San José, Costa Rica, since 1956

Workers at Largest Mental Hospital on Strike

A strike at the nation’s largest psychiatric hospital nearly has paralyzed services to its roughly 700 patients.

Roughly 100 employees are refusing to report for work, and are demanding 262 more employees to control and treat the severely mentally ill patients, leaving the hospital administration without a great bargaining position when the strike began May 16.

But as of Wednesday, negotiations still hadn’t yielded a resolution.

Saying patients are often armed with shanks and attacks are commonplace, workers are demanding the Social Security System (Caja), which manages the country’ socialized health care, needs to take action.

Juan Carlos Chinchilla of the cleaning staff said the facility has become increasingly dangerous during recent years and there has been no move to beef up staff.

“There’s a lack of security for us,” he said. “There are juveniles with criminal records, we’re four months overdue without pay and inmates are armed with spoons and pieces of glass.”

Nurse’s assistant Otto Guerrero said safety and pay are the primary issues for striking workers.

“Some employees have been forced to take out loans to pay the bills and the administration is not going to reimburse them,” he said. “(Some) inmates are a danger to employees – they fight and escape regularly, they’re always armed, and some don’t have the supervision they should.”

Nurse coordinator Anibal González said the hospital, beyond being underfunded, is poorly managed by Director Rosa María Villalobos.

Villalobos did not return Tico Times phone calls requesting comment.

“The profile (of patients) here changed to heavier drug use and more violence and the hospital was not prepared for this,” González said. “We have drug addicts here trafficking inside, unarmed guards and violence all the time. More than half the patients are chronic, but they can be rehabilitated but the management doesn’t treat them that way. We had a large budget surplus last year, but they didn’t spend it here.”

He also said security has deteriorated in recent years and pointed to a recent case that almost resulted in an employee’s death.

“About a month ago, in the men’s section, a patient attacked a nurse after he realized the nurse was alone,” González said. “He closed the door and began to strangle the nurse … It was only luck that another employee entered the room in time to save (the nurse).

González said the patient didn’t have any police supervision “because the judges are irresponsible.”

After many rounds of negotiations, the Caja has replaced some negotiators who union representatives said were inadequate.

“They’re offering practically nothing,” union representative Carlos Gómez said on May 16. “We’re going to maintain the strike indefinitely until the Caja responds. If we’re not going to relax, neither are they (administrators).”

González said there is a contingency plan in place to allow a skeleton staff to work to guarantee the inmates continue to eat and receive treatment.


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