VZCZCXYZ0009
PP RUEHWEB

DE RUEHMU #0250 0331701
ZNR UUUUU ZZH
P 021701Z FEB 06
FM AMEMBASSY MANAGUA
TO RUEHC/SECSTATE WASHDC PRIORITY 5111
INFO RUEHZA/WHA CENTRAL AMERICAN COLLECTIVE
RUEHC/DEPT OF LABOR WASHINGTON DC
RHEHNSC/NSC WASHINGTON DC

UNCLAS MANAGUA 000250 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPARTMENT FOR WHA/CEN 
 
E.O. 12958: N/A 
TAGS: PGOV SOCI ELAB EFIN NU
SUBJECT: AS MEDICAL STRIKE WIDENS, MINISTER OF HEALTH 
EXPLAINS ITS ORIGINS 
 
REF: MANAGUA 193 
 
¶1. (SBU) SUMMARY:  The doctor's strike that has paralyzed 
many public sector hospitals for over two weeks has widened 
to include the powerful Sandinista union Fetsalud, which 
represents the vast majority of public sector health care 
workers.  Minister of Health Margarita Gurdian insists that 
she cannot meet the 30 to 50 percent salary increases the 
unions are demanding, and states that even a 20 percent 
increase would be hard to "sell" to the International 
Monetary Fund (IMF).   Nicaragua's labor laws and culture, 
along with the machinations of the FSLN, combine to produce 
waves of public sector strikes at regular intervals.  As 
always, FSLN party boss Daniel Ortega will seek to use the 
medical strike, and threats of work stoppages and street 
protests in other sectors, in an attempt to wring political 
concessions from the GON.  END SUMMARY. 
 
¶2. (U) The doctors strike described in reftel has widened to 
include additional medical workers from the powerful 
(Sandinista) Fetsalud union.  While the strike was previously 
limited to a fluctuating number of the country's 4000 public 
sector doctors, Fetsalud has over 20,000 public sector 
medical workers in its ranks, giving it the power to 
completely shut down public hospitals if it wishes to do so. 
While the doctors, who have been striking since November, 
recently stated that they would accept a 30 percent salary 
increase for 2006, Fetsalud, led by FSLN National Assembly 
deputy Gustavo Porras, began a series of street protests on 
January 30 to demand a 48 percent increase in the salaries of 
all public sector medical workers.  Porras has threatened to 
shut down all but emergency services if the Ministry of 
Health (Minsa) does not meet his demands. 
 
¶3. (SBU) On January 31, poloff met Minister of Health 
Margarita Gurdian to discuss the ongoing doctors strike and 
the incipient Fetsalud work stoppage.  Gurdian stated that 
the root of the problem is the fact that, under Nicaraguan 
labor law, Minsa must negotiate a new collective bargaining 
agreement with the medical unions every two years.  Because 
of Nicaragua's conflict-prone labor climate and the desire of 
the FSLN to foment and exploit such conflict, Minsa must 
confront waves of strikes at least once every two years, as 
health workers pressure the government to offer higher 
salaries and more generous benefits and the Sandinistas seek 
to score political points. 
 
¶4. (SBU) Gurdian stated that she had steadfastly refused to 
offer doctors the huge salary increases they had originally 
demanded because she felt that any percentage increase should 
be applied across the board to all medical workers.  She 
added that any favoritism towards the doctors would have 
provoked an immediate walkout by Fetsalud.  The minister 
stated that her ministry cannot pay the 48 percent that 
Fetsalud is demanding, nor the 30 percent the doctors want. 
Gurdian felt that a 20 percent increase, which would require 
an additional 100 million cordobas from the Treasury 
Ministry, is more realistic.  Anything more would break 
Nicaragua's commitments to the IMF and even the additional 
100 million cordobas would still have to be "sold" to the 
fund by Gurdian and Treasury Minister Mario Arana. 
 
¶5. (SBU) Unless the GON is able to solve the growing medical 
strike by finding money in the budget to meet the unions, 
demands or via political negotiations with the FSLN (see 
below), Gurdian said that she saw little way out of the 
impasse.  She hoped that a planned "discussion forum" 
organized by the resident representatives of the U.N. 
agencies for February 3 will help.  The U.N. agencies have 
called on all the stakeholders (government, unions, NGOs, 
etc.) to participate and to develop a long-term national 
health care salary policy.  Such a policy could theoretically 
help Nicaragua break its regular two-year cycle of medical 
salary renegotiation and strikes.  Aside from making all 
involved lose credibility and endangering people,s lives, 
Gurdian stated that the strikes are also incredibly costly 
for Minsa. 
 
¶6. (U) On January 30, the political dimension of the strike 
(and additional future strikes that have been threatened by 
Sandinista unions in other sectors) was highlighted when 
Cardinal Miguel Obando y Bravo publicly "suggested" to 
President Bolanos that he should negotiate a solution with 
the person who "has influence in such moments"--Sandinista 
caudillo Daniel Ortega. 
TRIVELLI