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“Coronavirus” Bonuses to Health Workers in Kazakhstan: Will Be or Won’t Be

Kazakhstan suspended additional payments to health workers who are involved in the struggle against coronavirus despite the fact that the situation in the country got worse significantly.

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Bonuses were paid from March to May 2020, but now when the country registers nearly 1,600-1,900 cases daily payments were suspended.

Since March 1, according to the decree of President Kassym Zhomart-Tokayev, health workers of Kazakhstan were receiving bonuses for actual hours worked. Amounts depended on the level of risk of contamination.

Bonuses for 850 thousand tenge (2,064 dollars) were intended for health workers who have “very high” health risk. These are doctors, paramedical workers and medical attendants of infectious hospitals, including intensive care units.

A “high” health risk group contains doctors, paramedical workers and medical attendants of observatory clinics and ambulances. Their bonus is 425 thousand tenge (1,032 dollars).

The third group – “average” risk – is doctors, paramedical workers and medical attendants of quarantine hospitals, public health doctors (civil servants), drivers of ambulance cars, etc. Their bonus is 212.5 thousand tenge (516 dollars).

Nearly 36 billion tenge (87.44 million dollars) were allocated for bonuses from the public treasury. This president’s decision caused keen interest in public health workers. They thought they would earn decent money for the three months when presidential measures were valid. In fact, things were more complicated.

Courtesy of medical workers of Almaty regional hospital. 

According to a worker of the ambulance service, Bakdaulet Tanatarov, the rates of bonuses were not flat but depended on the number of hours spent with Covid-19 patients or exposed persons. For example, ambulance attendants could count on just a bit over 10 thousand tenge (24 dollars) per day, while drivers – on nearly 7 thousand tenge (17 dollars) per month.

“An ambulance crew could stay near a patient for thirty minutes maximum – the time needed to respond to a call and transport the patient to the infectious hospital. When they counted actual hours worked, we had to receive from 3 to 5 thousand tenge (7-12 dollars) per month. We have 14 ambulance crews. Only three crews could visit a Covid-19 patient during a month,” Tanatarov said.

Then the heads of medical facilities of the country suggested their own option of computation – payment for actual hours worked should be increased 10 times. As a result, an emergency doctor received about 100 thousand tenge (243 dollars), paramedical personnel received 60 thousand tenge per month (146 dollars), and ambulance car drivers received 30 thousand tenge (73 dollars).

Courtesy of Sandugash Zhanamanova

However, not all were satisfied with this scheme of payments, especially health workers who treated coronavirus patients directly. Nurse Sandugash Zhanamanova is one of them.

After completion of the medical college, she worked nearly 10 years in the public health system. According to her, she saw the wrong side of her work, but the coronavirus pandemic was the last drop and the woman wrote a notice of resignation:

At first, the hospital did not have enough protective equipment, we had to buy everything ourselves and it continued for a long time. The shortage of paramedics led to the fact that we had to work overtime, and later on we had problems with such payments.

My work is a high risk group. I worked for 15 days and 14 days more I was in quarantine. It means that they had to pay me extra money in the amount of 850 thousand tenge (2,065 dollars). But I received less than a half of that amount and my colleagues received the same. My health and the health of my relatives is more important. Therefore, I’d better resign. Why should I risk my life?

Health workers of infectious units and hospitals seemed to be in better position, but they did not receive 850 thousand, as well. Instead, they were paid 425 thousand tenge (1,032 dollars) after the computation of the number of hours spent with coronavirus patients.

Botagoz Zhakselekova. Photo: Republic of Kazakhstan Ministry of Health

However, according to representatives of the health ministry, this is a fair approach.

“This is an objective approach when an infectious disease physician who worked full month receives full amount, and his colleague, who joined them later and worked only 3-5 days this month, will receive a bonus proportionally to the period worked. Otherwise, it would cause indignation of health workers who worked full month and received the same bonus as their colleagues who worked for one or two days,” Botagoz Zhakselekova, a responsible secretary of the Kazakhstan health ministry, said at the briefing on April 11.

According to the public health ministry, over 132 thousand persons out of 400 hundred workers of health organisations received bonuses to their wage from March to May this year. The majority of workers were involved in anti-epidemic measures in three largest cities: Nur-Sultan, Almaty and Shymkent, – and the majority of bonuses were paid there, respectively.

Back then, the epidemiological situation in Kazakhstan was quiet. There were few coronavirus positive cases.

However, by mid-June, the situation in Kazakhstan began to deteriorate, and by early July the number of confirmed cases was more than 42 thousand people, including 188 deceased people. Hospitals in all regions are overcrowded; doctors feel tremendous load. They have to live at quarantine hospitals, which adds psychological trauma to the body.

It is this difficult and crucial moment when health workers need assistance from the state as bonuses to salaries. However, extra payments were suspended. As the health ministry promised, decision on continuation of financial support to health workers would be made based on epidemiological situation.

The head doctor of one of infectious hospitals said to CABAR.asia on the condition of anonymity what happens now in medical facilities of the country:

It’s very difficult for us, not all can withstand this load. Moreover, our work is dangerous. Some people resigned, we have a shortage of doctors. I do not know how to motivate them in this period.

We submitted the lists of health workers involved in treatment of Covid-19 patients to the Compulsory Medical Insurance Fund. They deal with payments. However, they failed to answer. They say they wait for the governmental decision. It is still unknown whether it would be or not.

Meanwhile, the tiredness and despair of health workers have led to public resentment of health workers who demand to appreciate their work properly. Doctors of the Almaty regional hospital invited media representatives to the medical facility to inform their problems to the health ministry and president of the country.

According to them, the hospital is in a critical situation: it lacks trained hands, no one hears doctors, and the increased load is not taken into account. Every doctor who administers treatment is replaced by a colleague. Today, one doctor in this hospital has 70 patients, while there should be 20 according to the protocol.

Courtesy of medical workers of Almaty regional hospital. 

Nurgazy Turdaliev, a critical care physician of the Almaty regional hospital:

We have five critical care physicians: one could hardly survive, the second one is in very grave condition, he has just came out, he stays at home with shortness of breath. So, there are three of us left, we work hard. I have been working for 15 days already, today I work during the day, tomorrow – at night. I receive the same salary as before. Is it fair? Of course, it is not.

Aiman Mukanova, doctor of observatory unit of the Almaty regional hospital:

We do not differentiate between patients, we do not say there are few of us, you are too many, we won’t examine you. Because there’s a procedure, so we examine everyone. However, we want to get paid. Or should we examine only 20 patients and say to the rest: sorry, there are no doctors available! Is it what we are supposed to say?

The current situation shows that it will take a long time to fight the virus. However, it remains unclear whether health workers across the country will get increased wages in the following months.

However, during the briefing of the government on May 11, deputy prime minister of Kazakhstan Yeraly Tugzhanov promised that bonuses to doctors and health workers involved in the fight against the coronavirus disease will be paid until August 2020. However, it is already the second half of July, and no payments for June were made.     

This article was prepared as part of the Giving Voice, Driving Change – from the Borderland to the Steppes Project.

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