforce are not burdened with too much work more than they can handle which usually results in physical, emotional and mental breakdown. Provision of medical equipments like gloves, face masks and aprons will prove very effective in protecting the young health workforce from health hazards and minimize their exposure to elements they come in contact with in their day-to-day activities. References

1. WHO
2. Mensura
3. WHO Healthy Workplace Framework: Background and Supporting Literature and Practices – Joan Burton
4. United Nations Global Compact, http://www.unglobalcompact.org/

About the author Francis Oluchukwu Francis is currently a 5th year Medical student in Ambrose Alli University, Edo State, Nigeria. His professional experiences include; An active member of the International Federation of Medical Students Association (IFMSA), Former Southern Public Relations Officer Nigerian Medical Students Association (NIMSA), Active Member Standing Committee on Reproductive health and HIV/AIDS. He is also the President of Dawn Foundation, a foundation passionate about Capacity building, Personal development and Community Impact. His Career Objective is to pursue an excellent and result-oriented practice in Medicine and Surgery, aiming to leverage a proven knowledge of advocacy, community outreach, and counseling skills to successfully achieve this. He has great organizational skills, strong leadership qualities and an innate love for writing and for humanity.