Zimbabwe's labour court has declared a doctors' strike illegal and ordered that they return to work, the Herald newspaper reported on Thursday.
The public service doctors went on strike in October, demanding that their salaries be increased to keep pace with the country's high inflation rate. Hospitals have since been functioning with a skeleton staff of nurses, foreign doctors and redeployed military medical staff.
Inflation is currently running at about 450 percent in Zimbabwe, and shrinking salaries are leaving people increasingly unable to meet their basic monthly expenses like food and rent.
The doctors say their salaries must be reviewed and adjusted to reflect these extreme hikes.
Nurses joined the strike too, but agreed to return to work when the government said their grievances would be "looked into".
On Wednesday the Health Ministry and the Public Service Commission took the matter to the Labour Court, which ruled that the doctors had breached provisions of the Labour Relations Act and had not followed the proper procedures.
The doctors had previously said they would only return to work if the government gave them a written undertaking that attention would be paid to their grievances.
The strike has once again spotlighted the shortcomings in Zimbabwe's health service, undermined by underfunding, low morale and staff attrition.
"As the need for health services are escalating, the impact of high staff attrition rates continues to severely impact on the delivery of services. As of May 2002, 24 percent of all medical posts in the provinces were vacant. Between January 2001 and May 2002, 12 percent of doctors, 13 percent of clinical officers, 18 percent of pharmacists and 8 percent of nurses left the Ministry of Health and Child Welfare," the latest UN Zimbabwe Humanitarian Situation Report said.
"The immediate priority must be to retain qualified health workers and resolve this crisis as quickly as possible to
ensure that health delivery is not further disrupted. The longer-term challenge remains to ensure there is enough
skilled health staff within the country to safeguard against the further erosion of basic health services," it added.
"The impact of low morale amongst health workers, is coupled with a dramatic decline in health spending from US $23.60 per capita in 1991 to US $14 in 2001, a shortage of foreign exchange to provide drugs and the ongoing brain drain of doctors and nurses leaving for better paid positions outside the country. The impact of these effects is most likely to be skewed wherein the most vulnerable will be the affected the most," the report warned.