PSI goes to the Inter-American Commission on Human Rights over working conditions for health professionals in Brazil

Health workers denounce the government before the Inter-American Commission on Human Rights and ask that the body adopt precautionary measures to guarantee the protection of health workers in Brazil in the face of covid-19. By Jamil Chade, UOL.

Public Services International (PSI) is coordinating the delivery of an official petition that exposes the lack of safety equipment, proper training and minimum working conditions - such as availability of water, soap and alcohol-based hand sanitizer - in addition to exhausting working hours in public and private health establishments.

The petition requests that the Inter-American Commission oblige the Brazilian state to acquire individual safety equipment, to carry out continuous testing for covid-19 and to provide technical training for health workers. The precautionary measures requested in this petition would help to guarantee dignified, healthy, and safe working conditions, hiring and replacing absent workers, and acquiring supplies for the proper care of all patients - including intubation medication and oxygen. The entities have also requested that the international body oblige Brazil to adopt campaigns in favor of health measures recommended by the World Health Organization (WHO) and that the Permanent National Negotiation Table of the public health system (SUS) be restored.

They also call for the "suspension of recommendations to use drugs proven ineffective to treat covid-19".

"The lack of policy coordination and measures to limit the pandemic by the Brazilian State have promoted the collapse of the health system and the illness, physical and mental suffering and avoidable deaths of these professionals, violating the right to life, health, integrity and dignified work, provided for in the American Convention on Human Rights," stated the entities in the document submitted to the IACHR which is part of the Organization of American States.

In addition to PSI, the following organizations signed the petition: the National Confederation of Health Workers (CNTS), the National Confederation of Social Security Workers (CNTSS), the Confederation of Federal Public Service Workers (CONDSEF), the Confederation of Brazilian Public Servants (CSPB), the National Federation of Nurses, FASUBRA - Federation of Unions of Brazilian University Workers, Staff union of Public Health, Science, Technology, Production and Innovation Workers at the Oswaldo Cruz Foundation, FEESSERS - Federation of Employees in Health Services Establishments of the State of Rio Grande do Sul, SEESP - São Paulo State Nurses Union, SINDENFRJ - Rio de Janeiro Nurses Union, SEEPE - Union of Nurses in the State of Pernambuco, SINPSI - Union of Psychologists in the State of São Paulo SINDSAÚDE/SP - Union of Public Health Workers in the State of São Paulo, SINDSEP/SP - Union of Workers in Public Administration and Municipalities in the city of São Paulo, SINTRASEB - Union of Workers in the Municipal Public Service of Blumenau, FETAM/SP - Federation of Workers in Administration and Municipal Public Service of the State of São Paulo, FETAMCE - Federation of Workers in the Municipal Public Service of the State of Ceará, FETAM/RN - Federation of Workers in Municipal Public Administration of Rio Grande do Norte, FETRAM/SC - Federation of Municipal Workers of Santa Catarina, FETAM/MG - Federation of Workers in Municipal Public Service of the State of Minas Gerais, FESSERGS - Federation of Trade Unions of Public Servants in the State of Rio Grande do Sul, FESSP-ESP - Federation of Trade Unions of Public Servants in the State of São Paulo, and the SEMESP - Union of São Paulo Physicians.

The petition states that “the federal government abdicated its role in coordinating health policies - including policies for the acquisition of supplies, vaccines, medicines and equipment, the establishment of guidelines and clinical protocols and immunization - thus creating diverse and unequal responses from subnational levels”.

"This lack of coordination has led to a shortage of supplies, oxygen, safety equipment, medicines and vaccines," they denounce.

The complaint also accuses the government of "repeatedly spreading contradictory, false information, contrary to scientific recommendations for tackling the covid-19 pandemic. "There were public campaigns against social distancing and the use of masks; messages that questioned vaccine safety; and the indiscriminate production, distribution and recommendation of drugs such as chloroquine, hydroxychloroquine and ivermectin (commonly known as the "covid kit") known to be ineffective for Covid-19, whose consumption has harmful effects for the population."

According to the unions, this is criminal. "The facts, when put together, perpetrated by agents of the Brazilian State in different governmental instances constitute, besides human rights violations, crimes comparable to systematic and intentional attacks against the Brazilian population, potentially even crimes under international law," they point out.

Specifically in relation to health workers, the document points out that “the lack of coordination between the federal and local governments and the adoption of measures to spread the pandemic by the Brazilian State have pushed health workers to the limit”. "In order to save lives, they have needed to adopt practices that have consequences similar to torture for them. The physical and mental damage to patients and health workers is already immeasurable," they say.

Precautionary measures

Faced with what they call "systematic and intentional actions and omissions, that spread the Covid-19 pandemic in the country", the workers are now formally requesting that the IACHR adopt precautionary measures. "Health workers, essential workers who act on the front line of confronting Covid-19, have had their human and fundamental rights violated," they warn.

According to the document, the Ministry of Health reports that a health professional died in Brazil every 19 hours. But doctors and nurses’ professional associations inform that the numbers are underreported and that, in fact, a health professional dies every 8 hours in the country due to the Covid-19 pandemic.

To support their request for an intervention of the IACHR, the unions shared the following results of a 2020 survey of 3,636 health workers:

  • 63% of health workers indicated that there was insufficient personal protective equipment (PPE);

  • 73.3% of health care workers reported working 12 hours or more without sufficient personal protective equipment (PPE) to replace or clean during the workday; Absence of appropriate safety equipment was reported in over 50% of cases for all areas (primary care, high complexity or other) and in all age groups.

  • 70% of health care workers reported not having received any training to deal with the Covid-19 pandemic;

  • 69.6% of health workers reported having received any training on protocols of care for people with Covid-19.

More recently, a survey by Fundação Oswaldo Cruz - Fiocruz and Fundação Getulio Vargas - FGV in March 2021 found that:

  • 55.6% of health professionals had not received (6.2%), or had received personal protective equipment (PPE) once or only a few times (49.4%);

  • 72.6% had not received any training to deal with the pandemic or on specific protocols for caring for people with Covid-19, including physicians and nurses;

  • 96.6% know fellow healthcare professionals who have been infected with Covid-19, with 31.2% of respondents reported having already had the disease;

  • 87.6% of healthcare professionals feel afraid of Covid-19;

  • 80.2% of health professionals indicate that they have their mental health affected because of working with Covid-19;

"The terrible working conditions to which Brazilian health workers are subjected - confirmed by internal and external research - verifies violations of basic principles of human rights and the guarantee of decent work, endangering both workers and those who receive health care. The intervention of international bodies such as the OAS' IACHR becomes even more important because Brazil is the epicentre of the pandemic and threatens the global capacity to limit the spread of covid-19", said Denise Motta Dau, subregional secretary for PSI in Brazil.

Eloísa Machado, a lawyer involved in the process, points out that "international accountability for human rights violations is a necessary step when violations are persistent and the national justice system is not effective.