AMERICAS: STATES ARE FAILING TO ADEQUATELY PROTECT RIGHTS OF HEALTH WORKERS ON THE FRONTLINES OF THE COVID-19 PANDEMIC

As government representatives meet at the World Health Organization’s annual assembly to make crucial decisions regarding the international response to the COVID-19 pandemic, Amnesty International released a report today on the dire state of the rights of health workers in the Americas. The report urges countries in the region to prioritize and protect health workers’ rights during and beyond the pandemic and calls on the United States to take swift and decisive action to guarantee continued funding to the WHO.

The cost of curing: Health workers’ rights in the Americas during COVID-19 and beyond documents how those on the frontlines of the pandemic are often working in unsafe conditions with insufficient protective equipment and risk reprisals from authorities or employers if they speak out, while some have even suffered death threats and physical attacks. The report also calls on governments to ensure safe working conditions for cleaners and other support staff who are at risk due to their work in healthcare facilities and nursing homes.

“In these difficult times we owe a great debt of gratitude to the hospital and nursing home cleaners, doctors, nurses, nursing assistants, hospital janitors and epidemiologists for their tireless work to keep us safe. But saying thank you is not enough. Governments must take action to ensure their basic rights and safety are never put at such horrendous risk again,” said Erika Guevara-Rosas, Americas director at Amnesty International.

“The Americas is home to about half the people in the world who have tested positive for COVID-19, with more than 2 million confirmed cases. As Latin America suffers its deadliest weeks yet, it is vital that all countries come together to ensure health financing is not undermined at this crucial time. This pandemic has no borders and the United States must support a global solution by joining other countries in funding the World Health Organization to ensure its technical and expert capacity is deployed where most needed.”

Out of 21 in-depth interviews conducted by Amnesty International with health workers in United States, Mexico, Honduras, Nicaragua, Guatemala, Dominican Republic, Colombia and Paraguay, only two told Amnesty International that they felt they had adequate or almost adequate Personal Protective Equipment (PPE). The rest raised concerns about the lack of adequate PPE. They also raised concerns regarding sick leave, rest breaks and inadequate mental health support at work.

WHO guidelines on rationing PPE outline that cleaners and housekeepers should have more PPE than many other hospital staff members, including doctors and nurses who may not have direct contact with COVID-19 patients. Yet Amnesty International found that cleaners were often poorly paid with precarious social security benefits and some worked for companies who did not ensure they have adequate PPE. One doctor from Honduras told Amnesty International he saw cleaners in his hospital using their bare hands to clean areas that had been exposed to patients with COVID-19.  

A 70-year-old cleaner who earned just over $5USD a day working for a private company at a state hospital in Mexico City told Amnesty International that, when he asked if he could stop cleaning areas that house dozens of COVID-19 patients, since he did not have any PPE and was at particular risk because of his age, his employer agreed but docked his pay by 16%.

Multiple health workers expressed their fear of reprisals for denouncing unsafe working conditions, and some of those that Amnesty International spoke with had been fired from their jobs for speaking up as whistle blowers or had faced disciplinary proceedings at work. Tainika Somerville, a certified nursing assistant at a nursing home owned by a private company in Chicago, was fired after she filmed a Facebook live stream denouncing lack of PPE at her workplace. Workers at nursing homes are at particular risk, with media in the United States and Canada reporting that they are epicentres of COVID-19-related deaths.

Workers in Nicaragua are at particular risk because the government has repeatedly understated the scale of the COVID-19 pandemic in the country. The Civilian Observatory on COVID-19 in Nicaragua  told Amnesty International that health workers have not only been fired for using PPE at work, but at times have had their protection equipment violently stripped from them. Although Nicaragua’s vice president announced on 28 April that PPE could be used and social distancing would begin, the government of Daniel Ortega continues to downplay the pandemic, despite an increase in cases. The Pan American Health Organization has warned of inadequate health measures in Nicaragua, while the Inter-American Commission on Human Rights has raised concerns regarding unfair dismissals of health workers who have spoken out in the country.

Restrictions of freedom of expression have also impacted the right to health and people’s access to health-related information. In Venezuela, where authorities have jailed journalists for publishing information about the pandemic, official data at the time of writing reports only 455 people infected with COVID-19 and only 10 deaths, which seems to have been under reported.

“It’s impossible to protect the health of over one billion people living in the Americas if governments insist on silencing the whistle-blowers, journalists and health workers who courageously raise their voices to denounce unsafe working conditions and rightly demand an adequate and accountable response to the pandemic,” said Erika Guevara-Rosas.

Health workers have also suffered stigmatization, physical attacks, death threats and denial of use of public transport in countries such as Colombia and Mexico, and even public stoning in Bolivia. While some governments have responded to such attacks with prompt statements and awareness-raising actions to publicly support the role of health workers, other leaders have taken actions to undermine them.

In mid-April, El Salvador’s president, Nayib Bukele, vetoed two decrees that would have strengthened the safety of health workers at work, just days after he accused human rights organizations of working “to make sure more people die.” The president’s statement disregarded the fact that the WHO specifically indicates that “violations or lack of attention to human rights can have serious health consequences.”