Long working hours a relic of colonialism, says doctorMonday, August 24, 2020
BY KIMBERLEY HIBBERT
A Jamaican doctor studying in the United States is calling for a review of the long hours that his colleagues here are made to work, describing it as a retention of the island's colonial past.
Dr Rani Sittol, who is currently doing postgraduate training in internal medicine in New Jersey, made the call against the backdrop of the recent sudden death earlier this month of 26-year-old medical intern Yakeev Morris en route to Kingston with a paediatric patient from Annotto Bay Hospital.
“Jamaican doctors work roughly 160 hours a week, but it is dependent on a lot. Whenever you're on duty — 36 hours at a time — you may have three or four duties a week. The other days you work eight hours, and roughly you leave when your work is done. So in reality you're paid for 36 hours, but you may work 38 or 39,” Dr Sittol told the Jamaica Observer.
“Who wants to work 160 hours a week? Who wants to not see their family? Who wants to fall asleep driving home? Who wants to spend how much years in school and come out to be a slave of a system that basically is an expression of colonialism or retention of colonialism in this post-modern society where we should be emancipated [and] independent? This is the relic of colonialism in society — the medical system,” he charged.
Dr Sittol argued that better wages and working hours for doctors should be on the lips of those demanding better from Government during the election season.
“This has nothing to do with JLP [Jamaica Labour Party] or PNP [People's National Party] because this problem pre-existed our political parties. This is something we retained from a British system,” he said.
“Even though the UK has advanced and has modernised, we have not. We have remained the relics of this colonial system, and people are resistant to change or we are held like this. We are paid poorly for the 40 hours per week so that we are forced to slave ourselves for the rest of the week yielding detrimental effects,” he continued.
Dr Sittol told the Observer that, unlike in Jamaica, the US frowns upon medical duties that surpass 80 hours per week. He said, too, that studies — though mostly done in nursing — all point to patient safety issues.
But he explained that the drawback is without doing the extra hours Jamaican doctors will not earn a liveable income.
“You get a base pay that pays you for 40 hours per week, Monday to Friday, 8:00 am to 4:00 pm — that's your base pay. That base pay, I've always said, is not a liveable income. For it to become liveable, that is, to pay all the debt you have from medical school, [and] to also pay for living expenses, one has to do duty hours, which is overtime, in order to boost your supplementary income,” Dr Sittol explained.
He also indicated that were doctors not to do the overtime hours it would pose a risk to patient care.
“If nobody chooses to do the overtime that simply means nobody will take care of the patients after 4:00 pm until 8:00 am on weekdays, and nobody will take care of the patients on weekends. Now, because it is an essential service, of course, it goes without saying that somebody must be there to take care of the patients [during] these out-of-hours times. And so, when doctors do those hours they are paid extra for that,” Dr Sittol said.
He admitted that alternatives have been put forward in the past to lessen the duty hours.
“What has been proposed in the past by various organisations is to increase base pay and set it at whatever hours you want to set it at; that way it is safer for people to work in limited hours and you will have all the shifts covered. If it is that persons are paid a little amount of money, then, of course, they are going to want to make up with their duty hours, and, of course, they are going to want to compete for duty hours because people have bills to pay, so doctors are going to say they want to work extra hours. But it's not because they want to work; it's because they have to work so they can earn,” he reasoned.
Overall, Dr Sittol said complaints about working hours for medical personnel are not new, but maintained that the issue should not this time around be a nine-day wonder.
“Usually there is an outcry for a short moment and nobody will do anything. That has been the case for us for a very long time. For a very long time there is an outcry over a short period over sexual harassment by seniors. For a short time there is an outcry over an under-resourced setting. For a short time there is a social media hype about people being overworked, and then nothing happens. Several doctors and medical students have been in car accidents due to fatigue, because they have fallen asleep because they are too exhausted... but nothing is done because we live in an immature system that doesn't react to the problems we face,” Dr Sittol charged.