By Joyce McClure
Yap State Gov. Jesse Salalu declared a state of emergency on March 31 due to a mass resignation of 40 doctors and nurses at Yap State Hospital.
"Due to the sudden departure of staff, the Department of Health Services is now in need of finding and recruiting qualified nurses and doctors to fill vacancies, so as to minimize disruptions to its operations and services," states the emergency declaration.
"There is no sufficient pool of qualified nurses and doctors available on island for immediate recruitment to help prevent or minimize disruptions to the operation and services of the hospital," Salalu said in his emergency declaration.
The emergency status authorizes the Department of Health Services to work with Waab Community Health Center to allow the sharing and realignment of human resources to the main hospital.
DHS will also look into the possibility of rehiring local retired medical professionals on a temporary basis.
Led by Dr. James Yaingeluo, the doctors and nurses handed in their resignations on March 29 after Salalu declined to hear their grievances.
When Salalu failed to appear at a meeting requested by the medical staff, a representative from the Office of the Attorney General and a cabinet member refused to discuss the matter with them.
Among the grievances are persistently severe understaffing, low salaries resulting in the inability to attract and keep qualified professionals, working without contracts, and the Yap State Legislature’s refusal to release JEMCO-approved Office of Insular Affairs grant funds for wage increases.
Many of the unresolved issues that date back to 2019 have been exacerbated during the pandemic.
Yap is reported to have the lowest pay rates in FSM’s health care sector and has difficulty recruiting qualified doctors and nurses due to the higher compensation offered by other health care institutions in the region. This is especially true since the onset of the pandemic when health care professionals began receiving significantly higher offers from employers.
A year ago, then Gov. Henry Falan submitted a supplemental budget request to the Yap State Legislature. Included in the request was $108,614 for doctors’ salaries. The money had been approved by JEMCO, granted by OIA and sourced from the Compact Health Sector.
Dr. Mandela A. Bodunrin, the hospital’s then chief of staff who has since left, requested the grant to increase doctors’ salaries in order to fill open positions for doctors that were going unfilled.
DHS was unable to compete in the marketplace for the talent it required at the salary levels it was offering.
The legislature has the power to approve all OIA grants prior to their release, but the finance committee stated that further review was needed.
The doctors then on-staff signed temporary contracts at the pay level authorized in the prior budget year while they awaited the legislature’s approval of Falan’s supplemental budget request.
Their overtime and on-call remuneration tapped out the DHS’s FY2021 budget early due to the dearth of doctors.
The temporary contracts expired in February 2021. The money from the grant was “to ensure continuity of the compensation until Sept. 30, 2021,” Falan said. The money would not come from the state’s general fund.
Understaffing and the inablity to attract qualified professionals became an even larger concern as the pandemic rapidly grew in importance within the medical community and compensation ballooned worldwide.
During one of the meetings of the state’s emergency task force addressing Covid-19, it was revealed that a number of nurses stated that they would quit once the border was opened and the first case was identified, adding another layer of stress to an already overburdened organization.
Yap’s border has been closed since April 2020. Repatriation of the state’s citizens who are stranded off-island has been in fits and starts, challenging the small medical team to manage quarantine and testing protocols while tending to the daily needs of the hospital’s patients.
The most recent announcement for a repatriation flight arriving from Guam on April 6 has been postponed.
A team from the FSM Department of Health was on Yap the week of March 27 assessing the state’s readiness to reopen its borders. Their report is being awaited but the lack of medical personnel will now undoubtedly influence that decision.
According to the Yap State Constitution, employees “have the right to form associations for the purpose of presenting their views to the government” and to be “free from restraint or reprisal in exercising this right. The government shall give reasonable opportunity to representatives of such associations to present their views.”
However, it also states that “employees, whether or not exempted by the public service system, shall not strike or cause work stoppage for the purpose of collective bargaining or presenting their views.”
Further, “the regulations shall prescribe a system for hearing the views of employees on their working conditions, status, pay and related matters and for hearing and adjudicating grievances of any employee or group of employees. These regulations shall ensure that employees are free from coercion, discrimination, and reprisals and that they may have representatives of their choice.”
Dominic Taruwemai, the acting DHS director, has not accepted the doctors' and nurses' resignations as of this writing.