Emerging from the COVID-19 pandemic, nurses and midwives in Fiji were demoralised, exhausted and leaving their profession in droves. Trade union rights had been repressed, social dialogue was non-existent, and the workforce had not seen a pay increase since 2018. In 2023 members of the Fiji Nursing Association (FNA) declared that enough was enough. They voted to band together, organise, and demand the respect and recognition they deserve. One year later, after 12 months of organising and growing their membership, nurses and midwives celebrated a significant victory. At the 2024 Annual General Meeting of FNA, Fiji’s Minister of Health, Dr Antonio Lalabalavu, annopunced that their demand for pay increase had been met for nurses across the board. The pay increases reached up to 41.3% for nurses in the lower-paid Band G.  

We are thankful to the new government for bringing back freedom and our rights as a union, so that the voices of the workers can be heard. We were the first union to make the move and we were tangled in the old laws and the new ones. We started the process with the old laws and while in the process the laws changed, but it is only about being patient, and getting evidence for breaking the ground to get through.”   

Filomena Talawadua, General Secretary, FNA

The Problem 

The COVID-19 pandemic saw countries across the world struggling to sustain deeply flawed national health systems. We are yet to have an accurate number on the lives lost, and we probably never will be able to measure the extreme levels of trauma and harassment that health and care workers underwent during the pandemic years. Post Covid, many countries witnessed an exodus of nurses, leaving the profession entirely, or migrating to other countries for better working conditions.  

In 2022 it was reported that 26.7% of Fijian nurses quit their jobs in 20221. The situation worsened in 2023 as the trend continued and exacerbated. The FNA’s membership reduced to an all-time low of 800 nurses last year. 

The decrease in nurses meant a worsening health care system with the remaining nurses taking the hit. The new government in Fiji faced the challenge of decreasing health and care resources. To address the situation, it entered into negotiations with workers and the union. In August last year, the government announced a pay raise for nurses and interns. The raise was 8% for the nurses and 15% for the interns. As the last pay rise for nurses in Fiji happened in 2018, this was long deserved and due, but not adequate.  

The FNA believed that, although the government attempted to address the issue by announcing the pay rise, it was inadequate and did not properly compensate the workforce for their hard work and dedication.  

Organise! Organise! Organise! 

"The 8% increase was not fair. For example, a nurse who has two years’ experience will be in the same salary bracket as a nurse who has been working for five years."

Dan Lowlex, Chairperson, FNA 

It was at this point that FNA decided that to claim their rightful pay they needed to demonstrate their collective power and take industrial action. While this was the logical step, low membership meant that the union’s power was low. FNA knew that what they needed was to build back their union strength and to have a majority of nurses take action.     

The bargaining committee took it upon themselves to make plans to engage all nurses and midwives across the island nation. The committee consisted of rank-and-file members who met in hospitals after work and over weekends. 

Voting was held to determine whether a large number of nurses believed that action should be taken to demand pay raise and other conditions. FNA realised that to be able to strike and escalate their campaign, they had to ensure that over 50% of the workforce would vote in affirmative for the action in a ballot that was run by the electoral commission.   

They faced many barriers. Fiji is composed of many small, remote islands, and is highly impacted by global warming.  Nurses are on the frontline of the increasingly deadly cyclones as well as slow onset events which impact communities' health and increase precarity. It was crucial for FNA to reach all these nurses and have conversations about the need for their critical work and for it to be recognised and respected in face of the increasing risks.  

At this point, the union quickly rallied itself into action. Through strategic planning, tight communication and structured organising, it mobilised nurses and increased membership. 

The union leadership developed and implemented a detailed awareness generation plan that included travelling to different islands to share with workers the need of the hour and the process of voting. Using a list of all members across 11 polling stations, they ensured that the union was able to reach out to all the listed members. They triangulated the data to ensure that in each polling station the member list correlated with that of the Ministry of Labour and Ministry of Health.  

The union used the ballot process as an opportunity to recruit more members and build their power. Members could see the union was active and committed to positive change. FNA successfully administered the secret ballot for industrial action. More than 70% of the total workforce voted in favour of industrial action. 

Acknowledging the importance of raising awareness of their situation, the union also made efforts to get their message out to the broader community. Through linking the workforce crisis with the negative health care outcomes for patients, FNA was able to garner community and patient support for their campaign and demonstrated popular support for fair pay for nurses.   

Victory: The power of the ballot 

When the government was informed of the results of the secret ballot, things took a quick turn. Almost immediately, the Ministry of Health called the union for mediation. A mediation document with seven demands was signed by the government and the union. Out of the seven, pay rise is the first demand that has been put into action.  

The increase will impact nurses across the board. It also highlights the difference in experience with multiple levels of increases: 16.67%, 28.21%, 33.3% and the highest being 41.3% for nurses in Band G. It is a truly stunning win for the union. It has been achieved with hours and hours of hard work, countless rank and file members standing up and engaging their colleagues, and strategic planning and coordination. The General Secretary of the FNA, Filomena Talawadua, shared that at the end of the day, “it was all about patience, dialogue, and providing evidence on the ground.”  

As nurses celebrated this win, they acknowledged the victory of the power of the collective. From less than 800 nurses when the campaign started, FNA increased their membership to more than 1500 nurses (of a total of 1744 public sector nurses in Fiji) through the meticulous organising efforts.  

Public Services International (PSI) supported the struggle in various ways. PSI’s training and its approach towards organising came handy for FNA. Members of FNA had participated in PSI’s programmes on organising.  They were also supported by the PSI Oceania network. In addition to face-to-face meetings, regular online meetings provided an opportunity to share updates, trouble shoot challenges and celebrate success. Public sector unions in Australia, New Zealand and across the Pacific Islands stood with FNA at every step of their campaign. 

I was a young member of FNA. Due to my potential, the FNA nominated me to attend PSI conferences and workshops abroad. It helped me to work with the union and organise and campaign for the secret ballot voting. Apart from learning effective organising, these trainings helped me in becoming a strong union member fighting for its members.”

Dan Lowlex, Chairperson, FNA 

With a final majority of over 70% in the secret ballot, the union was able to show its strength and force the government to pay heed. Such was the impact of their action that “the government is yet to officially declare the results of the vote”, Lowlex remarked.  

The Fight Continues... 

This achievement marks a major milestone, and the campaign now continues through bargaining on other working conditions. The nurses are now pushing for improvements in their working environment, including responding to increased workplace risks they encounter due to the escalating climate crisis.  

To make matters worse, instead of directing resources to invest in the workforce and quality public health system, the pandemic was used to push through controversial hospital privatisation, supported by the Australian government’s aid programme. Considering the continual trend of migration to higher-income countries, the FNA is also committed to ensuring that countries benefiting from this migration, such as Australia, provide their fair share of support for Fiji's public health system. 

This win for nurses in Fiji is a win for health care services. When governments recognise and secure the interests of health and care workers, they commit to the building of a robust public health care service. The health and care workforce are the backbone of a nation’s health system. By valuing workers, the Fiji government has demonstrated their commitment to the people of Fiji and their health. And FNA has led the way towards securing quality public health services for all.