“We have been silent for so many years”: Interview with a Hong Kong nurse on strike

KW Wu interviews a nurse who participated in last week’s health care workers strike. Introduction by Violet Bell.

Before last week, Hong Kong’s medical workers had never gone on strike, and they’ve never had a union that did more than give them shopping discounts and social events. The Hospital Authority Employees Alliance (HAEA), which only formed in December, now represents more than 20,000 employees in the territory’s public hospitals—fully a quarter of the staff. Last week, more than 7,000 new union members—from nurses to doctors to support and administrative staff—went on a historic five-day strike with five demands, including closing the border and ensuring a safe and fully-supplied working environment for staff.

The strike was precipitated by the outbreak of the coronavirus in neighboring China, and widespread criticism of the Hong Kong government’s response. While the confirmed infections (more than 44,000) and deaths (over 1,100) in the mainland have surpassed the 2002–2003 SARS epidemic, in Hong Kong only one person has died from the over 40 infected. But medical workers are concerned that the territory’s already overburdened public health sector will break under the strain of the outbreak.

Participation in the strike doubled overnight from the first to the second day, and barely tapered off from 7,000 for the duration. Strikers were joined by representatives from other newly formed unions and sympathetic politicians on the picket line, in their petition delivery to the Central Government Offices, and in their occupation of Hospital Authority Headquarters Office. After five days off the job, the HAEA narrowly voted to end the strike—but unions in industries from aviation to public transportation have since voted to strike in the coming days. 

In another article, we posed a number of questions about the trajectory of these new labor struggles. It’s one thing to read public statements from the HAEA organizing committee, and another thing to ask rank-and-file members about their first strike. Alice (whose name has been changed) has worked as a nurse at a large public hospital for six years. She answered these questions on the second day of the strike. We hope they shed some light on how a brand new union organized one of the biggest labor actions in recent Hong Kong history. Interview translated by Lala.

When did you start organizing a union?

In October, some people who were interested in organizing a union started to discuss the process. We formed the union in December. But it was not until this recent event that we became a bigger union.

How has the coronavirus affected the union? Can you compare the membership size from December to now?

The coronavirus boosted the number of union members. There weren’t that many members in December, but a lot of people joined the union after the outbreak. From December to January, the number of members increased tenfold. And even more people expressed their desire to help out and join the union after the announcement of the strike. A lot of us are dissatisfied with the government’s performance in handling the outbreak, so that’s why more people are joining us.  

What are the difficulties of going on strike? What do you think is the major obstacle in organizing a strike?

I personally am most worried about my patients. I am afraid that if we all go on strike in my ward, there will be no one to take care of the patients. Therefore, my colleagues and I discussed the strike beforehand just to make sure that the ward is still functioning, even at a minimal level. The union cannot guarantee that there’s always enough staff in all the wards, so it is more of our personal responsibility to coordinate with our colleagues and managers, to make sure that there is someone to take care of the patients. But then this makes me worry about burdening my colleagues by increasing their workload. Nonetheless, it always helps to discuss and coordinate with your colleagues beforehand—that’s the part where the union cannot help out.  

So that means you would inform your colleagues before the strike, right?

We would coordinate who would be working while some of us are on a strike.

Do your colleagues who aren’t on strike complain about it?

No, they don’t, because they understand. Even those who aren’t striking support us. They know that they are working for the patients, not for the government. And they are working just to keep up minimum operations. Usually that only takes one to two people per ward. I think the solidarity comes from the way we work, usually in a team, so we feel obligated to help out when our colleagues are in need. 

That’s very different from how people imagine the situation. A lot of people think those who do not go on strike are supporting the government.

Our industry has never been on strike before. This is our first time, and a lot of us are feeling the pressure because of the strike. Remember when the Level 10 typhoon hit Hong Kong and shut down public transportation? A lot of us chose to go back to work on foot, some even arrived early. Our industry has earned a reputation for being responsible and hard-working, so it is tough for us to persuade ourselves not to work. We shoulder stress from our managers and expectations from our patients. We are also burdened by our own worries about our patients. We are going on strike for the first time because we think this is the only way to make the government confront the problems we’re facing. What we are asking for is simple—close the border. It doesn’t look like something the government cannot achieve.

What kind of stress has your manager given you since the strike? 

I’m lucky because my boss didn’t say a lot about the strike, and my colleagues are on my side. So I’m a little less stressed. But I have heard of different situations from other union members. Some were threatened by their boss with firing if they went on strike, some were threatened with filing complaints and disciplinary reports, some were threatened with losing their professional license. Of course we know they cannot actually do that, but this still puts a lot of pressure on us. The union will continue to follow up these cases.  

Are there a lot of union members in your ward?

The number has been increasing since the coronavirus outbreak. Now half of them have joined the union. But some of them are still weighing whether or not to join the strike. 

Can you tell us a little bit more about your working conditions, especially before and after the outbreak of the coronavirus?

First of all, the protective facilities of the isolation wards are not working properly—like the negative pressure system. Therefore, when some colleagues were asked to work in those wards during this outbreak, they decided to collectively ask for sick leave. Second, a lot of working arrangements in the isolation wards are terrible. For example, we are asked to write our reports in a room that is far away from the patient. Since direct observation of the patients is not possible, we can only do it through a webcam. But you can’t even see if the patient is resting or dead through a webcam! Third, medical workers do not have enough medical protections. On TV, you see the police dressed like astronauts when handling patients with coronavirus. But we don’t have those protections. I always wonder—aren’t we the people who are at the front line fighting this disease? Why would they get the protection but not us? This is the same for masks. We only have Level 1 masks, while people on the street are already wearing Level 3 masks. Our boss told us that our masks are safe and good—but they are still just “safe and good” Level 1 masks, they cannot replace Level 3 masks. Their rhetoric just cannot convince me. 

These things put both the lives of the medical workers and patients at risk. We can’t work in such terrible conditions, but the boss thinks it’s okay. We realized that if we don’t fight back, we will have to accept the way things are. 

Is the supply of masks sufficient now?

I know some places lack masks now. But for us, the difference is that the way we get them has changed from requests to centralized distribution. I’m scared that they will distribute less one day. I am worried.  

So how is organizing the union going? What kind of work are you doing?

There is a lot to do now. We’re writing article after article to publicize the campaign and provide updates. We also have to respond to journalists and prepare press conferences. The workload is heavy. We have meetings until midnight every day. 

Have you found anyone to help out? It seems like more and more people are joining, making it a pretty big union. Is there any possibility that you can convert some potential members into organizers?

We already are. For example, we’ve enlisted newer members to help out at the street stations to promote the union. We are shifting more work to the membership, hoping to spread the workload of the organizers. Our union was just established and there is still a lot of basic administration to be done—the bank account was not even ready before the outbreak of the virus. The outbreak is an unexpected event, and no one wanted to see this happen. I am very thankful that a lot of people understand that.

As a union, are there any further demands that are not related to the coronavirus outbreak? What else do you guys want to fight for afterwards?

The aim of establishing the union was never to cope with a one-off catastrophe. There are a lot of problems in the Hospital Authority. If you go on Facebook and check out the “HA Secret” page, you’ll see a lot of my colleagues are not satisfied with the way things are going. There are too few beds, too many patients, and not enough staff. The ratio is not right.

We were trying to work on these issues before the outbreak of the coronavirus. A lot of problems stem from wages and political repression. We were already doing street stations to promote the union, and the boss would complain about the street stations—for us that already amounts to some form of censorship and oppression. 

There is also a problem with the patient to staff ratio. There are simply not enough beds. No matter how hard we work or how many overtime shifts we take through the Special Honorarium Scheme, there is always patient overflow. In the internal medicine department, there are so few beds in the ward that patients have to sleep on beds in the corridor. Those were only meant to be a temporary policy to solve the problem, but they’re still there. They never left. The so-called temporary beds are permanent beds now. You see beds along the corridor, under the sink, near the fire exit. I am so afraid that all of us would die if there were a fire. How can we pass the fire regulations? The depressing and ridiculous thing is that we don’t think the HA [Hospital Authority] has the will to change this situation. The temporary beds along the corridor have become a spectacle now.

Overcrowding also harms the patients. For example, when a patient who is supposed to receive care from the internal medicine ward has to sleep in a different ward, the distance between the two places makes first aid impossible. It takes 10 minutes to get there, so if something urgent were to happen to this patient, we could hardly reach them in time. Of course, the nurses and doctors of the new division can help, but a patient from a different division might require care that isn’t within their expertise. These medical workers would also obviously prefer to first take care of their own patients, in their own wards, because there is already too great a workload.

In some cases, patients from the internal medicine division would be placed in the cancer ward. Cancer patients have weak immune systems, so mixing patients from the internal medicine ward with cancer patients is putting the latter at risk. We have seen these situations year after year.

Before the formation of the union, what were the ways you could speak up?

Usually we would tell management. But they would always just ask us to “honorably endure” it. They keep repeating “honorable endurance” all the time, but who can honorably endure it if someone dies because of the mismanagement? The patient is dead already, how can they honorably endure it with you?

We have endured it for so many years, and so have our patients. We all have honorably endured it. Is there any improvement so far? No.

The government is now promoting the Voluntary Health Insurance Scheme, which encourages people to go to private hospitals instead of public ones—hoping that health insurance can cover the cost. What’s your take on that?

People are buying insurance because they know they might not make it into the public hospitals before they die. People who have a little bit more money would therefore buy an insurance policy, because they know they would otherwise have to queue up for years to use the services from the public medical system.

It seems like you guys have gone through a lot, and the establishment of a union is a huge leap forward. I’m hoping to see the union succeed in the future. The call for a strike is very delightful to me, I guess you guys are also empowered throughout the process?

It has been a tough road, but this step was very important. We never expected a coronavirus outbreak. But it has inspired a lot of our coworkers to come forward to do something. The culture of our industry is “endurance”—some might call it responsibility, others call it a burden. All in all, I doubt that so many of our colleagues would have stood up were it not for the coronavirus outbreak. Our colleagues really want to close the border. We have never been on strike to improve our working conditions or pay. We have been silent for so many years. We have never tried such a method before, so we’re hoping this can force the government to respond to our demand. 

Do you see this as the beginning of something else—perhaps a fight for the rights of patients and workers in the end? It is good to see people coming together in a collective action like this.

I hope so. I hope that the strike can create a ripple effect, and inspire more action. At least the union is providing a choice to our coworkers, so they know there are many ways to address our problems. Silently swallowing them alone is not the only option we have. But at the same time, I know a lot of my colleagues will still continue to “endure” everything. But at least we are offering them a choice, and they should know they have an option: we don’t always have to endure wrongs.